Diagnostic Imaging (Irene Gold) Part II and III Flashcards
1
Q
Who are all Benign Bone Tumors (BBT) referred to?
A
Orthopedist
2
Q
What are the four characteristics of all Benign Bone Tumors (BBT)?
A
Short zone of transition
Incidental finding
Geographic lesion
Encapsulated
3
Q
What is the name of the most common Benign Bone Tumor (BBT) of the appendicular skeleton?
A
Osteochondroma
4
Q
What are two types of Osteochondromas?
A
Pedunculated (Coat Hanger Exostosis/Cauliflower like)
Sessile
5
Q
What is the name for multiple Osteochondromas?
A
Hereditary Multiple Exostosis (HME)
6
Q
What percentage of Hereditary Multiple Exostosis (HME) undergo malignancy?
A
20%
7
Q
What is another name for a Unicameral Bone Cyst (UBC)?
A
Simple Bone Cyst (SBC)
8
Q
What is the location of a Simple Bone Cyst (SBC)?
A
Diaphyseal/Metaphyseal
Centrally Located
9
Q
What age is a Simple Bone Cyst (SBC) usually seen in?
A
Under the age of 20 years old
10
Q
What are the common locations of a Simple Bone Cyst (SBC) to appear?
A
Proximal:
Tibia
Fibula
Humerus
11
Q
What Radiographic sign is associated with a Simple Bone Cyst (SBC)?
A
Fallen Fragment Sign
12
Q
What is the location of a Aneurysmal Bone Cyst (ABC)?
A
Diaphyseal/Metaphyseal
Eccentrically Located
13
Q
What age and gender is an Aneurysmal Bone Cyst (ABC) usually seen in?
A
Females under the age of 20
14
Q
What is the location of a Giant Cell Tumor (GCT)?
A
Epiphyseal/Metaphyseal
15
Q
What age range usually has a Giant Cell Tumor (GCT)?
A
20-40 year olds
16
Q
What “classification” do 20% of Giant Cell Tumors become?
A
Quasi-Malignant
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
18
Q
What kind of appearance is seen on x-ray of a Giant Cell Tumor (GCT)?
A
Soap Bubble (Saponaceous)
19
Q
What is the location of a Chondroblastoma?
A
Epiphyseal/Metaphyseal
20
Q
What age would you commonly see a Chondroblastoma?
A
Younger than the age of 20
21
Q
What two Benign Bone Tumors (BBT) have night pain relieved by aspirin?
A
Osteoid Osteoma
Brodie’s Abscess (Chronic Osteomyelitis)
22
Q
What is another name for a Brodie’s Abscess?
A
Chronic Osteomyelitis
23
Q
What is the x-ray appearance for a Osteoid Osteoma and Brodie’s Abscess?
A
Radiolucent central “nidus” with severe reactive sclerosis
24
Q
What is the most common Benign Bone Tumor (BBT) of the hand?
A
Enchondroma
25
What kind of appearance with an Enchondroma have?
Stippled
| Cortical thinning
26
What is the name of the condition that is multiple Enchondromas?
Ollier's Disease
27
What percentage of people with Ollier's Disease may have malignant degeneration?
10%-50%
28
What two things will patients with Ollier's Disease have?
Predisposed to fracture
| Permanent Deformities
29
If a patient has soft tissue calcification and Enchondromas what is the condition called?
Maffucci's Syndrome
30
What is the most common Benign Bone Tumor (BBT) of the spine?
Hemangioma
31
What is another name for a Hemangioma?
Vascular Neoplasm
32
What is the appearance of a Hemangioma on x-ray?
Vertical Striations
| Corduroy Cloth Appearance
33
What is the name of the Benign Bone Tumor (BBT) that appears as a round/oblong radiopaque lesion; Bone Island?
Enostoma
34
What is it called when there are multiple Enostomas?
Osteopoikilosis
35
What is the name of the Benign Bone Tumor (BBT) that most commonly affects the neural arch?
Osteoblastoma
36
What vertebral level is most commonly effected by a Osteoblastoma?
Atlas, C1
37
What is the most common Benign Bone Tumor (BBT) to affect the skull?
Osteoma
38
In what part of the skull is an Osteoma most commonly found?
Frontal Sinuses
39
What x-ray view is best to see an Osteoma?
Caldwell Projection
40
What Benign Bone Tumor (BBT) has a monostotic form, is dark on x-ray and must have deformed bone?
Fibrous Dysplasia
41
What x-ray sign is associated with Fibrous Dysplasia; Monostotic form (70%)?
Rind Sign
42
In the condition of Fibrous Dysplasia what physiologically replaces normal bone?
Fibrous Tissue
43
What are four Characteristics and/or Appearances of Fibrous Dysplasia?
Saber Shin Tibia
Sheppard's Crook (Hip)
"Ground Glass" appearance
Jagged "Café Au Lait" spots ("Coast of Maine")
44
What Benign Bone Tumor (BBT) has a familial history?
Neurofibromatosis
45
What are eight Characteristics and/or Appearances of Neurofibromatosis?
- 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
46
What is another name for Multiple Myeloma?
Plasma Cell Sarcoma
47
What age is Multiple Myeloma often seen in?
50 years old
48
What are three characteristics are seen in Multiple Myeloma?
-Cachexia (Weakness or wasting of the body, from chronic disease)
-Weight Loss
Anemia
49
What is the most common primary malignancy of bone?
Multiple Myeloma
50
What part of the bone is effected in the condition of Multiple Myeloma?
Plasma Cells of Bone Marrow
51
What two "Terms/Names" are associated with Multiple Myeloma?
"Punched Out Lesions" (Multiple Dark Densities)
| "Rain Drop Skull"
52
What additional condition is can be seen in Multiple Myeloma?
Pathological collapse of a vertebra (Vertebral Plana)
53
What are four lab findings in Multiple Myeloma?
M Spike on the Immunoelctrophoresis
Reversal of the Albumin/Globulin (A/G) Ratio
Bence-Jones Proteinuria
Elevated Erythrocyte Sedimentation Rate (ESR)
54
What Special Test is ordered for Multiple Myeloma and what is the outcome of the Special test?
Special Test: Bone Scan
| Outcome/Result: Cold
55
What is the most common malignant tumor of bone?
Metastatic Disease (Lytic and Blastic)
56
What is the age that is associated with Lytic Metastatic Disease?
Older than 40
57
What two symptoms are often seen in a patient with Lytic Metastatic Disease?
Recent Unexplained weigh loss
| Skeletal Pain worse at night
58
What are the x-ray appearance of Lytic Metastatic Disease?
