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Diagnostic Imaging (Irene Gold) Part II and III Flashcards

1
Q

Who are all Benign Bone Tumors (BBT) referred to?

A

Orthopedist

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2
Q

What are the four characteristics of all Benign Bone Tumors (BBT)?

A

Short zone of transition
Incidental finding
Geographic lesion
Encapsulated

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3
Q

What is the name of the most common Benign Bone Tumor (BBT) of the appendicular skeleton?

A

Osteochondroma

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4
Q

What are two types of Osteochondromas?

A

Pedunculated (Coat Hanger Exostosis/Cauliflower like)

Sessile

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5
Q

What is the name for multiple Osteochondromas?

A

Hereditary Multiple Exostosis (HME)

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6
Q

What percentage of Hereditary Multiple Exostosis (HME) undergo malignancy?

A

20%

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7
Q

What is another name for a Unicameral Bone Cyst (UBC)?

A

Simple Bone Cyst (SBC)

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8
Q

What is the location of a Simple Bone Cyst (SBC)?

A

Diaphyseal/Metaphyseal

Centrally Located

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9
Q

What age is a Simple Bone Cyst (SBC) usually seen in?

A

Under the age of 20 years old

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10
Q

What are the common locations of a Simple Bone Cyst (SBC) to appear?

A

Proximal:
Tibia
Fibula
Humerus

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11
Q

What Radiographic sign is associated with a Simple Bone Cyst (SBC)?

A

Fallen Fragment Sign

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12
Q

What is the location of a Aneurysmal Bone Cyst (ABC)?

A

Diaphyseal/Metaphyseal

Eccentrically Located

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13
Q

What age and gender is an Aneurysmal Bone Cyst (ABC) usually seen in?

A

Females under the age of 20

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14
Q

What is the location of a Giant Cell Tumor (GCT)?

A

Epiphyseal/Metaphyseal

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15
Q

What age range usually has a Giant Cell Tumor (GCT)?

A

20-40 year olds

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16
Q

What “classification” do 20% of Giant Cell Tumors become?

A

Quasi-Malignant

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17
Q

What are five “characteristics” of a Quasi-Malignant tumor?

A 
Non-Expansible 
Pain and Swelling present
Pathological fracture
Reduce after surgery
Can come back
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18
Q

What kind of appearance is seen on x-ray of a Giant Cell Tumor (GCT)?

A

Soap Bubble (Saponaceous)

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19
Q

What is the location of a Chondroblastoma?

A

Epiphyseal/Metaphyseal

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20
Q

What age would you commonly see a Chondroblastoma?

A

Younger than the age of 20

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21
Q

What two Benign Bone Tumors (BBT) have night pain relieved by aspirin?

A

Osteoid Osteoma

Brodie’s Abscess (Chronic Osteomyelitis)

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22
Q

What is another name for a Brodie’s Abscess?

A

Chronic Osteomyelitis

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23
Q

What is the x-ray appearance for a Osteoid Osteoma and Brodie’s Abscess?

A

Radiolucent central “nidus” with severe reactive sclerosis

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24
Q

What is the most common Benign Bone Tumor (BBT) of the hand?

A

Enchondroma

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25
Q

What kind of appearance with an Enchondroma have?

A

Stippled

Cortical thinning

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26
Q

What is the name of the condition that is multiple Enchondromas?

A

Ollier’s Disease

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27
Q

What percentage of people with Ollier’s Disease may have malignant degeneration?

A

10%-50%

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28
Q

What two things will patients with Ollier’s Disease have?

A

Predisposed to fracture

Permanent Deformities

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29
Q

If a patient has soft tissue calcification and Enchondromas what is the condition called?

A

Maffucci’s Syndrome

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30
Q

What is the most common Benign Bone Tumor (BBT) of the spine?

A

Hemangioma

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31
Q

What is another name for a Hemangioma?

A

Vascular Neoplasm

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32
Q

What is the appearance of a Hemangioma on x-ray?

A

Vertical Striations

Corduroy Cloth Appearance

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33
Q

What is the name of the Benign Bone Tumor (BBT) that appears as a round/oblong radiopaque lesion; Bone Island?

A

Enostoma

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34
Q

What is it called when there are multiple Enostomas?

A

Osteopoikilosis

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35
Q

What is the name of the Benign Bone Tumor (BBT) that most commonly affects the neural arch?

A

Osteoblastoma

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36
Q

What vertebral level is most commonly effected by a Osteoblastoma?

A

Atlas, C1

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37
Q

What is the most common Benign Bone Tumor (BBT) to affect the skull?

A

Osteoma

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38
Q

In what part of the skull is an Osteoma most commonly found?

A

Frontal Sinuses

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39
Q

What x-ray view is best to see an Osteoma?

A

Caldwell Projection

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40
Q

What Benign Bone Tumor (BBT) has a monostotic form, is dark on x-ray and must have deformed bone?

A

Fibrous Dysplasia

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41
Q

What x-ray sign is associated with Fibrous Dysplasia; Monostotic form (70%)?

A

Rind Sign

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42
Q

In the condition of Fibrous Dysplasia what physiologically replaces normal bone?

A

Fibrous Tissue

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43
Q

What are four Characteristics and/or Appearances of Fibrous Dysplasia?

A

Saber Shin Tibia
Sheppard’s Crook (Hip)
“Ground Glass” appearance
Jagged “Café Au Lait” spots (“Coast of Maine”)

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44
Q

What Benign Bone Tumor (BBT) has a familial history?

A

Neurofibromatosis

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45
Q

What are eight Characteristics and/or Appearances of Neurofibromatosis?

A
  • Patient may present with:
  • Scoliosis
  • Cervical Kyphosis
  • Posterior Vertebral Scalloping, with Intervertebral Foramen (IVF) enlargement
  • Straight “Café Au Lait” spots (“Coast of California”)
  • Genetic Malformation
  • Rib Deformity
  • Lisch nodules; Growth on the iris of the eye, looks like a freckle
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46
Q

What is another name for Multiple Myeloma?

A

Plasma Cell Sarcoma

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47
Q

What age is Multiple Myeloma often seen in?

A

50 years old

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48
Q

What are three characteristics are seen in Multiple Myeloma?

A

-Cachexia (Weakness or wasting of the body, from chronic disease)
-Weight Loss
Anemia

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49
Q

What is the most common primary malignancy of bone?

A

Multiple Myeloma

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50
Q

What part of the bone is effected in the condition of Multiple Myeloma?

A

Plasma Cells of Bone Marrow

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51
Q

What two “Terms/Names” are associated with Multiple Myeloma?

A

“Punched Out Lesions” (Multiple Dark Densities)

“Rain Drop Skull”

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52
Q

What additional condition is can be seen in Multiple Myeloma?

A

Pathological collapse of a vertebra (Vertebral Plana)

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53
Q

What are four lab findings in Multiple Myeloma?

A

M Spike on the Immunoelctrophoresis
Reversal of the Albumin/Globulin (A/G) Ratio
Bence-Jones Proteinuria
Elevated Erythrocyte Sedimentation Rate (ESR)

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54
Q

What Special Test is ordered for Multiple Myeloma and what is the outcome of the Special test?

A

Special Test: Bone Scan

Outcome/Result: Cold

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55
Q

What is the most common malignant tumor of bone?

A

Metastatic Disease (Lytic and Blastic)

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56
Q

What is the age that is associated with Lytic Metastatic Disease?

A

Older than 40

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57
Q

What two symptoms are often seen in a patient with Lytic Metastatic Disease?

A

Recent Unexplained weigh loss

Skeletal Pain worse at night

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58
Q

What are the x-ray appearance of Lytic Metastatic Disease?

