Diagnostic Imaging Flashcards
Can imaging provide answers
no. imagining is a tool, they do not provide answers or substitute clinical reasoning. You still need to do a history and physical exam
What do ABC stand for
Alignment, Bone Density and Cartilage
When you take an x-ray, is one view enough
no, need at least 2 views
If you want to see the posterior humeral head, which view is best
A-P with internal rotation
What is a Hill Sach lesion
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
Why would we want a transscapular view and this view is aka
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
Purpose of West point view of the shoulder
Demonstrates:
same structures as axillary view
Best view of the anterior inferior glenoid
Axillary view demonstrates
Demonstrates:
Position of the humeral head in relation to the glenoid
Dislocations
Fractures
compression from dislocation
Proximal humerus and scapula
MRI of the shoulder is good for
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
What is a fat pad sign
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
What is a disadvantage of a lateral projection of the wrist and hand
lots of superimposition
How do we view the acetabulum
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.
What does a standard A-P view of the hip demonstrate
sacrum, pubis, ilium
femoral heads and neck
greater and lesser trochanter
partial view of the acetabulum
Why is the hip down in a frog leg position instead of sidlying
to much imposition with the femur
would you put someone with a hip fracture in a frog leg position
no
Sunrise view is for
the knee but there is a problem: this might be hard for someone to do who is in pain
Merchant view is good for
Solves the problem of the Sunrise method
What is the sulcus angle
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
What is the congruence angle
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
A tunnel or notch view is good for
avulsion fractures
What is a disadvantage to a standard A-P of the knee
Can not see lateral joint space, you need another view
Lateral view of the foot and ankle show us
Distal Tibia, talus and calcaneous in profile
Tibiotalar and subtalar joints
Posterior tibia or “3rd malleolus”
A mortise view is
Required for a complete evaluation of the ankle joint
BUT! if there is a suspected fracture, this is not done
Intermetatarsal angle is
the angle between the 1st and second metatarsals
MRIs and ACL tears
MRIs often miss meniscal tears in the presence of an ACL tear.
Menisci and OA
Meniscal tears with OA typically do not add to a person’s pain
