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Semester 4 PM Exam 4 > Elbow Imaging > Flashcards

Elbow Imaging Flashcards

1
Q

Elbow fractures are common in

A

children

Account for 15% of all fractures and about 50% of UE fx in those under 18 yo

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2
Q

What is often mistaken as a fracture

A

secondary ossification centers

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3
Q

Long bones (humerus) primary ossification

A

8 wks gestation

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4
Q

At birth - what is ossified

A

Shaft of humerus, ulna, and radius

Articulating surfaces of these bones are still cartilaginous

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5
Q

Development of secondary ossification centers - fuse earlier in who

A

females

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6
Q

What is the acronym for secondary ossification centers

A 
C - capitulum = 1 yr
R - radius = 3 yr
I - internal (med) epicondyle = 5 yr
T - trochlea = 7
O - olecranon = 9
E - external (lat) epicondyle = 11
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7
Q

Ages of secondary ossification centers are ____ but

A

Debated

But order of appearance is agreed upon

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8
Q

What is the first to appear and when

A

Capitulum

1-2 years

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9
Q

Capitulum fuses with what and when

A

Fuses with the trochlea and lateral epicondyle during puberty

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10
Q

Secondary ossification center - radius

A

about 3 years old

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11
Q

Fusion - radius

A

15 years F

17 years M

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12
Q

Secondary ossification center - med epicondyle

A

4 years old

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13
Q

Fustion - med epicondyle

A

16 years female

18 years male

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14
Q

What is the last epiphysis to fuse

A

Medial epicondyle

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15
Q

Secondary ossification center - trochlea

A

about 7 years old

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16
Q

Fusion - trochlea

A

More irregularity than other elbow areas

First with capitulum and then with lateral epicondyle (during puberty) and then with humerus

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17
Q

Olecranon begins ossification when

A

9 years old

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18
Q

Olecranon closes when

A

15 years F

17 years M

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19
Q

Last ossification center to appear

A

Lateral epicondyle

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20
Q

When does the ossifcation center appear of the lateral epicondyle

A

10-12 years old

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21
Q

When does lat epicondyle fuse and what does it fuse to

A

During puberty
Fuses with capitulum and trochlea
14 years F, 17 years M

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22
Q

Routine projections of the elbow

A

AP
Lateral
Oblique (upon request) - Internal or External

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23
Q

AP Projection - provides a good view of what

A

Distal humerus and proximal radius/ulna

24
Q

AP projection - position

A

Arm placed in ER
Elbow extension
Forearm supination
ANATOMIC POSITION

25
Q

Proximal radius is comprised of

A

Radial head
Radial neck
Radial tuberosity

26
Q

Capitulum and radius - extended position

A

No contact

27
Q

Olecranon - when elbow is extended it is between

A

the epicondyles and in the fossa

28
Q

Displacement of a fat pad is indicative of

A

inflammation in the area, most often secondary to a fracture

29
Q

Carrying angle - define and describe

A

Ulna angled in a lateral direction in relationship to the humerus
5-15 degrees
Medial trochlea is more distal

30
Q

A greater angulation of carrying angle seen on an AP radiograph can indicate what

A

possible fracture

31
Q

Lateral projection - position

A

Elbow 90 flex

Forearm supination with thumb up

32
Q

Lateral projection - what is placed next to the receptor

What direction does the ray go

A

Medial portion of the elbow

Central ray directed in a lateral to medial direction

33
Q

Olecranon fracture - often due to

A

Traumatic force that impacts olecranon onto distal humerus

FOOSH - can cause transverse fx due to forced contraction of triceps

34
Q

Olecranon fracture - what is more common - displaced or non

A

Displaced because of pull of triceps

35
Q

The alignment of the radial head should be reviewed in relationship to

A

the capitulum

36
Q

Teardrop area

A

Area where the epicondyles overlap

37
Q

Disruption of teardrop area can indicate

A

supracondylar fx?

38
Q

Oblique projection - when is it usually requested

A

pediatric trauma cases

39
Q

Displaced ant fat pad AKA

A

sail sign

40
Q

Internal oblique projection - position

A

Elbow extended

Forearm pronation

41
Q

Central ray direction with internal oblique projection

A

Ant to Post

42
Q

Internal oblique projection gives you a good view of what

A

Coronoid process

Also allows for close inspection of humeral ulnar articulation

43
Q

External oblique projection - position

A

Elbow extension

Forearm supination

44
Q

Central ray for external oblique projection

A

Anterior to Posterior

45
Q

What is the most common oblique taken when fracture is suspected in children

A

External oblique projections

46
Q

External oblique projection allows for examination of

A 
Radial head
Radial neck
Radial tuberosity 
All without superiposition of the ulna 
All 3 elbow joints can be examined
47
Q

Radius and ulna act as a ___ system

A

Ring system

Fx at any point may result in injury to another part of the ring

48
Q

Standard projections for the forearm

A

Lateral and AP

49
Q

Injury to forearm are said to occur in

A

proximal third, middle third, or distal third

50
Q

What is visualized with AP forearm

A

Shafts of ulna and radius

Wrist and elbow joints too

51
Q

What is visualized with lateral forearm

A

Shafts of ulna and radius

Wrist and elbow joints too

52
Q

Proximal 1/3 - most common fracture

A

Monteggia fracture

Proximal ulnar fracture associated with radial head dislocations

53
Q

Middle 1/3 - fractures in this area are common in

A

children

54
Q

Middle 1/3 fracture that occurs in adults is usually due to ___
Often results in ___

A

high energy injuries

open fractures and neuro damage

55
Q

A primary complication of middle 1/3 fracture

A

Compartment syndrome

Emergency care required - need a fasciotomy

56
Q

Distal 1/3 - common type

A

Galeazzi fracture - seen in middle or distal 1/3 with accompanying dislocation of distal radioulnar joint and maybe also a fracture of the ulnar styloid

Semester 4 PM Exam 4 (10 decks)

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