A

Moth eaten
Permeative pattern
“Eats” away pedicle
“Swiss Cheese” Skull

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59
Q

What lab will be ordered for both Lytic/Blastic Metastatic Disease?

A

Alkaline Phosphatase

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60
Q

What Special Test and result/outcome are ordered for a patient with both Lytic/Blastic Metastatic Disease?

A

Special Test: Bone Scan

Result/Outcome: Hot

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61
Q

What are the three conditions that have an Ivory White Vertebrae (IWV) on x-ray?

A

MPH

Metastatic Disease (Blastic)
Paget’s
Hodgkin’s Disease

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62
Q

What is the most common age and gender for the condition of Hodgkin’s Disease?

A

Males

20-40 years old

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63
Q

Along with an Ivory White Vertebrae (IWV) what other x-ray finding is seen in a Hodgkin’s Disease patient?

A

Anterior Scalloping of the vertebral body

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64
Q

What will be seen on the P-A chest film of a patient with Hodgkin’s Disease?

A

Unilateral hilar lymphadenopathy

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65
Q

How is Hodgkin’s Disease confirmed?

A

Biopsy

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66
Q

What does the presence of Reed-Sternberg Cells indicate?

A

Hodgkin’s Lymphoma

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67
Q

What age is Blastic Metastatic Disease seen in?

A

Over the age of 40

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68
Q

Where does Blastic Metastatic Disease metastases to and from?

A

Starts in the Prostate and goes to the Lumbar Spine (Through the Valves of Batson)

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69
Q

What is another name for Paget’s Disease?

A

Osteitis Deformans

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70
Q

What age and gender is the condition Osteitis Deformans often seen in?

A

Males over the age of 50

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71
Q

What are the four stages of Paget’s Disease?

A

Lytic or Destructive
Combined
Sclerotic
Malignant (Osteosarcoma)

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72
Q

What six thing are caused on x-ray with a patient with Paget’s Disease?

A 
Cortical Thickening
Picture Frame Vertebrae
Bone Expansion 
Increased Bone Density 
Coarsened Trabeculae 
Bowing Deformities
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73
Q

What Lab and Result/Outcome is ordered for a patient with Paget’s Disease or Osteosarcoma?

A

Lab: Alkaline Phosphatase

Result/Outcome: Increased

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74
Q

What Special Test and Result/Outcome is ordered for a patient with Paget’s Disease or Osteosarcoma?

A

Special Test: Bone Scan

Result/Outcome: Hot

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75
Q

What is the most common malignancy found in children?

A

Osteosarcoma

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76
Q

In what area of the bone is Osteosarcoma seen?

A

Diaphyseal

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77
Q

What age group is Osteosarcoma seen in most commonly?

A

10-30

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78
Q

What kind of reaction is seen in Osteosarcoma?

A

Periosteal Reaction

Speculated
Radiating
Sunburst

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79
Q

What two conditions are seen in patients over the age of 40, that have a periosteal reaction (Speculated/Radiating/Sunburst) reaction of bone?

A

Chondrosarchoma

Fibrosarcoma

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80
Q

What condition of bone is often seen in patients aged 10-25 years old?

A

Ewing’s Sarcoma

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81
Q

In what area of the bone is Ewing’s Sarcoma often found in?

A

Diaphysis of Long Bones

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82
Q

What type of Periosteal Reaction is seen in Ewing’s Sarcoma?

A

Multi-Paralleled Onion Skin (Laminated)

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83
Q

What are three other x-ray findings associated with Ewing’s Sarcoma?

A

Bone expansion
Codman’s Triangle
Saucerization

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84
Q

What is the name of the condition see in patients over 40 years old, that is described as “Aberrant notochordal Cell tumor”?

A

Chordoma

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85
Q

What are the two most common locations for a Chordoma?

A

Most Common- Sacrum

2nd Most Common- Skull

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86
Q

What age and gender range are most effected by scoliosis?

A

Females

13-19

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87
Q

How is scoliosis named?

A

For the side of major Convexity

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88
Q

What is the most common type of Scoliosis?

A

Right Thoracic Convex Idiopathic Scoliosis

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89
Q

In Rotatory Scoliosis to which side do the Spinous Processes deviate?

A

Concavity

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90
Q

In Simple Scoliosis what way do the Spinous Processes deviate?

A

Convexity

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91
Q

What two lines are used to measure Scoliosis?

A

Cobb’s

Resser Ferguson’s

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92
Q

What is the treatment of a patient that has a scoliosis that measures under 20 degrees?

A

Adjust and Monitor

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93
Q

Scoliosis: What range (in degrees) would you send a patient to an orthopedist for a Milwaukee Brace?

A

21-40 degrees

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94
Q

Over how many degrees is a patient with scoliosis referred to a surgical consultant?

A

Over 40 degrees

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95
Q

If a patient has a scoliosis of over 50 degrees what are to complications to be worried about?

A

Cardio-Pulmonary Compromise

Degenerative Joint Disease (DJD)

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96
Q

What are three way to monitor scoliosis?

A

Risser’s Sign
Left wrist films (Best)
Tanner’s Staging

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97
Q

What is Rheumatoid Arthritis called in Children?

A

Still’s Disease

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98
Q

What are seven x-ray finding in a patient with Rheumatoid Arthritis (RA)?

A
  • Symmetrical Distribution
  • Bilateral uniform loss of joint space
  • Rat bite erosions
  • Pannus formation
  • Periarticular Osteoporosis (Localized)
  • Distal Interphalangeal (DIP) joint spared
  • Atlanto-Axial Instability
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99
Q

What four signs seen in the hands of a patient with Rheumatoid Arthritis (RA)?

A

Haygarth’s nodes (Metacarpal Phalangeal (MCP) Joints)
Swan Neck deformity
Boutonniere Deformity
Ulnar or Fibular deviation (Lanois Deformity)

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100
Q

With a patient with Rheumatoid Arthritis (RA), what is the associated condition described as “Benign swelling of the semimembranosus bursa”?

A

Baker’s Cyst (Popliteal Fossa)

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101
Q

What four Labs with be positive in a patient with Rheumatoid Arthritis (RA)?

A

RA Latex
FANA
Erythrocyte Sedimentation Rate (ESR)
C Reactive Protein (CPR)

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102
Q

What type of anemia is seen in a Patient with Rheumatoid Arthritis (RA)?

A

Normocytic Normochromic Anemia

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103
Q

What is the name of the condition that is seen in a patient with Rheumatoid Arthritis (RA) and also has dry eyes and mouth?

A

Sjogren’s

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104
Q

What is another name for Ankylosing Spondylitis (AS)?

A

Marie Stumpell

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105
Q

Who would you co-manage patients with Rheumatoid Arthritis (RA), Systemic Lupus Erythematosus (SLE) and Ankylosing Spondylitis (AS)?

A

Rheumatologist

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106
Q

What age and gender does the condition of Ankylosing Spondylitis (AS) affect?

A

Male

15-35 years of age

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107
Q

Where does Ankylosing Spondylitis (AS) start?

A

Sacroiliac (SI) joint

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108
Q

What is an early sign of Ankylosing Spondylitis (AS)?

A

Low Back Pain (LBP) with morning stiffness

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109
Q

What condition is Ankylosing Spondylitis (AS) associated with?

A

Anterior Uveitis (Iritis)

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110
Q

What three orthopedic test are performed on a patient with Ankylosing Spondylitis (AS)?

A

Chest expansion
Forester’s Bowstring
Lewin Supine

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111
Q

What is the radiographic finding of the Sacroiliac (SI) joint in Ankylosing Spondylitis (AS)?

A

Bilateral Sacroiliac (SI) joint fusion (Ghost Joints)

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112
Q

What are the seven radiographic findings in Ankylosing Spondylitis (AS)?

