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Radiology > Final Exam Terms > Flashcards

Final Exam Terms Flashcards

1
Q

swimmers view is used to better visualize what bones

A

C7-T1

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2
Q

slipped capital femoral epiphysis aka SCFE is what type of fx?

A

salter 1

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3
Q

Hills-sachs defect is MC assoc with what type of injury

A

anterior shoulder dislocation

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4
Q

fx in what area is bad news for blood supply?

A

scaphoid

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5
Q

type of fx that obliterates the epiphysis

A

salter 5

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6
Q

follow up with a fx patient that is now 8MO post fx…on xray fx is not healed—name of this condition?

A

non-union

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7
Q

17 YOM football player presents after being tackled and slammed onto his right dominant shoulder forcefully 2 hours ago during a game, he has full active and passive ROM, but some pain with abduction. no obvious deformity, the skin over the shoulder is intact and not broken. what study do you order?

A

xray of shoulder in 2 views—-NOT MRI because this is still an acute trauma and we want to r/o posterior dislocation right away

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8
Q

image study of choice for orbital blow out fx

A

CT

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9
Q

which fx can cause leg length differences, angulation of bone and secondary osteoarthritis

A

salter 4 of lower extrem

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10
Q

what is the term for a fx that occurs following a force insufficient to break normal bone?

A

pathologic fx

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11
Q

what causes blurred film

A

movement of PT

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12
Q

___ results in direct force to the anterior shoulder, or indirect force applied to the arm combining adduction, extension and internal rotation

A

posterior shoulder dislocation

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13
Q

term used to describe the lighter areas on an exposed and processed film

A

radiopaque

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14
Q

waters view is done with which type of xrays

A

facial bone xrays

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15
Q

overall darkness of blackness on film=?

A

density

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16
Q

types of fx involves the growth plates of children

A

salter harris fxs

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17
Q

why do we get two views on xray -which views

A

visualize bone better and better localize abnormality AP lateral

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18
Q

can xray detect soft tissue swelling

A

only if it is significant

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19
Q

imaging modality to visualize bone marrow and soft tissues, muscles, tendons, ligaments

A

MRI

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20
Q

what would appear as decreased density on xray (3)

A

osteoporosis

localized osteolytic mets

MM

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21
Q

avascular necrosis of bone appears as incr or decr density

A

focal increased density (whiter)

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22
Q

MC cause in men of osteoblastic mets

A

prostate CA

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23
Q

common places for avasc necrosis (3)

A

scaphoid in wrist femoral head humeral head

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24
Q

most sensitive imaging to detect avasc necrosis

A

MRI

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25
Q

MC primary malignancy of bone in adults

A

multiple myeloma

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26
Q

how does MM show on xray

A

decr density

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27
Q

multiple, small, sharply-circumscribed (punched-out) lytic lesions of approximately the same size

A

disseminated MM

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28
Q

hallmark of MM

A

diffuse spinal osteoporosis

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29
Q

what is MM associated with

A
  1. diffuse spinal osteoporosis 2. multiple compression fxs
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30
Q

lytic lesions or punched out lesions

A

MM disseminated

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31
Q

joint space narrowing

A

arthritis

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32
Q

erosion and new bone formation that may occur in the same joint

A

psoriatic arthritis

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33
Q

pencil in cup

A

psoriatic arthritis

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34
Q

ankylosing spondylitis -MC in? -presentation -can be assoc with? -hallmark finding

A

MC in young males presentation: neck/low back pain, worse at night, better with exercise assoc with UC hallmark: sacroiliitis *fusion of lumbar spine and sacro-iliac joints

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35
Q

compression fx of spine -MC in -secondary to ? -s/s -study of first choice

A

women >>> men typically occur secondary to osteoporosis s/s *kyphosis *loss of overall body height conventional spine radiographs 1st image done

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36
Q

osteoporotic commpression fractures mc involve? spare what?

A

anterior and superior aspects of vertebral body—- SPARING posterior body

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37
Q

red flags for back pain (4)

A
  1. neuro deficits 2. tumor, hx of CA, weight loss, pain worse at night 3. infection or immunocomp 4. trauma
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38
Q

rules of 2 for imaging (4)

A

*2 views: ap and lateral *2 joints: above and below fx *2 sides: both limbs *2 occasions: some non-displaced fx wont show up for 10-14 days

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39
Q

This is an 81-year-old male with chronic back pain. What is the most likely diagnosis?

A

Multiple myeloma

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40
Q

These are the hands of a 45-year-old female with a rash. What is the most likely diagnosis?