Moth eaten
Permeative pattern
"Eats" away pedicle
"Swiss Cheese" Skull
59
What lab will be ordered for both Lytic/Blastic Metastatic Disease?
Alkaline Phosphatase
60
What Special Test and result/outcome are ordered for a patient with both Lytic/Blastic Metastatic Disease?
Special Test: Bone Scan
| Result/Outcome: Hot
61
What are the three conditions that have an Ivory White Vertebrae (IWV) on x-ray?
MPH
Metastatic Disease (Blastic)
Paget's
Hodgkin's Disease
62
What is the most common age and gender for the condition of Hodgkin's Disease?
Males
| 20-40 years old
63
Along with an Ivory White Vertebrae (IWV) what other x-ray finding is seen in a Hodgkin's Disease patient?
Anterior Scalloping of the vertebral body
64
What will be seen on the P-A chest film of a patient with Hodgkin's Disease?
Unilateral hilar lymphadenopathy
65
How is Hodgkin's Disease confirmed?
Biopsy
66
What does the presence of Reed-Sternberg Cells indicate?
Hodgkin's Lymphoma
67
What age is Blastic Metastatic Disease seen in?
Over the age of 40
68
Where does Blastic Metastatic Disease metastases to and from?
Starts in the Prostate and goes to the Lumbar Spine (Through the Valves of Batson)
69
What is another name for Paget's Disease?
Osteitis Deformans
70
What age and gender is the condition Osteitis Deformans often seen in?
Males over the age of 50
71
What are the four stages of Paget's Disease?
Lytic or Destructive
Combined
Sclerotic
Malignant (Osteosarcoma)
72
What six thing are caused on x-ray with a patient with Paget's Disease?
```
Cortical Thickening
Picture Frame Vertebrae
Bone Expansion
Increased Bone Density
Coarsened Trabeculae
Bowing Deformities
```
73
What Lab and Result/Outcome is ordered for a patient with Paget's Disease or Osteosarcoma?
Lab: Alkaline Phosphatase
| Result/Outcome: Increased
74
What Special Test and Result/Outcome is ordered for a patient with Paget's Disease or Osteosarcoma?
Special Test: Bone Scan
| Result/Outcome: Hot
75
What is the most common malignancy found in children?
Osteosarcoma
76
In what area of the bone is Osteosarcoma seen?
Diaphyseal
77
What age group is Osteosarcoma seen in most commonly?
10-30
78
What kind of reaction is seen in Osteosarcoma?
Periosteal Reaction
Speculated
Radiating
Sunburst
79
What two conditions are seen in patients over the age of 40, that have a periosteal reaction (Speculated/Radiating/Sunburst) reaction of bone?
Chondrosarchoma
| Fibrosarcoma
80
What condition of bone is often seen in patients aged 10-25 years old?
Ewing's Sarcoma
81
In what area of the bone is Ewing's Sarcoma often found in?
Diaphysis of Long Bones
82
What type of Periosteal Reaction is seen in Ewing's Sarcoma?
Multi-Paralleled Onion Skin (Laminated)
83
What are three other x-ray findings associated with Ewing's Sarcoma?
Bone expansion
Codman's Triangle
Saucerization
84
What is the name of the condition see in patients over 40 years old, that is described as "Aberrant notochordal Cell tumor"?
Chordoma
85
What are the two most common locations for a Chordoma?
Most Common- Sacrum
| 2nd Most Common- Skull
86
What age and gender range are most effected by scoliosis?
Females
| 13-19
87
How is scoliosis named?
For the side of major Convexity
88
What is the most common type of Scoliosis?
Right Thoracic Convex Idiopathic Scoliosis
89
In Rotatory Scoliosis to which side do the Spinous Processes deviate?
Concavity
90
In Simple Scoliosis what way do the Spinous Processes deviate?
Convexity
91
What two lines are used to measure Scoliosis?
Cobb's
| Resser Ferguson's
92
What is the treatment of a patient that has a scoliosis that measures under 20 degrees?
Adjust and Monitor
93
Scoliosis: What range (in degrees) would you send a patient to an orthopedist for a Milwaukee Brace?
21-40 degrees
94
Over how many degrees is a patient with scoliosis referred to a surgical consultant?
Over 40 degrees
95
If a patient has a scoliosis of over 50 degrees what are to complications to be worried about?
Cardio-Pulmonary Compromise
| Degenerative Joint Disease (DJD)
96
What are three way to monitor scoliosis?
Risser's Sign
Left wrist films (Best)
Tanner's Staging
97
What is Rheumatoid Arthritis called in Children?
Still's Disease
98
What are seven x-ray finding in a patient with Rheumatoid Arthritis (RA)?
- Symmetrical Distribution
- Bilateral uniform loss of joint space
- Rat bite erosions
- Pannus formation
- Periarticular Osteoporosis (Localized)
- Distal Interphalangeal (DIP) joint spared
- Atlanto-Axial Instability
99
What four signs seen in the hands of a patient with Rheumatoid Arthritis (RA)?
Haygarth's nodes (Metacarpal Phalangeal (MCP) Joints)
Swan Neck deformity
Boutonniere Deformity
Ulnar or Fibular deviation (Lanois Deformity)
100
With a patient with Rheumatoid Arthritis (RA), what is the associated condition described as "Benign swelling of the semimembranosus bursa"?
Baker's Cyst (Popliteal Fossa)
101
What four Labs with be positive in a patient with Rheumatoid Arthritis (RA)?
RA Latex
FANA
Erythrocyte Sedimentation Rate (ESR)
C Reactive Protein (CPR)
102
What type of anemia is seen in a Patient with Rheumatoid Arthritis (RA)?
Normocytic Normochromic Anemia
103
What is the name of the condition that is seen in a patient with Rheumatoid Arthritis (RA) and also has dry eyes and mouth?
Sjogren's
104
What is another name for Ankylosing Spondylitis (AS)?
Marie Stumpell
105
Who would you co-manage patients with Rheumatoid Arthritis (RA), Systemic Lupus Erythematosus (SLE) and Ankylosing Spondylitis (AS)?
Rheumatologist
106
What age and gender does the condition of Ankylosing Spondylitis (AS) affect?
Male
| 15-35 years of age
107
Where does Ankylosing Spondylitis (AS) start?
Sacroiliac (SI) joint
108
What is an early sign of Ankylosing Spondylitis (AS)?
Low Back Pain (LBP) with morning stiffness
109
What condition is Ankylosing Spondylitis (AS) associated with?
Anterior Uveitis (Iritis)
110
What three orthopedic test are performed on a patient with Ankylosing Spondylitis (AS)?