A 
Shiny Corner Sign (Early)
Bilateral marginal syndesmophytes 
Squaring of the vertebral bodies
Bamboo spine
Dagger Sign
Trolley Track Sign
Poker Sign
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113
Q

What two labs will be positive/increased in Ankylosing Spondylitis (AS)?

A

HLA B27

Erythrocyte Sedimentation Rate

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114
Q

What condition looks identical to Ankylosing Spondylitis (AS), in the pelvis but Gastrointestinal dysfunction?

A

Enteropathic Arthropathy

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115
Q

What are two other names for Enteropathic Arthropathy?

A

Crohn’s Disease

Ulcerative Colitis

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116
Q

What is the age and gender that the condition of Psoriatic Arthritis is seen?

A

Males

20-50 years of age

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117
Q

What three signs will be present in a patient that has Psoriatic Arthritis?

A

Silver Scale lesion on extensors
Pitted nails
Cocktail sausage digits

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118
Q

What are six radiographic findings in a patient with Psoriatic Arthritis?

A 
Non-marginal syndesmophytes of the spine 
Increased joint space
Mouse ear deformities
Pencil in Cup deformity 
Ray Sign
Atlanto-Axial instability
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119
Q

What lab will be positive in a patient with Psoriatic Arthritis?

A

HLA B27

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120
Q

What is another name for Reiter’s Disease?

A

Reactive Arthritis

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121
Q

What gender and age does the condition of Reactive Arthritis commonly affect?

A

Males

20-30 (+/-)

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122
Q

What are three symptoms are seen in patients with Reiter’s Disease?

A

Can’t see, Can’t pee, Can’t Dance with me

Conjunctivitis
Urethritis
Arthritis (Heel Spur)

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123
Q

What Venereal disease is usually the cause of Reactive Arthritis?

A

Chlamydia

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124
Q

What are three radiographic findings seen in Reiter’s Disease?

A

Non-Marginal Syndesmophytes of the spine
Calcaneal Spur (Heel Spur)
Fluffy Periostitis

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125
Q

What lab will be positive in the condition of Reactive Arthritis?

A

HLA B27

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126
Q

What gender is Systemic Lupus Erythematosus (SLE) most commonly seen in?

A

Females

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127
Q

What are the five signs/symptoms of Systemic Lupus Erythematosus (SLE)?

A 
Malar/Butterfly rash (Sunlight precipitates a skin rash)
Oral ulcers
Discoid lesions
Alopecia 
Raynaud's phenomenon
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128
Q

In what condition will Ulnar Deviation straighten out?

A

Systemic Lupus Erythematosus (SLE)

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129
Q

What Labs will be increased/positive in the condition of Systemic Lupus Erythematosus (SLE)?

A

LE Prep
FANA
Erythrocyte Sedimentation Rate (ESR)
Anti-DNA

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130
Q

What two things will be decreased in Systemic Lupus Erythematosus (SLE)?

A

Leukopenia (Decrease in White Blood Cells (WBC))

Thrombocytopenia (Decrease Thrombocyte)

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131
Q

What Is another name for Scleroderma?

A

Progressive Systemic Sclerosis

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132
Q

What gender and age is the condition of Progressive Systemic Sclerosis most commonly effect?

A

Females

30-50 years old

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133
Q

What symptom is associated with Scleroderma?

A

Erosion of the distal tufts of the phalanges

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134
Q

What condition has CREST syndrome?

A

Progressive Systemic Sclerosis

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135
Q

What is CREST Syndrome?

A

C- Calcinosis (Calcium deposits in the skin)
R- Raynaud’s Phenomenon
E- Esophageal Dysmotility (Difficulty Swallowing)
S- Sclerodactyly (Tightening of skin of fingers or toes)
T- Telangiectasia (Dilation of capillaries)

Seen in the condition of Progressive Systemic Sclerosis

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136
Q

What Labs will be increased/positive in Scleroderma?

A 
FANA
RA Latex (30%)
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137
Q

What is another name to Osteitis Condensans Ilia?

A

Osteitis Triangularis

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138
Q

What population is Osteitis Condensans Ilia seen in?

A

Multiparous Female

20-40 years of age

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139
Q

What condition has no labs and is self resolving?

A

Osteitis Condensans Ilia

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140
Q

What is the case management Osteitis Triangularis?

A

Trochanteric Belt for stability

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141
Q

What is the joint space on the x-ray in Osteitis Condensans Ilia?

A

Normal

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142
Q

What is the radiographic finding in Osteitis Triangularis?

A

Bilateral/Symmetrical triangular sclerosis areas on the lower half of the ilium

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143
Q

What is the most common joint affecting the knee?

A

Synoviochondrometaplsia

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144
Q

What condition is seen with “multiple loose bodies within the joint that are round or oval in shape”?

A

Synoviochondrometaplsia

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145
Q

What is another name for Neurogenic Arthropathy?

A

Charcot’s Joint

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146
Q

What four conditions do you often see Charcot’s Joints?

A

Diabetes
Tabes Dorsalis
Syphilis
Syringomyelia

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147
Q

What are the 6 D’s in weight bearing joints?

A 
Distension 
Density of Subchondral sclerosis 
Debris within the joint
Dislocation 
Disorganization 
Destruction of the bone
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148
Q

What are two other names for the condition of Diffuse Idiopathic Skeletal Hyperostosis (DISH)?

A

Forestier’s Disease

Ankylosing Hyperostosis

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149
Q

What is the gender and age often seen is Diffuse Idiopathic Skeletal Hyperostosis (DISH)?

A

Male

Over the age of 40 years old

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150
Q

What symptom is seen in Ankylosing Hyperostosis?

A

Neck stiffness or pain on swelling

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151
Q

What other condition is commonly seen/associated Diffuse Idiopathic Skeletal Hyperostosis?

A

Diabetes Mellitus

Hemoglobin, A1c, Fasting Blood Sugar (FBS)

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152
Q

What ligament is ossified in Forestier’s Disease?

A

Ossification Posterior Longitudinal Ligament (OPLL)

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153
Q

What are the radiographic finding of Diffuse Idiopathic Skeletal Hyperostosis (DISH)?

A

Four (4) contiguous segments involved
Flowing hyperostosis (Anterior Bridging)
Candle wax dripping
Disc space is preserved

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154
Q

What is the treatment for Forestier’s Disease?

A

Adjust; as long as no facet involvement, no inflammation

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155
Q

The HLA B27 lab will be positive in what percentage of patient’s with Ankylosing Hyperostosis?

A

30%

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156
Q

What is another name for Degenerative Joint Disease (DJD)?

A

Osteoarthritis

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157
Q

Is Degenerative Joint Disease (DJD) inflammatory or non-inflammatory disease?

A

Non-inflammatory

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158
Q

What are the most commonly involved joints in Degenerative Joint Disease (DJD)?

A

Weight Bearing Joints (Hip or Knee)

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159
Q

What is a common associated finding with Degenerative Joint Disease (DJD)?

A

Subchondral cyst

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160
Q

What condition usually become more stiff with rest and improves movement with activity?

A

Degenerative Joint Disease (DJD)

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161
Q

What are two complications of Degenerative Joint Disease (DJD)?

A 
Spinal Canal Stenosis
Intervertebral Foramen (IVF) Encroachment
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162
Q

What is the most common area of the spine effected by Degenerative Joint Disease (DJD)?

A

C5/C6

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163
Q

What three findings will you see in a patient’s spine with Degenerative Joint Disease (DJD)?

A

Intervertebral Disc (IVD) narrowing
Osteophytes
Endplate Sclerosis

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164
Q

What are four finding of the hand seen in patients with Degenerative Joint Disease (DJD)?

