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Semester 2 PM Exam 8 > Diagnostic Imaging > Flashcards

Diagnostic Imaging Flashcards

1
Q

Distal Femur - 2nd ossification center

A

Birth

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2
Q

Distal Femur - Ossification/Fusion

A

14-16 yrs females

16-18 yrs males

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3
Q

Proximal Tibia - 2nd ossification center

A

Birth

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4
Q

Proximal Tibia - Ossification/Fusion

A

14-16 yrs females

16-18 yrs males

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5
Q

Tibial Tuberosity - 2nd ossification center

A

8 yrs

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6
Q

Tibial tuberosity - ossification/fusion

A

13-15 yrs females
15-19 yrs males
TRACTION EPIPHYSIS

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7
Q

Patella - 2nd ossification center

A

4 yrs

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8
Q

Patella - ossification/fusion

A

puberty

Completely cartilage until 4 yrs old

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9
Q

Routine projections

A

AP
Lateral
Axial or tunnel of intercondylar fossa
Axial patellofemoral joint

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10
Q

AP of the knee

A 
Taken with knee in extension
Distal femur
Proximal tibia
Fibular head
Tibiofemoral joint
Trabecular markings observable
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11
Q

Lateral of the knee - position and beam

A

Knee is positioned into 20 degrees flexion

Beam moves medial to lateral with lateral knee closest to the film

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12
Q

Lateral of the knee - what is present

A 
Sesamoid bone (fabella) may be present
Bursa may be observable as a radiolucent line
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13
Q

Axial/Tunnel Intercondylar Fossa - position

A

Patient is prone with knee flexed to 40 degrees

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14
Q

Axial/tunnel Intercondylar fossa - beam

A

beam moves post to ant

It is a PA

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15
Q

Axial view of the patellofemoral jt. is AKA

A

Tangential
Sunrise
Skyline
Merchant’s view

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16
Q

Axial view of patellofemoral joint

A

Articular surfaces of the femur and patella

Knee is flexed to varying degrees

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17
Q

Lower leg imaging

A

AP and Lateral

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18
Q

Lower leg imaging used for what

A

to determine the condition of the tibia and fibula

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19
Q

Computed Tomography

A

Bony elements, fractures, and degenerative processes

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20
Q

CT myelogram

A

Tends to use contrast within the subarachnoid space - stenosis
Ionizing radiation exposure

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21
Q

CT good for

A

complex fractures

bone - degenerative processes

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22
Q

Magnetic Resonance Imaging

A

Soft tissue, inflammation, hemorrhage
More expensive and slower than CT
Metal is absolute contraindication
Can also do myelogram w/o contrast

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23
Q

Arthrography

A

Use of contrast within joint spaces
Plain film, CT, and MRI
Typically air and contrast medium is injected into the joint and an image is taken

24
Q

Diagnostic Ultrasound

A 
2-15 MHz
Bundled delivery (1% emission; 99% reception)
25
Q

Diagnostic Ultrasound used for

A

Muscle and tendon architecture, fiber degeneration and tears, nerve inflammation

26
Q

Downside to ultrasound for diagnosing

A

VERY operator dependent

Does not penetrate bone or transmit though air (lungs)

27
Q

Bone scan (Scintigraphy)

A

Use of radionuclide to image bone
“functional” imaging
Indicates abnormal areas of bone activity

28
Q

Bone Scan - Sn and Sp

A

Is highly sensitive but lacks specificity

29
Q

Closed vs. Open fracture

A 
Closed = skin and soft tissue are intact
Open = any open wound, any size, is caused by the fractured bone
30
Q

Fracture description must include

A 
Site and extent
Type
Alignment
Direction
Special Features
Associated abnormalities
31
Q

Site and Extent

A 
Anatomic location
Upper, middle, lower on the bone
Proximal or distal
Extra-articular or intra
IT, surgical neck, head...
32
Q

Type and Alignment

A

Complete or incomplete
Relationship of the longitudinal axis of fragments to each other
Position of distal fragment as related to proximal
Displacement
Distracted

33
Q

Direction

A

Fracture line in relationship to the longitudinal axis of the bone

34
Q

Different directions

A

Transverse
Longitudinal
Oblique
Spiral

35
Q

Comminuted

A

More than 2 fragments

36
Q

Special Features - Impaction

A

Depression

Compression

37
Q

Depression is common in

A

tibial condyle

38
Q

Compression is common in

A

vertebrae

compression from all sides

39
Q

Special features - avulsion

A

Most commonly where you have a traction epiphysis

40
Q

Special features - epiphyseal

A

Salter harris classification

if using this classification you know it is younger than 17

41
Q

Associated Features

A

Joint Dislocation

Soft tissue involvement

42
Q

Ottawa Rules

A 
Age 55 yrs or older
Tenderness at head of fibula
Isolated tenderness of patella
Inability to flex knee to 90 
Inability to WB (4 steps) immediately after injury or in ED
43
Q

Pittsburgh Rules

A

Blunt trauma or a fall plus either of the following:
Age younger than 12 yrs or older than 50 yrs
Inability to walk 4 WB steps in the ED

44
Q

Femoral Shaft Fracture

A

Life threatening - considerable bleeding, fat embolism (resp. issues)

45
Q

Massive forces required - femoral shaft fracture

A 
Almost always displaced
Other injuries probably exist
Circulatory issues
Severe pain
Rotation and angular displacement of distal end
46
Q

Tibial Plateau Fracture

A

Hohl classification system
Joint instability is common
MCL and LCL often involved
OFten need CT or MRI

47
Q

Tibial Plateau Fracture caused by

A

axial loading with valgus or varus forces such as a fall from a height or collision with bumper of a car
Due to impact of femoral condyle into tibial plateau

48
Q

Tibial Plateau Fracture - WB

A

Generally unable to WB

49
Q

Tibial Plateau Fracture - more commonly fracture where

A

Lateral tibial plateau is fractured more frequently than the medial

50
Q

Intercondylar Fracture

A

Direct blow to the proximal tibia with the knee or in rotation
Hyperextension with varus or valgus stress
Loss of cruciate ligaments may occur

51
Q

Patellar fractures

A

Disruption of the extensor mechanism

52
Q

Patellar fracture - occur as result of

Most common cause

A

May occur as a result of an indirect force such as a jump (deceleration) (quad contraction)
Direct blow like dashboard injury in a MVA or a fall on a flexed knee

53
Q

Continuous Passive Motion

A

Post operatively patients use this to ge tthem into flexion and extension
Data suggests not very helpful

54
Q

Tibial Plateau Fracture - what do they do surgically

A

Supporting the fracture fragments with small bone screws and the Ilizarov fixator - removed after 12 weeks

55
Q

Hemophilic Arthopathy

A

Common complication is bleeding into the joints

As PT you wont know until later if bleeding occurred

56
Q

Meniscal injury - what type of imaging

A

MRI is imaging modality of choice

Semester 2 PM Exam 8 (5 decks)

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