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Part 4 Boards X-ray > AP Pelvis > Flashcards

AP Pelvis Flashcards

1
Q

Check the lower 1/3 of the SI joints

A

DJD
OCI
AS

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2
Q

Check the inner portion of the pelvis for

A

Paget’s
Fractures
Protrusio Acetabuli

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3
Q

Check the outer portion of the pelvic inlet

A

Brim sign - early stage paget’s

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4
Q

Draw a line from outer portion of ilium to outer portion of ischium some portion of the femoral head is not inside this line
Kohler’s line

A

Congenital hip dysplasia

Hip dislocation

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5
Q

Congenital hip dysplasia

A

Putti’s triad - hypoplastic femoral head (smaller than usual)
Shallow acetabular shelf
Femoral head outside of acetabulum

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6
Q

Ortho exams congenital hip dysplasia

A

Telescoping
Ortolani’s
Barlows
Allis

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7
Q

DDX with hip dislocaiton by

A

Putti’s triad

Signs of trauma on film or in case hx

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8
Q

Refer congenital hip dysplasia

A

Pediatric orthopedist

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9
Q

Protrusio acetabuli

A

Axial migration of femoral head with uniform loss of joint space
Bilaterally most often occurs with RA
Seen with things that soften or weaken bone
Obliteration of kohler’s teardrop
Both heads of femur completely inside line - otto’s pelvis

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10
Q

Line of mensuration congenital hip dysplasia

A

Kohler’s

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11
Q

M/c/c protrusio acetabuli

A

RA (otto’s pelvis)

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12
Q

Causes of protrusio acetabuli

A 
Pagets
Fibrous dysplasia
DJD
Trauma
Osteomalacia
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13
Q

Compare side-to-side ilium ischium and pubis

A

Color
Shape
Size

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14
Q

Pagets aka

A

Osteitis deformans

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15
Q

Pagets demographic

A

Males >50

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16
Q

Stages pagets

A

Stage 1 = lytic or destructive
Stage 2 = combined
Stage 3 = sclerotic
Stage 4 = malignant (osteosarcoma)

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17
Q

Causes cortical thickening in the spine called picture frame vertebrae
Increased bone density
Coarsened trabeculae
Bone enlargement
Bone softening causing basilar invagination

A

Paget’s

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18
Q

Bowing deformities

A

Pagets

Saber shin and sheppard’s crook

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19
Q

Radiographic signs in extremities

Pagets

A 
Cotton wool appearance
Blade of grass appearance
Candle flame appearance
Sheaves of wheat
Sheaves of grain
Brim sign
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20
Q

Labs pagets

A

Increased alkaline phosphatase

Urinary hydroxyproline

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21
Q

Special test pagets

A

Bone scan

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22
Q

If not malignant stage pagets refer to

A

Orthopedist

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23
Q

Physiologic resorption of normal bone replaced by fibrous tissue fills medullary cavity

A

Fibrous dysplasia

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24
Q

Saber shin tibia

Sheppard’s crook

A

Pagets

Fibrous dysplasia

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25
Ground glass appearance Cafe au leit spots with coast of maine appearance Rind sign
Fibrous dysplasia
26
Cob web appearance
Fibrous dysplasia
27
Thick slerotic rind around radiolucent center
Rind sign
28
Fibrous dysplasia NEVER goes
Into epiphysis
29
Pagets vs fibrous dysplasia
Go to medulla vs soft tissue Same color = fibrous dysplasia Medulla whiter = pagets
30
Saddle fracture
Bilateral ischial and pubic fx
31
Avulsion fractures
ASIS - sartorius | AIIS - rectus femoris
32
Rider’s bone
Avulsion of the ischial tuberosity caused by forceful hamstring contraction - kicking horse to move
33
Compare side-to-sside femoral head and acetabulum
White = AVN until prover otherwise DJD AVN Mallum Coxa Senilis
34
DJD of the hip
>40 Superior lateral joint space is decreased or missing Whitening of femoral head similar to whitening on acetabulum above
35
AVN of the hip
Superior lateral joint space is PRESERVED | Femoral head is whiter in appearance/thickness compared to acetabulum above
36
M/c/c AVN of the hip
Trauma | 2nd = corticosteroids
37
Mallum coxa senilis
Severe DJD of the hip Decreased or missing superior lateral joint space Lipping/spurring Whitening of femoral head and acetabulum above May see subchondral cyst (geode) with this condition
38
Compare side-to-side femoral neck and shaft
Shape - PFF, SCFE, etc
39
Deformity due to pagets or fibrous dysplasia in femoral shaft
Sheppards crook deformity
40
SCFE
Boys 10-16 Usually overweight Salter harris type 1 fracture
41
Femoral head slides inferior and medial/femoral neck slides superior and lateral
Slipped capital femoral epiphysis
42
SCFE
Slipped capital femoral epiphysis
43
Lines SCFE
Klein’s Skinner;s Shenton’s
44
View SCFE
Frog leg view
45
Case management SCFE
Orthopedist
46
Legg calve perthes
AVN of the femoral head Boys 4-9 Painless limp or referred pain to groin and knee with lots of abduction and internal rotation
47
Radiographic signs legg calve perthes
Fragmentation of the femoral head (crescent sign) Flattening of the femoral head Increase white denisty of the femoral head (snowcap sign) Increased joint space
48
Healed legg calve perthes
Mushroom shaped appearance
49
Case management legg calve perthes
Refer to orthopedist for A brace
50
If left untreated legg calve perthes
Can lead to early DJD (mallum coxa senilis) or hip replacement
51
Takes ___ for AVN to show up on x-ray
2 months
52
No open growth plates
No SCFE
53
M/c femoral fx
Subcapital
54
2nd m/c femoral fx
Intertrochanteric
55
2 avulsion fx
Greater trochanter - glute med/min | Lesser trochanter - iliopsoas
56
Check the soft tissue inside the pelvic inlet
``` Uterine fibroid Calcified prostate Ureter stones Phelboliths Bladder calculi ```
57
Mulberry round mass appearace | Round white density in center of pelvic inlet
Uterine fibroid Fibroid cyst Leiomyoma
58
M/c benign tumor in females
Uterine fibriod
59
Pain, abnormal bleeding
Uterine fibroid
60
Location uterine fibroid
Midline horizontally
61
Case management uterine fibroid
Refer to OB/GYN | imaging = US
62
White spotty raspberry or blackberry on top of pubic symphysis
Calcified prostate
63
Dysuria Urinary hesitancy Male >50
Calcified prostate
64
Labs calcified prostate
PSA | Acid phosphatase elevated
65
metastasis prostate
Lumbar spine
66
Mets
Alkaline phosphatase
67
White densities upper half and lateral portion of pelvic inlet
Ureter stones
68
Line on top of femoral heads
Above line = ureter stones Below line, size of eraser tip = phleboliths Below line much larger = bladder calculi
69
Calcifications within veins, asymptomatic
Phleboliths
70
White densities bottom half of pelvic inlet within the bladder location
Bladder calculi

Part 4 Boards X-ray (22 decks)

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