A
  • Non-uniform loss of Joint space
  • Heberden’s Nodes seen at the Distal Interphalangeal (DIP) Joint
  • Decreased joint space with sclerosis
  • Asymmetrical Distribution
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165
Q

What is the x-ray finding of the hip in Degenerative Joint Disease (DJD)?

A

Decreased superolateral joint space with sclerosis

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166
Q

What is the radiographic finding of the knee in Degenerative Joint Disease (DJD)?

A

Decreased medial joint space with the lateral space preserved

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167
Q

What are three possible etiologies of Degenerative Joint Disease (DJD)?

A

Sports Injury
Unrelated Microtrauma
Genetic

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168
Q

What are the eight conditions classified as Inflammatory Arthritdes?

A

Rheumatoid Arthritis (RA)
Systemic Lupus Erythematosus (SLE)
Scleroderma
Osteitis Condensans Ilia

Psoriatic Arthritis
Enteropathic Arthropathy
Ankylosing Spondylitis
Reactive Arthritis (Reiter’s)

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169
Q

What are the four conditions classified as Degenerative Arthritdes?

A

Degenerative Joint Disease (DJD) (Osteoarthritis)
Diffuse Idiopathic Skeletal Hyperostosis (DISH)
Neurogenic Arthropathy
Synoviochondrometaplsia

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170
Q

What are the four conditions classified as Metabolic Arthritdes?

A
  • Gout
  • Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD)
  • Hydroxyapatite Deposition Disease (HADD)
  • Septic Arthritis
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171
Q

What age and gender is Gout often seen in?

A

Males

Older the 40 years of age

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172
Q

What causes the condition of Gout?

A

Overproduction of uric acid

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173
Q

What are the signs/symptoms of Gout?

A

Extremely painful, red, hot and swollen joint(s)

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174
Q

What is the most common joint for the condition of Gout to effect?

A

Metatarsal Phalangeal (MTP) joint of the big toe

Gout is mono-articular

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175
Q

What is the term for a “swollen first metatarsal phalangeal (MTP) joint”?

A

Podagra

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176
Q

In the condition that has tophi crystals often the ear?

A

Gout

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177
Q

What are the two radiographic findings in Gout?

A

Overhanging Margin

Juxta-articular erosion

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178
Q

What labs will be positive/increased in the condition in Gout?

A

Increased Uric Acid

Positive Erythrocyte Sedimentation Rate (ESR)

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179
Q

What Special Test will be done in the condition of Gout?

A

Joint Aspiration

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180
Q

What is the pharmacologic approach to help patients with Gout?

A

Acute Gout: Colchicine

Chronic Gout: Allopurinol

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181
Q

Who is a patient with Gout referred to?

A

Rheumatologist

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182
Q

What is something a patient with Gout can do to decrease the symptoms?

A

Dietary Changes

Don’t consume Red Wine and Cheese, purines are bad

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183
Q

What is another name for Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD)?

A

Pseudogout

184
Q

What condition has “Thin linear calcification parallel to the articular cortex within the joint space”?

A

Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD)

185
Q

What joint is Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD) most commonly seen in?

186
Q

What is the condition when the cartilage is affected with Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD)?

A

Chondrocalcinosis

187
Q

What is the best way to diagnosis and confirm Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD)?

188
Q

What condition most commonly effects the shoulder?

A

Hydroxyapatite Deposition Disease (HADD)

189
Q

What are the radiographic findings of Hydroxyapatite Deposition Disease (HADD)?

A

Round or oval calcifications near the insertion of the bursa or tendon

190
Q

What condition destroys the disc and has a lab of an increased White Blood Cell (WBC) counts?

A

Septic Arthritis

191
Q

How will an patient with Septic Arthritis present to the office?

A

Fever
Chills
Possible history of trauma/surgery

Joint will be:
Warm
Tender
Swollen

192
Q

What are two other terms of Avascular Necrosis (AVN)?

A

Osteonecrosis

Osteochondrosis

193
Q

What is the major cause of Avascular Necrosis (AVN)?

194
Q

How long does it take Avascular Necrosis (AVN) to heal?

A

8 months to 2 years

All Avascular Necrosis (AVN) are Self-Resolving

195
Q

What condition can Avascular Necrosis (AVN) lead to?

A

Degenerative Joint Disease (DJD)

196
Q

What two test are Special Test for Avascular Necrosis (AVN)?

A

Bone Scan

MRI

197
Q

What is the most common Avascular Necrosis (AVN) of the hand?

A

Scaphoid (Carpal Bone)

198
Q

What is the name of the Avascular Necrosis (AVN) of the Scaphoid?

A

Preiser’s

199
Q

What is the name of the Vertebral End Plate Epiphysis Avascular Necrosis (AVN)?

A

Scheuermann’s

200
Q

What is the location effected by Legg Calve Perthes?

A

Femoral (Head) Epiphysis

Avascular Necrosis (AVN)

201
Q

What bone is effected in Kohler’s Avascular Necrosis (AVN)?

A

Navicular (Tarsal)

Kold Feet

202
Q

What is the most common dislocation of the hand?

A

Lunate (Carpal)

203
Q

What is the name for the Avascular Necrosis (AVN) of the Lunate?

A

Keinboch’s

Kein Hands

204
Q

What bone is effected in Sever’s Avascular Necrosis (AVN)?

205
Q

What is the location of Blount’s Avascular Necrosis (AVN)?

A

Medial Tibial Condyle

206
Q

Where does Freiberg’s Avascular Necrosis (AVN) occur?

A

Head of the 2nd or 3rd Metatarsal

Freiberg’s Foot
(Morton’s Neuroma)

207
Q

Where is the Osteochondritis Dessicans Avascular Necrosis (AVN) located?

A

Articular surface of the Lateral aspect of the Medial Femoral Condyle

208
Q

When there is a Avascular Necrosis (AVN) of the Capitellum what is the name associated with it?

A

Panner’s

209
Q

What is the best radiographic view to see Osteochondritis Dessicans?

A

Tunnel View

210
Q

What population do you often see Osteochondritis Dessicans in?

A

Athletes

+/- 16-25 years old

211
Q

What condition has “knee locks out on extension” and associated with Wilson’s Sign?

A

Osteochondritis Dessicans

212
Q

What condition is most commonly seen +/- 10-16 year olds?

A

Scheuermann’s Disease

213
Q

What are the signs of Scheuermann’s Disease?

A

Round of the shoulders
Increased Kyphosis
Young patients with back pain

214
Q

What are two radiographic signs of Scheuermann’s Disease?

A
  • Slight loss of the anterior body height; of one or more vertebrae (10-15%)
  • Multiple endplate irregularities of three or more continuous vertebrae
215
Q

What are four Case Management ideas for a patient with Scheuermann’s Disease?

A

Thoracolumbar Brace
Strengthen Erector musculature
Stretch the Pectoralis muscle
Stop Physical Activates

216
Q

What two things can Scheuermann’s Disease lead to?

A

Permanent Postural Deformities

Early Degenerative Joint Disease (DJD)

217
Q

What is the name of the condition that has an Avascular Necrosis (AVN) of the femoral head?

A

Legg Calve Perthe’s

218
Q

What population is Legg Calve Perthe’s most commonly seen in?

A

+/- 4-9 Obese Males

219
Q

What are four radiographic findings will you see in Legg Calve Perthe’s?

A
  • Fragmentation of the femoral head (Crescent Sign)
  • Flattening of the femoral head
  • Increased white density of the femoral head (Snow Capped Appearance)
  • Increased joint space
220
Q

What is the appearance of a healed Legg Calve Perthe’s?

A

Mushroom Capped Appearance

221
Q

Who would you refer a patient with Legg Calve Perthe’s?

A

Orthopedist for an “A” Brace

222
Q

What Type of Salter Harris is the condition Slipped Capital Femoral Epiphysis?