Chest expansion
Forester's Bowstring
Lewin Supine
111
What is the radiographic finding of the Sacroiliac (SI) joint in Ankylosing Spondylitis (AS)?
Bilateral Sacroiliac (SI) joint fusion (Ghost Joints)
112
What are the seven radiographic findings in Ankylosing Spondylitis (AS)?
```
Shiny Corner Sign (Early)
Bilateral marginal syndesmophytes
Squaring of the vertebral bodies
Bamboo spine
Dagger Sign
Trolley Track Sign
Poker Sign
```
113
What two labs will be positive/increased in Ankylosing Spondylitis (AS)?
HLA B27
| Erythrocyte Sedimentation Rate
114
What condition looks identical to Ankylosing Spondylitis (AS), in the pelvis but Gastrointestinal dysfunction?
Enteropathic Arthropathy
115
What are two other names for Enteropathic Arthropathy?
Crohn's Disease
| Ulcerative Colitis
116
What is the age and gender that the condition of Psoriatic Arthritis is seen?
Males
| 20-50 years of age
117
What three signs will be present in a patient that has Psoriatic Arthritis?
Silver Scale lesion on extensors
Pitted nails
Cocktail sausage digits
118
What are six radiographic findings in a patient with Psoriatic Arthritis?
```
Non-marginal syndesmophytes of the spine
Increased joint space
Mouse ear deformities
Pencil in Cup deformity
Ray Sign
Atlanto-Axial instability
```
119
What lab will be positive in a patient with Psoriatic Arthritis?
HLA B27
120
What is another name for Reiter's Disease?
Reactive Arthritis
121
What gender and age does the condition of Reactive Arthritis commonly affect?
Males
| 20-30 (+/-)
122
What are three symptoms are seen in patients with Reiter's Disease?
Can't see, Can't pee, Can't Dance with me
Conjunctivitis
Urethritis
Arthritis (Heel Spur)
123
What Venereal disease is usually the cause of Reactive Arthritis?
Chlamydia
124
What are three radiographic findings seen in Reiter's Disease?
Non-Marginal Syndesmophytes of the spine
Calcaneal Spur (Heel Spur)
Fluffy Periostitis
125
What lab will be positive in the condition of Reactive Arthritis?
HLA B27
126
What gender is Systemic Lupus Erythematosus (SLE) most commonly seen in?
Females
127
What are the five signs/symptoms of Systemic Lupus Erythematosus (SLE)?
```
Malar/Butterfly rash (Sunlight precipitates a skin rash)
Oral ulcers
Discoid lesions
Alopecia
Raynaud's phenomenon
```
128
In what condition will Ulnar Deviation straighten out?
Systemic Lupus Erythematosus (SLE)
129
What Labs will be increased/positive in the condition of Systemic Lupus Erythematosus (SLE)?
LE Prep
FANA
Erythrocyte Sedimentation Rate (ESR)
Anti-DNA
130
What two things will be decreased in Systemic Lupus Erythematosus (SLE)?
Leukopenia (Decrease in White Blood Cells (WBC))
| Thrombocytopenia (Decrease Thrombocyte)
131
What Is another name for Scleroderma?
Progressive Systemic Sclerosis
132
What gender and age is the condition of Progressive Systemic Sclerosis most commonly effect?
Females
| 30-50 years old
133
What symptom is associated with Scleroderma?
Erosion of the distal tufts of the phalanges
134
What condition has CREST syndrome?
Progressive Systemic Sclerosis
135
What is CREST Syndrome?
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
136
What Labs will be increased/positive in Scleroderma?
```
FANA
RA Latex (30%)
```
137
What is another name to Osteitis Condensans Ilia?
Osteitis Triangularis
138
What population is Osteitis Condensans Ilia seen in?
Multiparous Female
| 20-40 years of age
139
What condition has no labs and is self resolving?
Osteitis Condensans Ilia
140
What is the case management Osteitis Triangularis?
Trochanteric Belt for stability
141
What is the joint space on the x-ray in Osteitis Condensans Ilia?
Normal
142
What is the radiographic finding in Osteitis Triangularis?
Bilateral/Symmetrical triangular sclerosis areas on the lower half of the ilium
143
What is the most common joint affecting the knee?
Synoviochondrometaplsia
144
What condition is seen with "multiple loose bodies within the joint that are round or oval in shape"?
Synoviochondrometaplsia
145
What is another name for Neurogenic Arthropathy?
Charcot's Joint
146
What four conditions do you often see Charcot's Joints?
Diabetes
Tabes Dorsalis
Syphilis
Syringomyelia
147
What are the 6 D's in weight bearing joints?
```
Distension
Density of Subchondral sclerosis
Debris within the joint
Dislocation
Disorganization
Destruction of the bone
```
148
What are two other names for the condition of Diffuse Idiopathic Skeletal Hyperostosis (DISH)?
Forestier's Disease
| Ankylosing Hyperostosis
149
What is the gender and age often seen is Diffuse Idiopathic Skeletal Hyperostosis (DISH)?
Male
| Over the age of 40 years old
150
What symptom is seen in Ankylosing Hyperostosis?
Neck stiffness or pain on swelling
151
What other condition is commonly seen/associated Diffuse Idiopathic Skeletal Hyperostosis?
Diabetes Mellitus
Hemoglobin, A1c, Fasting Blood Sugar (FBS)
152
What ligament is ossified in Forestier's Disease?
Ossification Posterior Longitudinal Ligament (OPLL)
153
What are the radiographic finding of Diffuse Idiopathic Skeletal Hyperostosis (DISH)?
Four (4) contiguous segments involved
Flowing hyperostosis (Anterior Bridging)
Candle wax dripping
Disc space is preserved
154
What is the treatment for Forestier's Disease?
Adjust; as long as no facet involvement, no inflammation
155
The HLA B27 lab will be positive in what percentage of patient's with Ankylosing Hyperostosis?
30%
156
What is another name for Degenerative Joint Disease (DJD)?
Osteoarthritis
157
Is Degenerative Joint Disease (DJD) inflammatory or non-inflammatory disease?
Non-inflammatory
158
What are the most commonly involved joints in Degenerative Joint Disease (DJD)?
Weight Bearing Joints (Hip or Knee)
159
What is a common associated finding with Degenerative Joint Disease (DJD)?
Subchondral cyst
160
What condition usually become more stiff with rest and improves movement with activity?
Degenerative Joint Disease (DJD)
161
What are two complications of Degenerative Joint Disease (DJD)?
```
Spinal Canal Stenosis
Intervertebral Foramen (IVF) Encroachment
```
162
What is the most common area of the spine effected by Degenerative Joint Disease (DJD)?
