Extremity Views

Question 1

Motive

Answer 1

Pain or dysfunction

Question 2

Check the periosteum

Answer 2

Periosteal reaction - parallel and spiculated

Question 3

Parallel periosteal reaction aka

Answer 3

Linear

Laminated

Question 4

Parallel periosteal reaction

Answer 4

Ewing’s sarcoma
Infection
Trauma
Only in long bones

Question 5

Spiculated periosteal reaction aka

Answer 5

Sunburst

Radiating

Question 6

Trauma

Answer 6

Look for fx or bony callus

Question 7

Infection

Answer 7

WBC count, staph aureus

Question 8

<25 laminated without bony callus

Answer 8

Either Ewing’s or osteomyelitis

Question 9

> 30 without callus

Answer 9

Osteomyelitis

Question 10

Spiculated/radiating/sunburst primary bone cancer

Answer 10

Osteosarcoma
Chondrosarcoma
Fibrosarcoma

Question 11

Only time you pick osteosarcoma over 30

Answer 11

Late stage paget’s

Question 12

Trauma and infeciton do not

Answer 12

Expand

Question 13

Check the cortex

Answer 13

Thinning
Thickening
Interruption
Deformity of the cortex

Question 14

Thinning of the cortex

Answer 14

Osteoporosis

Grey bone/grey soft tissue with pencil thin cortices

Question 15

Thickening cortex

Answer 15

Paget’s

Question 16

Interruption of cortex

Answer 16

Fracture or non-union

Question 17

Deformity of cortex

Answer 17

Pagets

Fibrous dysplasia

Question 18

Check teh medulla

Answer 18

Whiter - blastic mets
Pagets

Darker - lytic mets, mm, BBT

Question 19

Loss of joint space

Answer 19

Yes = DJD/RA
No = AVN

Question 20

Salter harris fracture types 1-5

Answer 20

Type 1 - epiphysis slides along metaphysis (SCFE)
Type 2 - through growth center and metaphysis
Type 3 - through growth center and epiphysis
Type 4 - thorugh epiphysis, growth center, and metaphysis
Type 5 - compression of growth center

Question 21

Most common salter harris

Answer 21

Type 2 through growth center and metaphysis

Question 22

Calcification of the muscle belly

M/c seen in biceps and quadriceps

Answer 22

Myositis ossificans

Question 23

Calcium within muslce
Can work on them
M/c/c major repetitive trauma
Pt typically an athlete

Answer 23

Myositis ossificans

Question 24

3 ways to differentiate between primary malignancy (sarcoma) and Myositis ossificans

Answer 24

Both look extremely white on film
Periosteal rxn = primary malignancy
MO usually parallel to shaft