A

Type 1 Salter Harris

223
Q

What gender and age is effected in the condition of Slipped Capital Femoral Epiphysis?

A

Males (Boy)

+/- 10-16 years of age

224
Q

What direction does the femoral Head slide in Slipped Capital Femoral Epiphysis?

A

Inferior and Medial

225
Q

What direction does the femoral Neck side in Slipped Capital Femoral Epiphysis?

A

Superior and Lateral

226
Q

What three lines are used to assess Slipped Capital Femoral Epiphysis?

A

Klein’s
Shenton’s
Skinner’s

227
Q

In a patient that has Slipped Capital Femoral Epiphysis, who should they be referred to?

A

Orthopedist

228
Q

What are the components of Putti’s Triad, seen in Congenital Hip Dysplasia?

A

Hypolastic Femoral head
Shallow Acetabular Shelf
Femoral head outside of the Acetabulum

229
Q

What are four orthopedic exams performed in patients with Congenital Hip Dysplasia?

A

Hip Telescoping
Ortolani’s
Barlow’s
Allis’

230
Q

What is the name of the condition that has “Axial migration of the femoral head with uniform loss of joint space”?

A

Protrusio Acetabuli

231
Q

What condition is often seen with Bilateral Protrusio Acetabuli?

A

Rheumatoid Arthritis (RA)

232
Q

What other five conditions are often seen with Protrusio Acetabuli?

A 
Osteoporosis
Osteomalacia
Paget's 
Trauma
Idiopathic
233
Q

What line is used to measure Protrusio Acetabuli?

A

Kohler’s Line

234
Q

On an x-ray what will be completely obliterated in the condition of Protrusio Acetabuli?

A

Kohler’s Teardrop

235
Q

What type of fracture is described as “Portion of the bone torn away by muscle or ligament by traction force”?

A

Avulsion Fracture

236
Q

What is a Comminuted Fracture?

A

Fracture with more than two fragments

237
Q

What is the term used for “Displacement or separation of a slightly moveable joint”?

238
Q

What is a Compound (Open) Fracture?

A

Skin Ruptured and bone Exposed

239
Q

In what population will you see a Greenstick/Hickory Stick Fracture?

A

Children, an incomplete fracture

240
Q

How is an Impaction Fracture described?

A

Bone fragments driven into one another

241
Q

What is the name of the fracture that has “one side of the cortex affected/ incomplete fracture?

A

Torus/Buckling Fracture

242
Q

What kind of fracture is caused by insufficiency or repetitive motion?

A

Stress/Fatigue Fracture

243
Q

What kind of fracture is not always seen on x-ray and my become more evident a week to ten days after the initial injury?

A

Occult Fracture

244
Q

What is the name of the fracture that is seen in the first metacarpal?

A

Bennett’s Fracture

245
Q

What is the name of the fracture seen in the second and third metacarpals?

A

Boxer’s Fracture

246
Q

Where is a Bar Room Fracture most commonly seen?

A

Fracture of the forth and fifth metacarpal

247
Q

What carpal bone is the most commonly fractured?

248
Q

What is the name given to the fracture of the proximal Ulna?

A

Nightstick Fracture

249
Q

What is the name of the fracture that has a fractured ulna with radial head displacement?

A

Monteggia Fracture
M(OOO)UUUU
M= Monteggia
U=Ulna Fractured

250
Q

How is a Galeazzi Fracture described?

A

Fracture of the distal 1/3 of the radius with dislocation of the distal radio-ulnar joint
GRRRRRRR
G=Galeazzi
R=Radial Fractured

251
Q

What fracture type is a “Fracture of the distal radius with Posterior displacement of the distal fragment”?

A

Colles Fracture

252
Q

What is a Smith’s Fracture?

A

Fracture of the distal radius with Anterior displacement of the distal fragment

253
Q

What is the common are of a March/Stress fracture to occur?

A

Second, Third, Forth metatarsals

254
Q

What fracture usually occurs as a transverse fracture at the Base of the fifth metatarsal?

A

Jones Fracture

255
Q

What is the name of an avulsion fracture of a Spinous process?

A

Clay Shoveler’s Fracture

256
Q

What is the most common area for a Clay Shoveler’s Fracture to happen?

257
Q

What is the cause of a Clay Shoveler’s Fracture?

A

Hyper-flexion injury

258
Q

What is the name of the fracture that is Unstable and effects the pedicels bilaterally of C2?

A

Hangman’s Fracture

259
Q

What is the most common cause of a Hangman’s Fracture?

A

Hyper-extension injury

260
Q

What fracture type is a “Fracture through the anterior and posterior arches of the atlas due to axial compression”?

A

Jefferson Bursting Fracture

261
Q

What is often seen on x-ray in a patient that has a Jefferson Bursting Fracture?

A

Large Periodentoid Space

262
Q

What type of Odontoid fracture is an “Avulsion of the tip of the dens”?

263
Q

How is a Type II Odontoid Fracture described?

A

Fracture through the base of the dens

264
Q

What Type of Odontoid Fracture is through the Body of C2?

265
Q

What is the name of the fracture that is described as “Avulsion fracture of the anterior inferior aspect of the vertebral body from a hyperextension trauma”?

A

Teardrop Fracture

266
Q

Where is the most common place for a Teardrop Fracture to happen?

267
Q

What other issues is seen in patient’s with a Teardrop Fracture?

A

Acute Anterior Cervical Cord Syndrome

268
Q

Is a Teardrop Fracture stable or unstable?

A

Highly Unstable Fracture

269
Q

What condition effects the Tibial Apophysis in patients of +/- 10-16 years of age?

A

Osgood Schlatter’s

270
Q

What kind of brace is used in Osgood Schlatter’s Disease?

A

Cho-Pat Brace

271
Q

What are two symptoms of Osgood Schlatter’s Disease?

A

Pinpoint Pain

Swelling

272
Q

What is the name of the avulsion fracture of the ischial tuberosity?

A

Rider’s Bone Fracture

273
Q

What fracture is described as a “Horizontal fracture through a single body and posterior arch”?

A

Chance Fracture

274
Q

What is another name for the Chance Fracture?

A

Seatbelt Fracture

275
Q

What is the most common levels for a Seatbelt/Chance Fracture to occur at?

276
Q

What condition is a “Fracture through the pars interarticularis without slippage?

A

Spondylolysis

277
Q

How is the condition of Spondylolisthesis described?

A

Slippage of the vertebral body with or without fracture

278
Q

What type of Spondylolisthesis is a Congenital defect?

A

Type I/ Dysplastic

279
Q

What is the definition of a Type II/Isthmic Spondylolisthesis?

A

Fracture through the Pars

280
Q

What is the most common level of a Type II/Isthmic Spondylolisthesis?

281
Q

What is a common population to see a Type II/Isthmic Spondylolisthesis?

282
Q

What is the Type of Spondylolisthesis that is Degenerative Joint Disease (DJD) of the facet joint?

A

Type III/Degenerative

283
Q

What is the most common level to have a Type III/Degenerative Spondylolisthesis?

284
Q

Where is the fracture located in a Type IV/Traumatic Spondylolisthesis?

A

Fracture through the pedicle (Fracture anywhere but the Pars)

285
Q

What Type of Spondylolisthesis is considered Pathological?

A

Type V

Seen in Bone Diseases (i.e Paget’s)

286
Q

What two grades of Spondylolisthesis can be Adjusted?

A

Grade 1

Grade 2

287
Q

What is the preferred Grading Scale of Spondylolisthesis?

A

Meyerding’s

288
Q

What are the grades and percentages of Spondylolisthesis?

A

Grade 1- Up to 25%
Grade 2- 26-50%
Grade 3- 51-75%
Grade 4- 76-100%

289
Q

What Grade of Spondylolisthesis has the Radiographic finding of “Inverted Napoleon Hat Sign”?