C5/C6
163
What three findings will you see in a patient's spine with Degenerative Joint Disease (DJD)?
Intervertebral Disc (IVD) narrowing
Osteophytes
Endplate Sclerosis
164
What are four finding of the hand seen in patients with Degenerative Joint Disease (DJD)?
- Non-uniform loss of Joint space
- Heberden's Nodes seen at the Distal Interphalangeal (DIP) Joint
- Decreased joint space with sclerosis
- Asymmetrical Distribution
165
What is the x-ray finding of the hip in Degenerative Joint Disease (DJD)?
Decreased superolateral joint space with sclerosis
166
What is the radiographic finding of the knee in Degenerative Joint Disease (DJD)?
Decreased medial joint space with the lateral space preserved
167
What are three possible etiologies of Degenerative Joint Disease (DJD)?
Sports Injury
Unrelated Microtrauma
Genetic
168
What are the eight conditions classified as Inflammatory Arthritdes?
Rheumatoid Arthritis (RA)
Systemic Lupus Erythematosus (SLE)
Scleroderma
Osteitis Condensans Ilia
Psoriatic Arthritis
Enteropathic Arthropathy
Ankylosing Spondylitis
Reactive Arthritis (Reiter's)
169
What are the four conditions classified as Degenerative Arthritdes?
Degenerative Joint Disease (DJD) (Osteoarthritis)
Diffuse Idiopathic Skeletal Hyperostosis (DISH)
Neurogenic Arthropathy
Synoviochondrometaplsia
170
What are the four conditions classified as Metabolic Arthritdes?
- Gout
- Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD)
- Hydroxyapatite Deposition Disease (HADD)
- Septic Arthritis
171
What age and gender is Gout often seen in?
Males
| Older the 40 years of age
172
What causes the condition of Gout?
Overproduction of uric acid
173
What are the signs/symptoms of Gout?
Extremely painful, red, hot and swollen joint(s)
174
What is the most common joint for the condition of Gout to effect?
Metatarsal Phalangeal (MTP) joint of the big toe
Gout is mono-articular
175
What is the term for a "swollen first metatarsal phalangeal (MTP) joint"?
Podagra
176
In the condition that has tophi crystals often the ear?
Gout
177
What are the two radiographic findings in Gout?
Overhanging Margin
| Juxta-articular erosion
178
What labs will be positive/increased in the condition in Gout?
Increased Uric Acid
| Positive Erythrocyte Sedimentation Rate (ESR)
179
What Special Test will be done in the condition of Gout?
Joint Aspiration
180
What is the pharmacologic approach to help patients with Gout?
Acute Gout: Colchicine
| Chronic Gout: Allopurinol
181
Who is a patient with Gout referred to?
Rheumatologist
182
What is something a patient with Gout can do to decrease the symptoms?
Dietary Changes
| Don't consume Red Wine and Cheese, purines are bad
183
What is another name for Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD)?
Pseudogout
184
What condition has "Thin linear calcification parallel to the articular cortex within the joint space"?
Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD)
185
What joint is Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD) most commonly seen in?
Knee
186
What is the condition when the cartilage is affected with Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD)?
Chondrocalcinosis
187
What is the best way to diagnosis and confirm Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD)?
MRI
188
What condition most commonly effects the shoulder?
Hydroxyapatite Deposition Disease (HADD)
189
What are the radiographic findings of Hydroxyapatite Deposition Disease (HADD)?
Round or oval calcifications near the insertion of the bursa or tendon
190
What condition destroys the disc and has a lab of an increased White Blood Cell (WBC) counts?
Septic Arthritis
191
How will an patient with Septic Arthritis present to the office?
Fever
Chills
Possible history of trauma/surgery
Joint will be:
Warm
Tender
Swollen
192
What are two other terms of Avascular Necrosis (AVN)?
Osteonecrosis
| Osteochondrosis
193
What is the major cause of Avascular Necrosis (AVN)?
Trauma
194
How long does it take Avascular Necrosis (AVN) to heal?
8 months to 2 years
| All Avascular Necrosis (AVN) are Self-Resolving
195
What condition can Avascular Necrosis (AVN) lead to?
Degenerative Joint Disease (DJD)
196
What two test are Special Test for Avascular Necrosis (AVN)?
Bone Scan
| MRI
197
What is the most common Avascular Necrosis (AVN) of the hand?
Scaphoid (Carpal Bone)
198
What is the name of the Avascular Necrosis (AVN) of the Scaphoid?
Preiser's
199
What is the name of the Vertebral End Plate Epiphysis Avascular Necrosis (AVN)?
Scheuermann's
200
What is the location effected by Legg Calve Perthes?
Femoral (Head) Epiphysis
Avascular Necrosis (AVN)
201
What bone is effected in Kohler's Avascular Necrosis (AVN)?
Navicular (Tarsal)
| Kold Feet
202
What is the most common dislocation of the hand?
Lunate (Carpal)
203
What is the name for the Avascular Necrosis (AVN) of the Lunate?
Keinboch's
| Kein Hands
204
What bone is effected in Sever's Avascular Necrosis (AVN)?
Calcaneus
205
What is the location of Blount's Avascular Necrosis (AVN)?
Medial Tibial Condyle
206
Where does Freiberg's Avascular Necrosis (AVN) occur?
Head of the 2nd or 3rd Metatarsal
| Freiberg's Foot
(Morton's Neuroma)
207
Where is the Osteochondritis Dessicans Avascular Necrosis (AVN) located?
Articular surface of the Lateral aspect of the Medial Femoral Condyle
208
When there is a Avascular Necrosis (AVN) of the Capitellum what is the name associated with it?
Panner's
209
What is the best radiographic view to see Osteochondritis Dessicans?
Tunnel View
210
What population do you often see Osteochondritis Dessicans in?
Athletes
| +/- 16-25 years old
211
What condition has "knee locks out on extension" and associated with Wilson's Sign?
Osteochondritis Dessicans
212
What condition is most commonly seen +/- 10-16 year olds?
Scheuermann's Disease
213
What are the signs of Scheuermann's Disease?
Round of the shoulders
Increased Kyphosis
Young patients with back pain
214
What are two radiographic signs of Scheuermann's Disease?
- Slight loss of the anterior body height; of one or more vertebrae (10-15%)
- Multiple endplate irregularities of three or more continuous vertebrae
215
What are four Case Management ideas for a patient with Scheuermann's Disease?
Thoracolumbar Brace
Strengthen Erector musculature
Stretch the Pectoralis muscle
Stop Physical Activates
216
What two things can Scheuermann's Disease lead to?
