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UKMLA Prep > Clinical imaging > Flashcards

Clinical imaging Flashcards

Conditions and presentations

1
Q

Aneurysm imaging

A

*MRI
* Catheter cerebral angiography

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2
Q

Difficulty speaking

A
  • Non contrast head CT
  • cranial MRI with diffusion imaging
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3
Q

Double vision

A

Pre and post contrast MRI
Make sure attention to orbits, optic nerves, tracts and optic radiations.

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4
Q

What is an extradural (epidural) haematoma?

A

A collection of blood between the skull and the dura, typically caused by trauma.

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5
Q

What is the classical presentation of a patient with an extradural haematoma?

A

Initially loses, briefly regains, and then loses consciousness after a low-impact head injury.

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6
Q

What is the ‘lucid interval’ in the context of extradural haematomas?

A

A brief regain of consciousness after a head injury before losing it again due to expanding haematoma.

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7
Q

What imaging appearance characterizes an extradural haematoma?

A

A biconvex (lentiform), hyperdense collection around the surface of the brain.

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8
Q

What is the definitive treatment for an extradural haematoma?

A

Craniotomy and evacuation of the haematoma.

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9
Q

What are the Ottawa Rules for ankle x-rays?

A

An x-ray is required if there is pain in the malleolar zone and any one of the following:
* Bony tenderness at the lateral malleolar zone
* Bony tenderness at the medial malleolar zone
* Inability to walk four weight-bearing steps.

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10
Q

What are the common features of a hip fracture?

A
  • Pain
  • Shortened and externally rotated leg
  • Non-displaced or incomplete neck of femur fractures may allow weight bearing.
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11
Q

What is the Garden classification for hip fractures?

A
  • Type I: Stable fracture with impaction in valgus
  • Type II: Complete fracture but undisplaced
  • Type III: Displaced fracture, usually rotated and angulated
  • Type IV: Complete bony disruption.
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12
Q

What is the management for a displaced intracapsular hip fracture?

A

Total hip replacement or hemiarthroplasty, with total hip replacement favored if the patient is fit.

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13
Q

What are the common sites of metatarsal fractures?

A

The proximal 5th metatarsal is the most commonly fractured, while the 1st metatarsal is the least commonly fractured.

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14
Q

What is a stress fracture?

A

A fracture that occurs due to repeated mechanical stress.

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15
Q

What are the clinical features of metatarsal stress fractures?

A
  • Pain and bony tenderness
  • Swelling
  • Antalgic gait.
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16
Q

What is De Quervain’s tenosynovitis?

A

An inflammation of the sheath containing the extensor pollicis brevis and abductor pollicis longus tendons.

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17
Q

What is Finkelstein’s test used to diagnose?

A

De Quervain’s tenosynovitis.

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18
Q

What is the classic presentation of lateral epicondylitis (tennis elbow)?

A

Pain and tenderness localized to the lateral epicondyle, worsened by resisted wrist extension.

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19
Q

What characterizes a Colles’ fracture?

A

Transverse fracture of the radius, 1 inch proximal to the radio-carpal joint, with dorsal displacement.

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20
Q

What is a Boxer fracture?

A

A minimally displaced fracture of the fifth metacarpal, typically from punching a hard surface.

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21
Q

What are the features of supracondylar fractures?

A
  • Typically seen in children
  • Result from a fall onto an outstretched hand
  • Pain and swelling over the elbow.
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22
Q

What is the Salter-Harris classification used for?

A

Classifying growth plate fractures in children.

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23
Q

What is a common sign of a proximal 5th metatarsal fracture?

A

Proximal avulsion fractures (pseudo-Jones fractures) occurring at the proximal tuberosity.

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24
Q

What are the management options for undisplaced patella fractures?

A

Non-operatively managed in a hinged knee brace for 6 weeks with full weight bearing.

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25
Q

What is the primary concern with displaced fractures of the hip?

A

Risk of avascular necrosis due to blood supply disruption.

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26
Q

What does an isotope scan or MRI help establish in the case of suspected stress fractures?

A

The presence of a stress fracture when X-rays are often normal.

27
Q

What does growth plate tenderness typically indicate?

A

An underlying fracture, even if the x-ray appears normal.

28
Q

Which types of injuries usually require surgery?

A

Types III, IV, and V injuries.

29
Q

List some indicators of non-accidental injury in children.

A
  • Delayed presentation
  • Delay in attaining milestones
  • Lack of concordance between proposed and actual mechanism of injury
  • Multiple injuries
  • Injuries at sites not commonly exposed to trauma
  • Children on the at-risk register
30
Q

What genetic condition may cause pathological fractures?

