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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
Q

Ground glass appearance
Cafe au leit spots with coast of maine appearance
Rind sign

A

Fibrous dysplasia

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26
Q

Cob web appearance

A

Fibrous dysplasia

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27
Q

Thick slerotic rind around radiolucent center

A

Rind sign

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28
Q

Fibrous dysplasia NEVER goes

A

Into epiphysis

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29
Q

Pagets vs fibrous dysplasia

A

Go to medulla vs soft tissue
Same color = fibrous dysplasia
Medulla whiter = pagets

30
Q

Saddle fracture

A

Bilateral ischial and pubic fx

31
Q

Avulsion fractures

A

ASIS - sartorius

AIIS - rectus femoris

32
Q

Rider’s bone

A

Avulsion of the ischial tuberosity caused by forceful hamstring contraction - kicking horse to move

33
Q

Compare side-to-sside femoral head and acetabulum

A

White = AVN until prover otherwise
DJD
AVN
Mallum Coxa Senilis

34
Q

DJD of the hip

A

> 40
Superior lateral joint space is decreased or missing
Whitening of femoral head similar to whitening on acetabulum above

35
Q

AVN of the hip

A

Superior lateral joint space is PRESERVED

Femoral head is whiter in appearance/thickness compared to acetabulum above

36
Q

M/c/c AVN of the hip

A

Trauma

2nd = corticosteroids

37
Q

Mallum coxa senilis

A

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
Q

Compare side-to-side femoral neck and shaft

A

Shape - PFF, SCFE, etc

39
Q

Deformity due to pagets or fibrous dysplasia in femoral shaft

A

Sheppards crook deformity

40
Q

SCFE

A

Boys 10-16
Usually overweight
Salter harris type 1 fracture

41
Q

Femoral head slides inferior and medial/femoral neck slides superior and lateral

A

Slipped capital femoral epiphysis

42
Q

SCFE

A

Slipped capital femoral epiphysis

43
Q

Lines SCFE

A

Klein’s
Skinner;s
Shenton’s

44
Q

View SCFE

A

Frog leg view

45
Q

Case management SCFE

A

Orthopedist

46
Q

Legg calve perthes

A

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
Q

Radiographic signs legg calve perthes

A

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
Q

Healed legg calve perthes

A

Mushroom shaped appearance

49
Q

Case management legg calve perthes

A

Refer to orthopedist for A brace

50
Q

If left untreated legg calve perthes

A

Can lead to early DJD (mallum coxa senilis) or hip replacement

51
Q

Takes ___ for AVN to show up on x-ray

A

2 months

52
Q

No open growth plates

A

No SCFE

53
Q

M/c femoral fx

A

Subcapital

54
Q

2nd m/c femoral fx

A

Intertrochanteric

55
Q

2 avulsion fx

A

Greater trochanter - glute med/min

Lesser trochanter - iliopsoas

56
Q

Check the soft tissue inside the pelvic inlet

A 
Uterine fibroid
Calcified prostate
Ureter stones
Phelboliths
Bladder calculi
57
Q

Mulberry round mass appearace

Round white density in center of pelvic inlet

A

Uterine fibroid
Fibroid cyst
Leiomyoma

58
Q

M/c benign tumor in females

A

Uterine fibriod

59
Q

Pain, abnormal bleeding

A

Uterine fibroid

60
Q

Location uterine fibroid

A

Midline horizontally

61
Q

Case management uterine fibroid

A

Refer to OB/GYN

imaging = US

62
Q

White spotty raspberry or blackberry on top of pubic symphysis

A

Calcified prostate

63
Q

Dysuria
Urinary hesitancy
Male
>50

A

Calcified prostate

64
Q

Labs calcified prostate

A

PSA

Acid phosphatase elevated

65
Q

metastasis prostate

A

Lumbar spine

66
Q

Mets

A

Alkaline phosphatase

67
Q

White densities upper half and lateral portion of pelvic inlet

A

Ureter stones

68
Q

Line on top of femoral heads

A

Above line = ureter stones
Below line, size of eraser tip = phleboliths
Below line much larger = bladder calculi

69
Q

Calcifications within veins, asymptomatic

A

Phleboliths

70
Q

White densities bottom half of pelvic inlet within the bladder location

A

Bladder calculi

Part 4 Boards X-ray (22 decks)

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