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Clinical Imaging > Elbow and Arm > Flashcards

Elbow and Arm Flashcards

1
Q

What are routine x-ray projections of the elbow?

A

AP and Lateral

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2
Q

What are routine x-ray projections of the Humerus?

A

AP and Lateral

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3
Q

What are some clinical indications for the elbow?

A

Trauma
Bony tenderness
Suspected fracture of the proximal radius and ulna
Suspected fracture of the distal humerus
Radial head dislocations
Obvious deformity
Detecting joint effusions
Arthritis
Infection

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4
Q

What are additional projections of the elbow?

A

Coyle’s projection and Jones Orthopaedic Projection

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5
Q

What can a Coyle’s projection show?

A

Radial head Fx or dislocation
Capitellum Fx

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6
Q

How does the arm need to be positioned for a Coyle’s projection?

A

X-ray beam at 45 degrees
Radial head isolated,
Radiocapitellar joint open

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7
Q

What can a Jones Orthopaedic Projection show?

A

Good for a Pt. who cannot straighten arm d/t pain
suspected supracondylar fractures in younger patients
Intra-articular loose bodies

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8
Q

What are the names of the anterior fat pads?

A

Coronoid Fat Pad
Radial Fat Pad

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9
Q

What is the name of the posterior fat pad?

A

Olecranon fat pad

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10
Q

What is the anterior humeral line?

A

Line of measurement
Draw a line down anterior surface of Humerus
It should intersect the middle 1/3 of the Capitellum

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11
Q

What does FOOSH stand for?

A

Fall onto out stretched hand

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12
Q

What is the radiocapitellar line?

A

Line of measurement
Line drawn down the neck of the Radius
Should intersect the Capitulum
Line must run along Radial Neck and not shaft of Radius due to the slight angulation of the neck of the Radius

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13
Q

What could a fat pad sail sign be indicative of in adults?

A

Radial head fracture

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14
Q

What could a fat pad sail sign be indicative of in Children?

A

Supracondylar fracture

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15
Q

What could a posterior fat pad abnormality indicate in adults?

A

non-displaced occult radial head fracture

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16
Q

What could a posterior fat pad abnormality indicate in children?

A

non-displaced occult supracondylar fracture

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17
Q

What is Olecranon Foramen?

A

Normal anatomical variant of the Olecranon Fossa (also known as Septal Aperture or Supratrochlear Foramen)
In an x-ray - Increased lucency in the distal Humerus at the Olecranon Fossa

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18
Q

What causes an Olecranon Foramen?

A

An aperture formed by the failure of ossification of the septum that separates the coronoid and olecranon fossae

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19
Q

What is Radioulnar Synostosis?

A

Abnormal connection between the Radius and Ulna

20
Q

How is Radioulnar Synostosis diagnosed?

A

Reduced RoM, usually pronation and supination of hand.
Not usually painful unless it causes subluxation of Radial Head
X-ray : bony fusion and continuous cortex between the proximal radius and ulnar with no radioulnar joint space

21
Q

What is the clinical significance of radioulnar synostosis?

A

Can be associated with dislocation of the Radial Head

22
Q

What is the Supracondylar Process of Humerus?

A

Bony spur projecting distally on the anteromedial surface of the Humerus, approximately 5cm above medial epicondyle.
“Struthers Ligament” may connect spur to medial epicondyle

23
Q

What does Supracondylar Process of Humerus display like on an x-ray?

A

small bony spur projecting anteromedially from the humeral metadiaphysis towards theelbow joint.

24
Q

What does occult mean?

A

not accompanied by readily discernible signs or symptoms

25
Q

What causes radial head fracture?

A

Indirect trauma, fall onto abducted arm with slight flexion of elbow joint

26
Q

What does a radial fracture look like on an x-ray?

A

Can be Occult – Sail Sign / posterior fat pad sign
Radiolucent line; break in the cortex; displacement of cortex

27
Q

what is a Radial Tuberosity Pseudocyst/tumour?

A

anatomical variant that mimics a bone lesion

28
Q

What causes a Radial Tuberosity Pseudocyst/tumour?

A

The radial tuberosity has an area of focal trabeculae rarefaction as it is a “low stress” region

29
Q

How does a Radial Tuberosity Pseudocyst/tumour display on x-ray?

A

lateral projection – ovoid radiolucent lesion (tumour or cyst-like appearance)

30
Q

What is the clinical significance of a Radial Tuberosity Pseudocyst/tumour?

A

misdiagnosed as bone tumour or cyst
Artefactual – misrepresentations of natural tissue due to imaging technique

31
Q

What is the clinical considerations of a Humeral Head Pseudocyst/tumour

A

misdiagnosed as bone tumour or cyst
“do not touch” lesion

32
Q

What causes a Humeral Head Pseudocyst/tumour?

A

Greater tuberosity of the humeral head has greater quantity of spongy bone

33
Q

What is a Prominent Deltoid Insertion?

A

anatomical variant that mimics a bone lesion

34
Q

What does a prominent deltoid insertion look like on an x-ray?

A

localised cortical thickening of the lateral humeral midshaft at the insertion site of the deltoid muscle
clinical significance - resembles periostitis and may be mistaken for a lesion

35
Q

What is the name of the accessory ossicle of the elbow?

A

Os Supratrochlear Dorsale

36
Q

Where is the Os Supratrochlear Dorsale located?

A

Olecranon fossa of humerus

37
Q

What is the name of the sesamoid bone of the elbow?

A

Patella Cubiti

38
Q

Where is the Patella Cubiti located?

A

Distal Triceps Brachii
Similar appearance to Patella on x-ray

39
Q

What does CRITOE stand for?

A

6 elbow ossification centres
Capitellum
Radial Head
Internal (medial) epicondyle
Trochlea
Olecranon
External (lateral) epicondyle

40
Q

At what age does the capitellum ossify?

A

1 year old

41
Q

At what age does the radial head ossify?

A

3 years old

42
Q

At what age does the internal (medial) epicondyle ossify?

A

5 years old

43
Q

At what age does the Trochlea ossify?

A

7 years old

44
Q

At what age does the olecranon ossify?

A

9 years old

45
Q

At what age does the External (lateral) epicondyle ossify?

A

11 years old

Clinical Imaging (22 decks)

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