Diagnostic Imaging

Question 1

Can imaging provide answers

Answer 1

no. imagining is a tool, they do not provide answers or substitute clinical reasoning. You still need to do a history and physical exam

Question 2

What do ABC stand for

Answer 2

Alignment, Bone Density and Cartilage

Question 3

When you take an x-ray, is one view enough

Answer 3

no, need at least 2 views

Question 4

If you want to see the posterior humeral head, which view is best

Answer 4

A-P with internal rotation

Question 5

What is a Hill Sach lesion

Answer 5

Is a compression fracture of the posterior surface of the humeral head. This happens with an anterior translation

you will see a flattening of the humeral head

To have this you must have a shoulder dislocation

Question 6

Why would we want a transscapular view and this view is aka

Answer 6

Lateral, Y

Demonstrates dislocation

Look for the “Y” and determine if the humeral head is “in the Y”
This view will tell you the direction of the location

Question 7

Purpose of West point view of the shoulder

Answer 7

Demonstrates:
same structures as axillary view

Best view of the anterior inferior glenoid

Question 8

Axillary view demonstrates

Answer 8

Demonstrates:
Position of the humeral head in relation to the glenoid

Dislocations

Fractures
compression from dislocation

Proximal humerus and scapula

Question 9

MRI of the shoulder is good for

Answer 9

Rotator Cuff tendon tears - asymptomatic population can have rotator cuff tears

Labral tears

Instability

Occult Fracture - fractures that can not be seen on x-ray

Question 10

What is a fat pad sign

Answer 10

A lot of swelling in the joint pushes out the capsule. Also referred to as a sail sign because it looks like the sail of a boat

Question 11

What is a disadvantage of a lateral projection of the wrist and hand

Answer 11

lots of superimposition

Question 12

How do we view the acetabulum

Answer 12

Since the acetabulum is hard to see, you look for 6 lines relating to the acetabulum and the surrounding structures.

Distortions of the lines could mean a fracture, especially if you see this in the teardrop.

Question 13

What does a standard A-P view of the hip demonstrate

Answer 13

sacrum, pubis, ilium

femoral heads and neck

greater and lesser trochanter

partial view of the acetabulum

Question 14

Why is the hip down in a frog leg position instead of sidlying

Answer 14

to much imposition with the femur

Question 15

would you put someone with a hip fracture in a frog leg position

Answer 15

no

Question 16

Sunrise view is for

Answer 16

the knee but there is a problem: this might be hard for someone to do who is in pain

Question 17

Merchant view is good for

Answer 17

Solves the problem of the Sunrise method

Question 18

What is the sulcus angle

Answer 18

Is the angle between the deepest part and out to the femoral condyles.

Normal is around 138. If the angle is greater than that, then there is an increased chance of a subluxation of the lateral femoral condyles

Question 19

What is the congruence angle

Answer 19

2 lines. On bisects the sulcus angle and the other is from the higher point of the patella. This is the angle between the two lines.
normal is -6 +/- 11
A larger angle could explain patella pain

Question 20

A tunnel or notch view is good for

Answer 20

avulsion fractures

Question 21

What is a disadvantage to a standard A-P of the knee

Answer 21

Can not see lateral joint space, you need another view

Question 22

Lateral view of the foot and ankle show us

Answer 22

Distal Tibia, talus and calcaneous in profile

Tibiotalar and subtalar joints

Posterior tibia or “3rd malleolus”

Question 23

A mortise view is

Answer 23

Required for a complete evaluation of the ankle joint

BUT! if there is a suspected fracture, this is not done

Question 24

Intermetatarsal angle is

Answer 24

the angle between the 1st and second metatarsals

Question 25

MRIs and ACL tears

Answer 25

MRIs often miss meniscal tears in the presence of an ACL tear.

Question 26

Menisci and OA

Answer 26

Meniscal tears with OA typically do not add to a person’s pain