A

Grade 3

Grade 4

290
Q

What is the purpose of flexion and extension films?

291
Q

What Special Test should be order in a patient that has a Spondylolisthesis?

292
Q

What is the most common dislocated carpal bone?

293
Q

What is associated with a Lunate Dislocation?

294
Q

What two signs are associated with a Scaphoid Dislocation?

A

Terry Thomas Sign

Signet Ring Sign

295
Q

What joint is effective in a chronic anterior shoulder dislocation?

A

Glenohumeral Joint

296
Q

What two deformities are seen in Glenohumeral Joint Dislocation?

A

Bankhart

Hill-Sacks/Hatchet

297
Q

What is a SLAP Lesion?

A

Superior Labrum Anterior to Posterior

298
Q

What is torn is a SLAP Lesion?

A

Glenoid Labral Tear

299
Q

What condition is associated with a SLAP Lesion?

A

Shoulder Instability

300
Q

What is the Congenital Anomaly that the “Arcuate foramen form when the Atlanto-occipital ligament calcifies”?

A

Posterior Ponticus

301
Q

What is another name for the Posterior Ponticus?

A

Posticus Ponticus

302
Q

What two structures are transmitted through the Posticus Ponticus?

A

Sub-occipital nerve

Vertebral Artery

303
Q

What condition is there a 20% missing of the Transverse Ligament?

A

Down’s Syndrome

304
Q

What area will be increased on radiographic films in a Patient with Down’s Syndrome?

A

Atlanto Dens Interspace (ADI)

Must do flexion and extension films before adjusting

305
Q

What is the name of the condition when the “cephalic part of the dens is not fused with the body of C2?

A

Os Odontoideum

306
Q

What finding are seen on the x-ray of a patient that has an Os Odontoideum?

A

Smooth, Wide, Lucent defect between the body of C2 and the dens

307
Q

What condition has two adjacent vertebrae ossified at birth?

A

Congenital Block

308
Q

What are two radiographic findings in Congenital Block?

A

Wasp Waist Appearance

Hypoplastic (Rudimentary) Disc

309
Q

What condition has the following three symptoms:
Short Webbed Neck
Low Hair Line
Decreased Range of Motion (ROM)?

A

Klippel-Feil Syndrome

310
Q

What two other conditions is Klippel-Feil syndrome associated with?

A

Sprengle’s Deformity

Onovertebral Bone

311
Q

What is the definition of Klippel-Feil Syndrome?

A

Multiple Congenital Blocks

312
Q

What two associated conditions are seen in Pedicle Agenesis?

A

Contra lateral pedicle hypertrophy

Sclerosis

313
Q

What is the name of the Congenital Anomaly that is “Failure of the anterior center of the vertebral body to ossify properly”?

A

Butterfly Vertebra

314
Q

What is the Congenital Anomaly that has “Failure of development of a lateral ossification center”?

A

Hemivertebra

315
Q

What condition can an isolated wedged vertebra (Hemivertebra) cause?

316
Q

What type of deformity is often seen with a Hemivertebra?

A

Gibbus Deformity

317
Q

What Congenital Anomaly is “Failure for the lamina to fuse”?

A

Spina Bifida

318
Q

In the condition of Spina Bifida, what lab will be Increased and what macronutrient with be Deficient?

A

Increased: Fetoprotein
Deficient: Folic Acid

319
Q

What is Sacralization (Transitional Vertebrae)?

A

L5 Transverse Processes (TP) may fuse or form joints with the sacrum

320
Q

What is it called if a patient has six lumbar vertebrae or the first sacral segment appears like a lumbar segment?

A

Lumbarization (Transitional Vertebrae)

321
Q

What is it called when two articular plans/facets are asymmetrical?

A

Facet Tropism

322
Q

What is the most common level for Facet Tropism to occur?

323
Q

What is Knife-Clasp Syndrome?

A

Spina Bifida of S1 with L5 Spinous enlargement

324
Q

In what movement is pain caused in Knife-Clasp Syndrome?

325
Q

What is the angle for Coxa Vara and Coxa Valga?

A

Cox Vara: Less than 120 degrees

Cox Valga: Greater than 130 degrees

326
Q

What line is used to measure both Coxa Vara and Coxa Valga?

A

Mikulicz’s

327
Q

What is the name of the abnormality of the upper extremity that has a shortened distal radius?

A

Madelung’s Deformity

328
Q

What two things can cause Madelung’s Deformity?

A
  • Asymmetrical prominence of the ulnar styloid (Radial Deviation)
  • Posterior subluxation of the distal ulna
329
Q

What is the upper extremity abnormality that is described as “Ulna is usually shorter than the radius”?

A

Negative Ulnar Variance

330
Q

When is a Negative Ulnar Variance often seen?

A

With a Scapho-Lunate dislocation

331
Q

What is the name of the condition that has “Calcification of the medical collateral ligament”?

A

Pelligrini Steida

332
Q

What is the name of the condition that has “calcification of a muscle belly”?

A

Myositis Ossificans

333
Q

What two muscles will you often see the condition of Myositis Ossificans?

A

Biceps

Quadriceps

334
Q

What is the name of the condition that has “calcification within veins”?

A

Pheboliths

335
Q

Is Pheboliths symptomatic or asymptomatic?

A

Asymptomatic

336
Q

On what x-ray view will you see the Fat Pads of the elbow?

337
Q

What is often seen when the Fat Pats of the Elbow are disrupted?

A

Fracture of the radial head

338
Q

What age and gender do you often see a Calcified Prostate?

A

Males

Over the age of 50

339
Q

Where is the prostate located/ where will the patient feel pain?

A

On top of the symphisis pubis

340
Q

What two labs are increased if a patient has Prostate issues?

A

Prostate Specific Antigen (PSA)

Acid Phosphatase

341
Q

Where does Prostate issues most commonly metastasize to?

A

Lumbar Spine

342
Q

What lab will be increased in metastasized prostate issues?

A

Alkaline Phosphatase

343
Q

What is the most common benign tumor in females?

A

Uterine Fibroid

344
Q

What are two other names for a Uterine Fibroid; tumor of smooth muscle?

A

Fibroid Cyst

Leiomyoma

345
Q

What is the referral pain for a patient with Cholelithiasis?

A

Inferior border of the right scapula (Viscerosomatic)

346
Q

What organ does the term Cholelithiasis refer to?

A

Gallbladder

347
Q

What two Special Test are used for the condition of Cholelithiasis?

A

Ultrasound

Cholecystogram

348
Q

What is the most common location of a Abdominal Aortic Aneurysm (AAA)?

A

Distal to the Renal Arteries

349
Q

At what diameter is it classified as an Abdominal Aortic Aneurysm (AAA)?

A

Larger than 3.8 cm

Normal Abdominal Aortic can measure up to 3.8 cm

350
Q

What are three radiographic findings of Abdominal Aortic Aneurysm (AAA)?

A

Aortic Dilation
Curvilinear Calcification
Fusiform Appearance

351
Q

What four Special test would you do for a patient who has an Abdominal Aortic Aneurysm (AAA)?

A

Doppler Ultrasound
Diagnostic Ultrasound
Ultrasonography
CT

352
Q

Who do you refer a patient with an Abdominal Aortic Aneurysm (AAA) to?

A

Vascular Specialist

353
Q

What are the two classic radiographic findings in the condition of Sickle Cell Anemia?

A

“Hair on End” in the skull

“H” shaped vertebrae

354
Q

What are two other names for Thalassemia?

A

Cooley’s Anemia

Mediterranean Anemia

355
Q

What condition is seen with a “Hereditary disorder of hemoglobin synthesis”

A

Thalassemia

356
Q

What kind of Anemia is seen in patients with Thalassemia?