Permanent Postural Deformities
| Early Degenerative Joint Disease (DJD)
217
What is the name of the condition that has an Avascular Necrosis (AVN) of the femoral head?
Legg Calve Perthe's
218
What population is Legg Calve Perthe's most commonly seen in?
+/- 4-9 Obese Males
219
What are four radiographic findings will you see in Legg Calve Perthe's?
- 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
What is the appearance of a healed Legg Calve Perthe's?
Mushroom Capped Appearance
221
Who would you refer a patient with Legg Calve Perthe's?
Orthopedist for an "A" Brace
222
What Type of Salter Harris is the condition Slipped Capital Femoral Epiphysis?
Type 1 Salter Harris
223
What gender and age is effected in the condition of Slipped Capital Femoral Epiphysis?
Males (Boy)
| +/- 10-16 years of age
224
What direction does the femoral Head slide in Slipped Capital Femoral Epiphysis?
Inferior and Medial
225
What direction does the femoral Neck side in Slipped Capital Femoral Epiphysis?
Superior and Lateral
226
What three lines are used to assess Slipped Capital Femoral Epiphysis?
Klein's
Shenton's
Skinner's
227
In a patient that has Slipped Capital Femoral Epiphysis, who should they be referred to?
Orthopedist
228
What are the components of Putti's Triad, seen in Congenital Hip Dysplasia?
Hypolastic Femoral head
Shallow Acetabular Shelf
Femoral head outside of the Acetabulum
229
What are four orthopedic exams performed in patients with Congenital Hip Dysplasia?
Hip Telescoping
Ortolani's
Barlow's
Allis'
230
What is the name of the condition that has "Axial migration of the femoral head with uniform loss of joint space"?
Protrusio Acetabuli
231
What condition is often seen with Bilateral Protrusio Acetabuli?
Rheumatoid Arthritis (RA)
232
What other five conditions are often seen with Protrusio Acetabuli?
```
Osteoporosis
Osteomalacia
Paget's
Trauma
Idiopathic
```
233
What line is used to measure Protrusio Acetabuli?
Kohler's Line
234
On an x-ray what will be completely obliterated in the condition of Protrusio Acetabuli?
Kohler's Teardrop
235
What type of fracture is described as "Portion of the bone torn away by muscle or ligament by traction force"?
Avulsion Fracture
236
What is a Comminuted Fracture?
Fracture with more than two fragments
237
What is the term used for "Displacement or separation of a slightly moveable joint"?
Diastasis
238
What is a Compound (Open) Fracture?
Skin Ruptured and bone Exposed
239
In what population will you see a Greenstick/Hickory Stick Fracture?
Children, an incomplete fracture
240
How is an Impaction Fracture described?
Bone fragments driven into one another
241
What is the name of the fracture that has "one side of the cortex affected/ incomplete fracture?
Torus/Buckling Fracture
242
What kind of fracture is caused by insufficiency or repetitive motion?
Stress/Fatigue Fracture
243
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?
Occult Fracture
244
What is the name of the fracture that is seen in the first metacarpal?
Bennett's Fracture
245
What is the name of the fracture seen in the second and third metacarpals?
Boxer's Fracture
246
Where is a Bar Room Fracture most commonly seen?
Fracture of the forth and fifth metacarpal
247
What carpal bone is the most commonly fractured?
Scaphoid
248
What is the name given to the fracture of the proximal Ulna?
Nightstick Fracture
249
What is the name of the fracture that has a fractured ulna with radial head displacement?
Monteggia Fracture
M(OOO)UUUU
M= Monteggia
U=Ulna Fractured
250
How is a Galeazzi Fracture described?
Fracture of the distal 1/3 of the radius with dislocation of the distal radio-ulnar joint
GRRRRRRR
G=Galeazzi
R=Radial Fractured
251
What fracture type is a "Fracture of the distal radius with Posterior displacement of the distal fragment"?
Colles Fracture
252
What is a Smith's Fracture?
Fracture of the distal radius with Anterior displacement of the distal fragment
253
What is the common are of a March/Stress fracture to occur?
Second, Third, Forth metatarsals
254
What fracture usually occurs as a transverse fracture at the Base of the fifth metatarsal?
Jones Fracture
255
What is the name of an avulsion fracture of a Spinous process?
Clay Shoveler's Fracture
256
What is the most common area for a Clay Shoveler's Fracture to happen?
C6-T1
257
What is the cause of a Clay Shoveler's Fracture?
Hyper-flexion injury
258
What is the name of the fracture that is Unstable and effects the pedicels bilaterally of C2?
Hangman's Fracture
259
What is the most common cause of a Hangman's Fracture?
Hyper-extension injury
260
What fracture type is a "Fracture through the anterior and posterior arches of the atlas due to axial compression"?
Jefferson Bursting Fracture
261
What is often seen on x-ray in a patient that has a Jefferson Bursting Fracture?
Large Periodentoid Space
262
What type of Odontoid fracture is an "Avulsion of the tip of the dens"?
Type I
263
How is a Type II Odontoid Fracture described?
Fracture through the base of the dens
264
What Type of Odontoid Fracture is through the Body of C2?
Type III
265
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"?
Teardrop Fracture
266
Where is the most common place for a Teardrop Fracture to happen?
C2
267
What other issues is seen in patient's with a Teardrop Fracture?
Acute Anterior Cervical Cord Syndrome
268
Is a Teardrop Fracture stable or unstable?
Highly Unstable Fracture
269
What condition effects the Tibial Apophysis in patients of +/- 10-16 years of age?
Osgood Schlatter's
270
What kind of brace is used in Osgood Schlatter's Disease?
Cho-Pat Brace
271
What are two symptoms of Osgood Schlatter's Disease?
Pinpoint Pain
| Swelling
272
What is the name of the avulsion fracture of the ischial tuberosity?
Rider's Bone Fracture
273
What fracture is described as a "Horizontal fracture through a single body and posterior arch"?
Chance Fracture
274
What is another name for the Chance Fracture?
Seatbelt Fracture
275
What is the most common levels for a Seatbelt/Chance Fracture to occur at?
L1-L3
276
What condition is a "Fracture through the pars interarticularis without slippage?
Spondylolysis
277
How is the condition of Spondylolisthesis described?
Slippage of the vertebral body with or without fracture
278
What type of Spondylolisthesis is a Congenital defect?
Type I/ Dysplastic
279
What is the definition of a Type II/Isthmic Spondylolisthesis?
Fracture through the Pars
280
What is the most common level of a Type II/Isthmic Spondylolisthesis?
L5
281
What is a common population to see a Type II/Isthmic Spondylolisthesis?