A

Osteogenesis imperfecta.

31
Q

What is osteogenesis imperfecta characterized by?

A
  • Defective osteoid formation
  • Failure of maturation of collagen in connective tissues.
32
Q

What does radiology show in osteogenesis imperfecta?

A
  • Translucent bones
  • Multiple fractures, particularly of long bones
  • Wormian bones
  • Trefoil pelvis.
33
Q

What are the four subtypes of osteogenesis imperfecta?

A
  • Type I: Normal collagen quality, insufficient quantity
  • Type II: Poor collagen quantity and quality
  • Type III: Poorly formed collagen, normal quantity
  • Type IV: Sufficient collagen quantity, poor quality.
34
Q

What is osteopetrosis?

A

A condition where bones become harder and denser.

35
Q

What is a common cause of scaphoid fractures?

A

Falling onto an outstretched hand (FOOSH).

36
Q

What is the blood supply risk associated with scaphoid fractures?

A

Avascular necrosis due to interruption of blood supply.

37
Q

What are the typical signs of a scaphoid fracture?

A
  • Point of maximal tenderness over the anatomical snuffbox
  • Wrist joint effusion
  • Pain on telescoping of the thumb
  • Tenderness of the scaphoid tubercle
  • Pain on ulnar deviation of the wrist.
38
Q

What imaging is considered definitive for confirming a scaphoid fracture?

A

MRI.

39
Q

What is the initial management of suspected scaphoid fractures?

A
  • Immobilization with a splint or backslab
  • Referral to orthopaedics
  • Clinical review in 7-10 days.
40
Q

What are the complications of scaphoid fractures?

A
  • Non-union
  • Avascular necrosis.
41
Q

What characterizes a Colles’ fracture?

A
  • Transverse fracture of the radius
  • 1 inch proximal to the radio-carpal joint
  • Dorsal displacement and angulation.
42
Q

What is a Smith’s fracture?

A

A reverse Colles’ fracture with volar angulation of the distal radius fragment.

43
Q

What is a Bennett’s fracture?

A

An intra-articular fracture at the base of the thumb metacarpal.

44
Q

What is a Monteggia’s fracture?

A

Dislocation of the proximal radioulnar joint in association with an ulna fracture.

45
Q

What is a Galeazzi fracture?

A

Radial shaft fracture with associated dislocation of the distal radioulnar joint.

46
Q

What is Barton’s fracture?

A

Distal radius fracture with associated radiocarpal dislocation.

47
Q

What are the main physical signs of scaphoid fractures?

A
  • Swelling and tenderness in the anatomical snuffbox
  • Pain on wrist movements
  • Pain on longitudinal compression of the thumb.
48
Q

What is the most common cause of posterior heel pain?

A

Achilles tendon disorders.

49
Q

What are common features of Achilles tendinopathy?

A
  • Gradual onset of posterior heel pain
  • Pain worse following activity
  • Morning pain and stiffness.
50
Q

What should be suspected in an Achilles tendon rupture?

A

Audible ‘pop’, sudden onset significant pain, inability to walk.

51
Q

What is the initial imaging modality of choice for suspected Achilles tendon rupture?

A

Ultrasound.

52
Q

What are the components of the ankle joint?

A
  • Distal tibia
  • Distal fibula
  • Superior aspect of the talus.
53
Q

What is a sprain?

A

A stretching, partial or complete tear of a ligament.

54
Q

What is the most common mechanism for low ankle sprains?

A

Inversion injury.

55
Q

What is the RICE protocol for treating sprains?

A
  • Rest
  • Ice
  • Compression
  • Elevation.
56
Q

What characterizes high ankle sprains?

A

Severe injuries to the syndesmosis, often with external rotation of the foot.

57
Q

What is iliotibial band syndrome?

A

A common cause of lateral knee pain in runners.

58
Q

What is the most commonly injured knee ligament?

A

Anterior cruciate ligament (ACL).

59
Q

What is a typical presentation of an ACL injury?

A
  • Sudden ‘popping’ sound
  • Knee swelling
  • Instability.
60
Q

What does Thessaly’s test assess?

A

Meniscal tears by weight bearing and twisting the knee.

61
Q

What is plantar fasciitis?

A

The most common cause of heel pain seen in adults.

62
Q

What is the management for plantar fasciitis?

A
  • Rest the feet
  • Good arch support shoes
  • Insoles and heel pads.
63
Q

What should be considered in case of isolated deltoid ligament injuries?

A

Look for Maisonneuve fracture of the proximal fibula.

UKMLA Prep (41 decks)

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