A

Microcytic Hypochromic Anemia

357
Q

What are the two x-ray finding is patients with Thalassemia?

A

“Erlenmeyer Flask deformity”– Widened Epiphysis

“Hair on End” in the skull

358
Q

What gender and age is Hyperparathyroidism often seen in?

A

Females

30-50 years old

359
Q

What two things does an overactive Parathyroid gland cause?

A

Increase: Blood Calcium
Decrease: Phosphorus

360
Q

In what condition will you see “Brown Tumors” (Central Geographic osteopenia in bones)?

A

Hyperparathyroidism

361
Q

What are the two classic radiographic findings in Hyperparathyroidism?

A

“Salt and Pepper” Skull

“Rugger-Jersey Spine”

362
Q

What lab will be increased in Hyperparathyroidism?

A

Alkaline Phosphatase

363
Q

What is another name for Osteopetrosis?

A

Marble Bone

364
Q

What condition is hereditary and an absents of bone marrow?

A

Osteopetrosis

365
Q

What are two associated conditions with Osteopetrosis?

A

Anemia

Hepatosplenomegaly

366
Q

What are the early and late radiographic findings of Osteopetrosis?

A

Early: “Bone within a Bone”
Late: “Sandwich Vertebrae”

367
Q

A deficiency in one of the three following macronutrients can cause Rickets?

A

Vitamin D
Vitamin C
Phosphorus

368
Q

Where is Rickets most commonly seen?

A

At the growth plates, usually of long bones

369
Q

What are common muscle finding in a patient with Rickets?

A

Weakness

Tetany

370
Q

What will be three things seen on x-ray in a patient with Rickets?

A
  • “Paintbrush Metaphysis” (Absent zone of Provisional Calcification)
  • Bone Deformity
  • Lucency
371
Q

What special imaging uses a contrast and has a 10X better image quality than plan film?

372
Q

What kind of units is a CT measured in?

A

Hounsfield

373
Q

What are seven major conditions that can a CT help with?

A
  1. Anything in the LUNG
  2. Aneurysms
  3. Brodie’s Abscess
  4. Spina Bifida
  5. Spondylitis
  6. Spinal Canal Stenosis
  7. Lateral Recess Stenosis
Minor Things:
Discitis
Osteomyelitis
Occult fractures
Bone fragment locations
Intra-articular fractures 
Calcification of soft tissue 
Traumatic Lesions
Pathologies 
Abnormalities
374
Q

What Special Imaging measures bone Density for Osteoporosis?

A

Dual Energy X-Ray Absorptiometry (DEXA Scan)

375
Q

What is the usual radioactive injection substance in a Bone Scan?

A

Technetium 99

376
Q

What is another name for a Bone Scan?

A

Scintigraphy

377
Q

What does a Bone Scan measure?

A

“Attempt” to lay down new bone

378
Q

What condition does a Cold Bone Scan indicate?

A

Multiple Myeloma (MM)

379
Q

What five conditions does a Hot Bone Scan indicate?

A 
Avascular Necrosis (AVN) (ALL)
Metastatic Disease (Blastic and Lytic)
Paget's 
Hodgkin's
Fractures
380
Q

What Special Imaging shows Soft Tissue 100x better than CT?

381
Q

MRI does not use radiation, what is used instead?

A

Gadolinium

382
Q

What three conditions is MRI best for?

A 
Multiple Sclerosis (MS);plaqueing in brain and spinal cord
Avascular Necrosis
383
Q

T1 weighted MRI are used for what conditions?

A

Fatty Pathologies (i.e. Muscular Dystrophy)

384
Q

T2 weighted MRI are used for what conditions?

A

Water Density (i.e. Cerebrospinal Fluid (CSF))

385
Q

What color is bone on MRI?

A

Black (Signal Void)

386
Q

In an MRI what color is the weighted component?

387
Q

What Special Imaging utilizes signal intensities and surface coils?

388
Q

What Special Imaging is used for Soft Tissue?

389
Q

What six components are seen using the Special Imaging; MRI?

A 
Intervertebral Disc (IVD)
Spinal Cord
Meninges
Meniscus
Ligaments
Bone
390
Q

Where is the Basilar Angle Line drawn from?

A

Drawn from the nasion to the center of the Sella Turcica

A line is drawn from the basion (Anterior Foramen Magnum) to the center of the Sella Turcica.

391
Q

What is the Significance of (Martin’s) Basilar Angle?

A

If the angle is greater than 152 degrees it indicates Platybasia which is associated with Basilar Impression

392
Q

What are the landmarks that McGregor’s Line is drawn from?

A

From the hard palate to the base of the occiput

393
Q

What is the significance of McGregor’s Line?

A

Most accurate line to evaluate Basilar Impression

If the odontoid is greater than 8mm above this line in males, or greater than 10mm in females, it indicates Basilar Impression

394
Q

What are the landmarks of Chamberlain’s Line?

A

Hard palate to the Opishtion (Posterior foramen Magnum)

395
Q

What is the significance of Chamberlain’s Line?

A

If the odontoid is more than 7mm above this line, it indicates Basilar Impression

396
Q

What Landmarks are McRae’s Line drawn from?

A

Anterior foramen magnum (Basion) to the posterior foramen magnum (Opishtion)

397
Q

What is the Significance of McRae’s Line?

A

If the odontoid is above this line, it indicates Basilar Impression

398
Q

What are the Landmarks used to measure the Atlantodental Interspace (ADI)?

A

C1 (Atlas) anterior tubercle to the odontoid

399
Q

What is the Significance of the Atlantodental Interspace (ADI)?

A

Space larger than 3mm in Adults, 5 mm in Children

Indicates: Transverse ligament rupture or instability due to trauma

Down’s Syndrome or Inflammatory Arthritis

400
Q

What Landmark’s are used to drawn George’s Line?

A

Posterior body margins are checked for alignment with what should be a smooth, continuous line

401
Q

What is the Significance of George’s Line?

A

Discontinuous, line may indicate A-P vertebral malposition such as:
Anterolisthesis
Retrolisthesis

402
Q

What Landmarks are used to draw the Posterior Cervical Line?

A

Lines drawn at each spinolaminar junction should form a smooth arc-like curve

403
Q

What is the Significance of the Posterior Cervical Line?

A

Discontinuous, line may indicate A-P vertebral malposition such as:
Anterolisthesis
Retrolisthesis

404
Q

What are the Landmarks for the Stress Lines of the Cervical Spine?

A

Lines are drawn at the posterior bodies of C2 and C7

405
Q

What is the Significance of the Stress Lines of the Cervical Spine?

A

Flexion should intersect at C5/C6
Extension should intersect at C4/C5

May be altered by muscle spasm, joint fixation, or disc degeneration

406
Q

What is the Landmarks for Prevertebral Soft Tissue?

A

Anterior vertebral bodies to posterior margins of air shadow of:
Pharynx
Larynx
Trachea

407
Q

What is the significance of the Prevertebral Soft Tissues?

A

Indicates a soft tissue mass, tumor (No accident), infection, Hematoma (Injury)

Spaces
Retropharyngeal (C2-C4): Greater than 7 mm
Retrolaryngeal (C5): Greater than 14 mm
Retrotracheal (C6-C7): Greater than 22 mm

408
Q

What Landmarks are used for Cobb’s Method?

A

Locate the superior and inferior extremes of the scoliosis

Draw a parallel line through the superior end plate of extreme superior vertebra and though the inferior end plate of the extreme inferior vertebra

Intersecting perpendicular lines are drawn and the angle is measured

409
Q

What is the Significance of Cobb’s Method?

A

Best Method to evaluate Scoliosis

410
Q

What Landmarks are used for Risser-Ferguson Method?