Gymnast
282
What is the Type of Spondylolisthesis that is Degenerative Joint Disease (DJD) of the facet joint?
Type III/Degenerative
283
What is the most common level to have a Type III/Degenerative Spondylolisthesis?
L4
284
Where is the fracture located in a Type IV/Traumatic Spondylolisthesis?
Fracture through the pedicle (Fracture anywhere but the Pars)
285
What Type of Spondylolisthesis is considered Pathological?
Type V
Seen in Bone Diseases (i.e Paget's)
286
What two grades of Spondylolisthesis can be Adjusted?
Grade 1
| Grade 2
287
What is the preferred Grading Scale of Spondylolisthesis?
Meyerding's
288
What are the grades and percentages of Spondylolisthesis?
Grade 1- Up to 25%
Grade 2- 26-50%
Grade 3- 51-75%
Grade 4- 76-100%
289
What Grade of Spondylolisthesis has the Radiographic finding of "Inverted Napoleon Hat Sign"?
Grade 3
| Grade 4
290
What is the purpose of flexion and extension films?
Stability
291
What Special Test should be order in a patient that has a Spondylolisthesis?
SPECT
292
What is the most common dislocated carpal bone?
Lunate
293
What is associated with a Lunate Dislocation?
Pie Sign
294
What two signs are associated with a Scaphoid Dislocation?
Terry Thomas Sign
| Signet Ring Sign
295
What joint is effective in a chronic anterior shoulder dislocation?
Glenohumeral Joint
296
What two deformities are seen in Glenohumeral Joint Dislocation?
Bankhart
| Hill-Sacks/Hatchet
297
What is a SLAP Lesion?
Superior Labrum Anterior to Posterior
298
What is torn is a SLAP Lesion?
Glenoid Labral Tear
299
What condition is associated with a SLAP Lesion?
Shoulder Instability
300
What is the Congenital Anomaly that the "Arcuate foramen form when the Atlanto-occipital ligament calcifies"?
Posterior Ponticus
301
What is another name for the Posterior Ponticus?
Posticus Ponticus
302
What two structures are transmitted through the Posticus Ponticus?
Sub-occipital nerve
| Vertebral Artery
303
What condition is there a 20% missing of the Transverse Ligament?
Down's Syndrome
304
What area will be increased on radiographic films in a Patient with Down's Syndrome?
Atlanto Dens Interspace (ADI)
Must do flexion and extension films before adjusting
305
What is the name of the condition when the "cephalic part of the dens is not fused with the body of C2?
Os Odontoideum
306
What finding are seen on the x-ray of a patient that has an Os Odontoideum?
Smooth, Wide, Lucent defect between the body of C2 and the dens
307
What condition has two adjacent vertebrae ossified at birth?
Congenital Block
308
What are two radiographic findings in Congenital Block?
Wasp Waist Appearance
| Hypoplastic (Rudimentary) Disc
309
What condition has the following three symptoms:
Short Webbed Neck
Low Hair Line
Decreased Range of Motion (ROM)?
Klippel-Feil Syndrome
310
What two other conditions is Klippel-Feil syndrome associated with?
Sprengle's Deformity
| Onovertebral Bone
311
What is the definition of Klippel-Feil Syndrome?
Multiple Congenital Blocks
312
What two associated conditions are seen in Pedicle Agenesis?
Contra lateral pedicle hypertrophy
| Sclerosis
313
What is the name of the Congenital Anomaly that is "Failure of the anterior center of the vertebral body to ossify properly"?
Butterfly Vertebra
314
What is the Congenital Anomaly that has "Failure of development of a lateral ossification center"?
Hemivertebra
315
What condition can an isolated wedged vertebra (Hemivertebra) cause?
Scoliosis
316
What type of deformity is often seen with a Hemivertebra?
Gibbus Deformity
317
What Congenital Anomaly is "Failure for the lamina to fuse"?
Spina Bifida
318
In the condition of Spina Bifida, what lab will be Increased and what macronutrient with be Deficient?
Increased: Fetoprotein
Deficient: Folic Acid
319
What is Sacralization (Transitional Vertebrae)?
L5 Transverse Processes (TP) may fuse or form joints with the sacrum
320
What is it called if a patient has six lumbar vertebrae or the first sacral segment appears like a lumbar segment?
Lumbarization (Transitional Vertebrae)
321
What is it called when two articular plans/facets are asymmetrical?
Facet Tropism
322
What is the most common level for Facet Tropism to occur?
L5/S1
323
What is Knife-Clasp Syndrome?
Spina Bifida of S1 with L5 Spinous enlargement
324
In what movement is pain caused in Knife-Clasp Syndrome?
Extension
325
What is the angle for Coxa Vara and Coxa Valga?
Cox Vara: Less than 120 degrees
Cox Valga: Greater than 130 degrees
326
What line is used to measure both Coxa Vara and Coxa Valga?
Mikulicz's
327
What is the name of the abnormality of the upper extremity that has a shortened distal radius?
Madelung's Deformity
328
What two things can cause Madelung's Deformity?
- Asymmetrical prominence of the ulnar styloid (Radial Deviation)
- Posterior subluxation of the distal ulna
329
What is the upper extremity abnormality that is described as "Ulna is usually shorter than the radius"?
Negative Ulnar Variance
330
When is a Negative Ulnar Variance often seen?
With a Scapho-Lunate dislocation
331
What is the name of the condition that has "Calcification of the medical collateral ligament"?
Pelligrini Steida
332
What is the name of the condition that has "calcification of a muscle belly"?
Myositis Ossificans
333
What two muscles will you often see the condition of Myositis Ossificans?
Biceps
| Quadriceps
334
What is the name of the condition that has "calcification within veins"?
Pheboliths
335
Is Pheboliths symptomatic or asymptomatic?
Asymptomatic
336
On what x-ray view will you see the Fat Pads of the elbow?
Lateral
337
What is often seen when the Fat Pats of the Elbow are disrupted?
Fracture of the radial head
338
What age and gender do you often see a Calcified Prostate?
Males
| Over the age of 50
339
Where is the prostate located/ where will the patient feel pain?
On top of the symphisis pubis
340
What two labs are increased if a patient has Prostate issues?
Prostate Specific Antigen (PSA)
| Acid Phosphatase
341
Where does Prostate issues most commonly metastasize to?
Lumbar Spine
342
What lab will be increased in metastasized prostate issues?
Alkaline Phosphatase
343
What is the most common benign tumor in females?
Uterine Fibroid
344
What are two other names for a Uterine Fibroid; tumor of smooth muscle?
Fibroid Cyst
| Leiomyoma
345
What is the referral pain for a patient with Cholelithiasis?
Inferior border of the right scapula (Viscerosomatic)
346
What organ does the term Cholelithiasis refer to?
Gallbladder
347
What two Special Test are used for the condition of Cholelithiasis?
Ultrasound
| Cholecystogram
348
What is the most common location of a Abdominal Aortic Aneurysm (AAA)?
Distal to the Renal Arteries
349
At what diameter is it classified as an Abdominal Aortic Aneurysm (AAA)?
Larger than 3.8 cm
| Normal Abdominal Aortic can measure up to 3.8 cm
350
What are three radiographic findings of Abdominal Aortic Aneurysm (AAA)?
Aortic Dilation
Curvilinear Calcification
Fusiform Appearance
351
What four Special test would you do for a patient who has an Abdominal Aortic Aneurysm (AAA)?
Doppler Ultrasound
Diagnostic Ultrasound
Ultrasonography
CT
352
Who do you refer a patient with an Abdominal Aortic Aneurysm (AAA) to?
Vascular Specialist
353
What are the two classic radiographic findings in the condition of Sickle Cell Anemia?
"Hair on End" in the skull
| "H" shaped vertebrae
354
What are two other names for Thalassemia?
Cooley's Anemia
| Mediterranean Anemia
355
What condition is seen with a "Hereditary disorder of hemoglobin synthesis"
Thalassemia
356
What kind of Anemia is seen in patients with Thalassemia?
Microcytic Hypochromic Anemia
357
What are the two x-ray finding is patients with Thalassemia?
"Erlenmeyer Flask deformity"-- Widened Epiphysis
| "Hair on End" in the skull
358
What gender and age is Hyperparathyroidism often seen in?
Females
| 30-50 years old
359
What two things does an overactive Parathyroid gland cause?
Increase: Blood Calcium
Decrease: Phosphorus
360
In what condition will you see "Brown Tumors" (Central Geographic osteopenia in bones)?
Hyperparathyroidism
361
What are the two classic radiographic findings in Hyperparathyroidism?
"Salt and Pepper" Skull
| "Rugger-Jersey Spine"
362
What lab will be increased in Hyperparathyroidism?
Alkaline Phosphatase
363
What is another name for Osteopetrosis?
Marble Bone
364
What condition is hereditary and an absents of bone marrow?
Osteopetrosis
365
What are two associated conditions with Osteopetrosis?
Anemia
| Hepatosplenomegaly
366
What are the early and late radiographic findings of Osteopetrosis?
Early: "Bone within a Bone"
Late: "Sandwich Vertebrae"
367
A deficiency in one of the three following macronutrients can cause Rickets?
Vitamin D
Vitamin C
Phosphorus
368
Where is Rickets most commonly seen?
At the growth plates, usually of long bones
369
What are common muscle finding in a patient with Rickets?
Weakness
| Tetany
370
What will be three things seen on x-ray in a patient with Rickets?
- "Paintbrush Metaphysis" (Absent zone of Provisional Calcification)
- Bone Deformity
- Lucency
371
What special imaging uses a contrast and has a 10X better image quality than plan film?
CT
372
What kind of units is a CT measured in?
Hounsfield
373
What are seven major conditions that can a CT help with?
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
What Special Imaging measures bone Density for Osteoporosis?
Dual Energy X-Ray Absorptiometry (DEXA Scan)
375
What is the usual radioactive injection substance in a Bone Scan?
Technetium 99
376
What is another name for a Bone Scan?
Scintigraphy
377
What does a Bone Scan measure?
"Attempt" to lay down new bone
378
What condition does a Cold Bone Scan indicate?
Multiple Myeloma (MM)
379
What five conditions does a Hot Bone Scan indicate?
```
Avascular Necrosis (AVN) (ALL)
Metastatic Disease (Blastic and Lytic)
Paget's
Hodgkin's
Fractures
```
380
What Special Imaging shows Soft Tissue 100x better than CT?
MRI
381
MRI does not use radiation, what is used instead?
Gadolinium
382
What three conditions is MRI best for?
```
Multiple Sclerosis (MS);plaqueing in brain and spinal cord
Avascular Necrosis
```
383
T1 weighted MRI are used for what conditions?
Fatty Pathologies (i.e. Muscular Dystrophy)
384
T2 weighted MRI are used for what conditions?
Water Density (i.e. Cerebrospinal Fluid (CSF))
385
What color is bone on MRI?
Black (Signal Void)
386
In an MRI what color is the weighted component?
White
387
What Special Imaging utilizes signal intensities and surface coils?
MRI
388
What Special Imaging is used for Soft Tissue?
MRI
389
What six components are seen using the Special Imaging; MRI?
```
Intervertebral Disc (IVD)
Spinal Cord
Meninges
Meniscus
Ligaments
Bone
```
390
Where is the Basilar Angle Line drawn from?
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
What is the Significance of (Martin's) Basilar Angle?
If the angle is greater than 152 degrees it indicates Platybasia which is associated with Basilar Impression
392
What are the landmarks that McGregor's Line is drawn from?
From the hard palate to the base of the occiput
393
What is the significance of McGregor's Line?
**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
What are the landmarks of Chamberlain's Line?
Hard palate to the Opishtion (Posterior foramen Magnum)
395
What is the significance of Chamberlain's Line?
If the odontoid is more than 7mm above this line, it indicates Basilar Impression
396
What Landmarks are McRae's Line drawn from?
Anterior foramen magnum (Basion) to the posterior foramen magnum (Opishtion)
397
What is the Significance of McRae's Line?
If the odontoid is above this line, it indicates Basilar Impression
398
What are the Landmarks used to measure the Atlantodental Interspace (ADI)?
C1 (Atlas) anterior tubercle to the odontoid
399
What is the Significance of the Atlantodental Interspace (ADI)?
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
What Landmark's are used to drawn George's Line?
Posterior body margins are checked for alignment with what should be a smooth, continuous line
401
What is the Significance of George's Line?
Discontinuous, line may indicate A-P vertebral malposition such as:
Anterolisthesis
Retrolisthesis
402
What Landmarks are used to draw the Posterior Cervical Line?
Lines drawn at each spinolaminar junction should form a smooth arc-like curve
403
What is the Significance of the Posterior Cervical Line?
Discontinuous, line may indicate A-P vertebral malposition such as:
Anterolisthesis
Retrolisthesis
404
What are the Landmarks for the Stress Lines of the Cervical Spine?
Lines are drawn at the posterior bodies of C2 and C7
405
What is the Significance of the Stress Lines of the Cervical Spine?