A

Locate the superior and inferior extremes of scoliosis and the apical segment

Diagonal lines are drawn to locate the center of the vertebral bodies

Two lines are drawn connecting the center of the apical segment with each end vertebra and resulting angle is measured

411
Q

What is the Significance of Risser-Ferguson Method?

A

Scoliosis Evaluation

Values are 25% below Cobb Method of evaluation

412
Q

What Landmarks are used to draw Sacral Inclination?

A

Tangential line is drawn parallel and through the posterior margin of S1 and a vertical line is drawn intersecting the sacral line

413
Q

What is the Significance of Sacral Inclination?

A

Hypo/Hyperlordosis

Normal angle: 30-72 degrees
Average angle: 46 degrees

414
Q

What Landmarks are used to draw the Lumbosacral Angle?

A

Oblique lines are drawn through and parallel to the sacral base

Horizontal line parallel to the bottom or the edge of the film

415
Q

What are two other names for the Lumbosacral Angle?

A

Sacral Base Angle

Ferguson’s Angle

416
Q

What is the Significance of the Sacral Base Angle?

A

Hypo/Hyperlordosis

Normal angle: 26-57 degrees
Average angle: 41 degrees

417
Q

What Landmarks are used to draw Meyerding’s Grading Method of Spondylolisthesis?

A

The sacral base is divided into quadrants and the relative position of the posterior inferior aspect of L5

418
Q

What is the Significance of Meyerding’s Grading Method?

A

Determines the degree of Anterolisthesis

419
Q

What Landmarks are used to draw Ullman’s Line?

A

Line drawn parallel and through the sacral base

Perpendicular line drawn from the sacral promontory

420
Q

What is another name for Ullman’s Line?

A

Garland Thomas Line?

421
Q

What is the Significance of Ullman’s Line?

A

L5 beyond the perpendicular line: Spondylolisthesis

422
Q

What are the Landmarks used to draw Eisenstein’s Method?

A

Line drawn to connect the tips of the superior and inferior articular processes
The distance to the posterior body margin an the midpoint is measured

423
Q

What is the Significance of Eisenstein’s Method?

A

A measurement less than 15 mm: Spinal Canal Stenosis

424
Q

What are the Landmarks used for Canal/Body Ratio?

A

A: Interpedicular Distance
B: Sagittal Canal Dimension (Eisenstein’s Method)
C: Transverse Body Dimension
D: Sagittal Body Dimension

425
Q

What is the Significance of Canal/Body Ratio?

A

Ratio: 1x2/3x4

Higher the ratio, the smaller the canal

If greater than 1.6 at L3, L4 of if the ratio is 1:6.5 at L5=
Canal Stenosis

426
Q

What Landmarks are used to drawn the Lumbosacral Disc Angle?

A

Lines are drawn parallel and through the inferior end plate of L5 and the Superior end plate of S1

427
Q

What is the Significance of the Lumbosacral Disc Angle?

A

Hypo/Hyperlordosis

Normal angle: 10-15 degrees

428
Q

What is another name for Ferguson’s Line?

A

Lumbar Gravity Line

429
Q

What Landmarks are used to draw Ferguson’s Line?

A

Vertical line is drawn though the center of the L3 vertebral body

430
Q

What is the Significance of the Lumbar Gravity Line?

A

The line should intersect the sacral base

Line Anterior to the Sacrum: Hyperlordosis
Line Posterior to the Sacrum: Hypolordosis

431
Q

What Landmarks are used to draw Macnab’s Line?

A

A line is drawn parallel and through the inferior end plate

432
Q

What is the Significance of Macnab’s Line?

A

If the line intersects the superior articular process of the vertebra below:
Facet Imbrication
Extension Malposition

433
Q

What Landmark’s are used to draw Hadley’s “S” Curve?

A

A curvilinear line is drawn along the inferior aspect of the transverse process and the inferior articular process, and through the joint space to the superior articular process of the vertebrae below

434
Q

What is the significance of Hadley’s “S” Curve?

A

Should be a smooth “S” shaped curve

An interruption in the “S” curve indicates:
Subluxation
Facet Imbrication

435
Q

What are the Landmarks used to draw Kohler’s Line?

A

A line is drawn along the Pelvic inlet to the outer aspect of the Obturator Foramen

436
Q

What is the Significance of Kohler’s Line?

A

If the Acetabular floor crosses the line it indicates:
Unilaterally: Protrusio Acetabuli
Bilaterally: Rheumatoid Arthritis (RA)

437
Q

What Landmarks are used to draw Shenton’s Line?

A

A smooth curvilinear line is drawn along the inferior femoral neck to the superior aspect of the Obturator foramen

438
Q

What is the Significance of Shenton’s Line?

A

An interruption/discontinuous line indicates:
Dislocation
Femoral Neck Fracture
Slipped Capital Femoral Epiphysis (SCFE)

439
Q

What Landmarks are used to draw the Iliofemoral Line?

A

A smooth curvilinear line is drawn along the outer ilium, across the joint and onto the femoral neck

440
Q

What is the Significance of the Iliofemoral Line?

A 
Bilateral asymmetry indicated:
Slipped Capital Femoral Epiphysis (SCFE)
Dislocation
Fracture
Dysplasia
441
Q

What Landmarks are used to draw the Femoral Angle?

A

Two lines are drawn through and parallel to the mid-axis of the femoral shaft and the femoral neck

442
Q

What is another name for the Femoral Angle?

A

Mikulicz’s Angle

443
Q

What is the Significance of the Femoral Angle?

A

Normal is 120-130 degrees

Less than 120 degrees: Coxa Vara
Greater than 130 degrees: Coxa Valga

444
Q

What Landmarks are used to draw Skinner’s Line?

A

Line drawn through and parallel to the femoral shaft

Perpendicular line is drawn tangential to the tip of the greater trochanter

445
Q

What is the Significance of Skinner’s Line?

A

Fovea Capitus should lie above or at the level of the trochanter line.
If the Fovea Capitus falls below the line, it indicates:
Fracture
Coxa Vara
Cox Valga

446
Q

What Landmarks are used to draw Klein’s Line?

A

A line is drawn along the outer margin of the femoral neck

447
Q

What is the Significance of Klein’s Line?

A

The femoral head should intersect this line
Failure to intersect this line indicates:
Slipped Capital Femoral Epiphysis (SCFE)

448
Q

What are the Landmarks used for the Patellar Position?

A

A line is drawn between the superior and inferior patellar pole
A line is drawn between the inferior patellar pole and the Tibial tubercle

449
Q

What is the Significance of the Patellar Position?

A

Patellar length and patellar tendon should be approximately equal

If the tendon length is 20% greater than the patellar length indicates:
Patella Alta

450
Q

What are the Landmarks for Heel Pad Measurement?

A

The shortest distance is measured between the plantar surface of the calcaneus and the external skin

451
Q

What is the Significance of the Heel Pad measurement?

A

If the distance is
Greater than 25 mm in males
Greater than 23 mm in females

Indicates increased thickening often associated with Acromegaly

452
Q

What are the Landmarks used for Boehler’s Angle?

A

The three highest points on the superior aspect of the Calcaneus are connected with two lines

453
Q

What is the Significance of Boehler’s Angle?

A

If the angle is greater than 28 degrees it indicates:
Calcaneal Fracture (Less than 22 Degrees)
Dysplastic Calcaneus

Normal Angle: 28-40 degrees
Average Angle: 34 degrees

454
Q

What are three signs/symptoms a patient with Reye’s Syndrome will have?

A

Deafness
Neurological Defects
Seizures

455
Q

What condition will have Anderssen Lesions?

A

Ankylosing Spondylitis (AS)

456
Q

What condition will you see a Subchondral Cyst?

A

Degenerative Joint Disease (DJD)

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