Flexion should intersect at C5/C6
Extension should intersect at C4/C5
May be altered by muscle spasm, joint fixation, or disc degeneration
406
What is the Landmarks for Prevertebral Soft Tissue?
Anterior vertebral bodies to posterior margins of air shadow of:
Pharynx
Larynx
Trachea
407
What is the significance of the Prevertebral Soft Tissues?
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
What Landmarks are used for Cobb's Method?
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
What is the Significance of Cobb's Method?
Best Method to evaluate Scoliosis
410
What Landmarks are used for Risser-Ferguson Method?
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
What is the Significance of Risser-Ferguson Method?
Scoliosis Evaluation
Values are 25% below Cobb Method of evaluation
412
What Landmarks are used to draw Sacral Inclination?
Tangential line is drawn parallel and through the posterior margin of S1 and a vertical line is drawn intersecting the sacral line
413
What is the Significance of Sacral Inclination?
Hypo/Hyperlordosis
Normal angle: 30-72 degrees
Average angle: 46 degrees
414
What Landmarks are used to draw the Lumbosacral Angle?
Oblique lines are drawn through and parallel to the sacral base
Horizontal line parallel to the bottom or the edge of the film
415
What are two other names for the Lumbosacral Angle?
Sacral Base Angle
| Ferguson's Angle
416
What is the Significance of the Sacral Base Angle?
Hypo/Hyperlordosis
Normal angle: 26-57 degrees
Average angle: 41 degrees
417
What Landmarks are used to draw Meyerding's Grading Method of Spondylolisthesis?
The sacral base is divided into quadrants and the relative position of the posterior inferior aspect of L5
418
What is the Significance of Meyerding's Grading Method?
Determines the degree of Anterolisthesis
419
What Landmarks are used to draw Ullman's Line?
Line drawn parallel and through the sacral base
| Perpendicular line drawn from the sacral promontory
420
What is another name for Ullman's Line?
Garland Thomas Line?
421
What is the Significance of Ullman's Line?
L5 beyond the perpendicular line: Spondylolisthesis
422
What are the Landmarks used to draw Eisenstein's Method?
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
What is the Significance of Eisenstein's Method?
A measurement less than 15 mm: Spinal Canal Stenosis
424
What are the Landmarks used for Canal/Body Ratio?
A: Interpedicular Distance
B: Sagittal Canal Dimension (Eisenstein's Method)
C: Transverse Body Dimension
D: Sagittal Body Dimension
425
What is the Significance of Canal/Body Ratio?
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
What Landmarks are used to drawn the Lumbosacral Disc Angle?
Lines are drawn parallel and through the inferior end plate of L5 and the Superior end plate of S1
427
What is the Significance of the Lumbosacral Disc Angle?
Hypo/Hyperlordosis
Normal angle: 10-15 degrees
428
What is another name for Ferguson's Line?
Lumbar Gravity Line
429
What Landmarks are used to draw Ferguson's Line?
Vertical line is drawn though the center of the L3 vertebral body
430
What is the Significance of the Lumbar Gravity Line?
The line should intersect the sacral base
Line Anterior to the Sacrum: Hyperlordosis
Line Posterior to the Sacrum: Hypolordosis
431
What Landmarks are used to draw Macnab's Line?
A line is drawn parallel and through the inferior end plate
432
What is the Significance of Macnab's Line?
If the line intersects the superior articular process of the vertebra below:
Facet Imbrication
Extension Malposition
433
What Landmark's are used to draw Hadley's "S" Curve?
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
What is the significance of Hadley's "S" Curve?
Should be a smooth "S" shaped curve
An interruption in the "S" curve indicates:
Subluxation
Facet Imbrication
435
What are the Landmarks used to draw Kohler's Line?
A line is drawn along the Pelvic inlet to the outer aspect of the Obturator Foramen
436
What is the Significance of Kohler's Line?
If the Acetabular floor crosses the line it indicates:
Unilaterally: Protrusio Acetabuli
Bilaterally: Rheumatoid Arthritis (RA)
437
What Landmarks are used to draw Shenton's Line?
A smooth curvilinear line is drawn along the inferior femoral neck to the superior aspect of the Obturator foramen
438
What is the Significance of Shenton's Line?
An interruption/discontinuous line indicates:
Dislocation
Femoral Neck Fracture
Slipped Capital Femoral Epiphysis (SCFE)
439
What Landmarks are used to draw the Iliofemoral Line?
A smooth curvilinear line is drawn along the outer ilium, across the joint and onto the femoral neck
440
What is the Significance of the Iliofemoral Line?
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Bilateral asymmetry indicated:
Slipped Capital Femoral Epiphysis (SCFE)
Dislocation
Fracture
Dysplasia
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What Landmarks are used to draw the Femoral Angle?
Two lines are drawn through and parallel to the mid-axis of the femoral shaft and the femoral neck
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What is another name for the Femoral Angle?
Mikulicz's Angle
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What is the Significance of the Femoral Angle?
Normal is 120-130 degrees
Less than 120 degrees: Coxa Vara
Greater than 130 degrees: Coxa Valga
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What Landmarks are used to draw Skinner's Line?
Line drawn through and parallel to the femoral shaft
| Perpendicular line is drawn tangential to the tip of the greater trochanter
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What is the Significance of Skinner's Line?
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
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What Landmarks are used to draw Klein's Line?
A line is drawn along the outer margin of the femoral neck
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What is the Significance of Klein's Line?
The femoral head should intersect this line
Failure to intersect this line indicates:
Slipped Capital Femoral Epiphysis (SCFE)
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What are the Landmarks used for the Patellar Position?
A line is drawn between the superior and inferior patellar pole
A line is drawn between the inferior patellar pole and the Tibial tubercle
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What is the Significance of the Patellar Position?
Patellar length and patellar tendon should be approximately equal
If the tendon length is 20% greater than the patellar length indicates:
Patella Alta
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What are the Landmarks for Heel Pad Measurement?
The shortest distance is measured between the plantar surface of the calcaneus and the external skin
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What is the Significance of the Heel Pad measurement?
If the distance is
Greater than 25 mm in males
Greater than 23 mm in females
Indicates increased thickening often associated with Acromegaly
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What are the Landmarks used for Boehler's Angle?
The three highest points on the superior aspect of the Calcaneus are connected with two lines
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What is the Significance of Boehler's Angle?
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
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What are three signs/symptoms a patient with Reye's Syndrome will have?
Deafness
Neurological Defects
Seizures
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What condition will have Anderssen Lesions?
Ankylosing Spondylitis (AS)
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What condition will you see a Subchondral Cyst?
Degenerative Joint Disease (DJD)