A

Psoriatic arthritis

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41
Q

define incomplete fx

A

only part of the cortex is fx

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42
Q

causes of incomplete fx and list the types

A

soft bones (kids), bone dz like Paget Dz

Types: greenstick and Torres/Buckle

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43
Q

define buckle fx

A

compression of cortex

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44
Q

how can you describe a fx (4) and give ex for each

A
  1. number of fx fragments–simple or communited (more than 2)
  2. Direction of fx line–transverse, oblique, spiral
  3. Relationship of one fragment to another—displacement, angulation, shortening, rotation
  4. open to the atmosphere—closed or open (compound)
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45
Q

MOA for a transverse fx

A

force applied perpendicular to long axis of bone—fx occurs at point of impact

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46
Q

MOA for obliqe fx

A

force applied along the long axis of bone—fx occurs somewhere along shaft

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47
Q

MOA for spiral fx

  • stable or unstable
  • assoc with?
A

twisting or torque injury

EX: planting foot in a hole while running

***unstable***

*assoc with soft-tissue injuries like tears in ligaments and tendons

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48
Q

dislocation and subluxations only occur where

A

at the joints

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49
Q

subluxation

A

bones that originally formed the two components of a joint are in partial contact with eachother

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50
Q

amount by which the distal fragment is off-set, front-back and side-side, from proximal fragment

A

displacement

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51
Q

describe angulation

A

angle b/w distal and proximal fragments as a function of degree to which the distal fragment is deviated from the position it wuld have assume were it in its normal position

-decr in degrees

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52
Q

this term describes how much, if any, overlap there is of the ends of the fracture fragments

A

shortening

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53
Q

opposite term from shortening?

A

distraction

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54
Q

describe distraction

A

distance the bone fragments are sep from each other

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55
Q

rotation almost always involves

A

long bones—femur or humerus

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56
Q

fx produces two fragments

A

simple fx

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57
Q

fx produces more than 2 fragments

A

comminuted fx

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58
Q

fx line is perpendicular to the long axis of the bone—what kind of fx is this

A

transverse

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59
Q

fx line is diagonal in orientation relative to the long axis of the bone–what kind of fx

A

oblique

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60
Q

are spiral fx stable or unstable

A

unstable

61
Q

upper extrem spiral fx in a child suggestive of

A

child abuse

62
Q

stress fx also called

A

linear fx

63
Q

fx=one thin line with no additional lines splintering from it and no compression or distortion of the bones

A

linear fx or stress fx

64
Q

stress fx MC where

A

skull

65
Q

another term for open fx

A

compound fx

66
Q

complication of compound fx

A

osteomylitis

67
Q

shortening=?

distraction=?

A

shortening=overlap

distraction=lenghening

68
Q

to appreciate rotation, what must you do

A

visualize joint above and below the fx

69
Q

MC elbow fx in adults and children

A

fx of the radial head=adult

Supacondylar fx of the distal humerus=children

70
Q
A

supracondylar fx of the distal humuers— MC elbow fx in kids

71
Q

supracondylar fx of the distal humerus in a child will produce?

A

posterior displacement of distal humerus

+posterior fat pad***

72
Q

+posterior fat pad sign

A

radial head fx

*swelling of the joint capsule due to traumatic hemarthrosis

73
Q

PT complaining of pain—- but the xray is normal–what would this suggest

A

stress fx

***appears normal in up to 85% of fxs

74
Q

if a stress fx is not shown on xray, when will it be diagnosable?

A

not until after periosteal new bone formation occurs

75
Q

appearance of a thin, dense zone of sclerosis across the medullary cavity of the cancellous

A

stress fx

76
Q

common locations for stress fx (3)

A

shafts of long bones—prox femur or prox tibia

calcenous

second and third metatarsals

77
Q

what is a march fx

A

stress fx of the second and third metatarsals

78
Q
A
79
Q

remodeling of bone begins when

A

8-12 weeks post fx

80
Q

Healing of the fracture fragments occurs in a mechanically or cosmetically unacceptable position

A

malunion

81
Q

This implies that fracture healing will never occur. It is characterized by smooth and sclerotic fracture margins with distraction of the fracture fragments

A

nonunion

82
Q

The fracture does not heal in the expected time for a fracture at that particular site (e.g., longer than 6 to 8 weeks

A

delayed union

83
Q

study of choice for skull fx

A

ct with bone windows

84
Q

skull fx may be assoc with

A

epidural hematoma

85
Q

MC bone fx in a basilar skull fx

A

temporal bone

86
Q

basilar skull fx

  • MC in?
  • can cause?
  • PE findings
A

MC in young men–>secondary to high risk behaviors

  • can cause tear in dura mater–>CSF rhinorrhea and/or otorrhea
  • battle’s sign–echymosis behind ear
  • racoon eyes
87
Q

if temporal fx suspected in basilar skull fx, what imaging is indicated

A

high resolution CT done on temporal bone

88
Q

MOA causing orbital flow blowout fx

  • what part of orbit is fx
  • what muscle can get trapped–what can happen as a result
A

direct impact on the orbit

-ball hitting the eye for ex

**causes sudden rise in intra-orbital pressure–>fx of the inferior orbital floor or medial wall of orbit

-inferior rectus muscle can get trapped–>restriction of upward gaze + diplopia

89
Q

decrease visual acuity

diplopia (esp with upward gaze)

orbital emphysema

epistaxis

A

orbital flow blowout fx

90
Q

image test of choice for orbital floor blowout fx

-sign?

A

CT scan

*shows teardrop sign

91
Q

tear drop sign on CT

A

orbital floor blowout fx

*herniating tissue and muscle

92
Q

MC facial fx?

A

nasal bone injury

93
Q

waters view

A

view done to look at nasal bone injury on xray

*pt gazes upward

*angled PA image

94
Q

MC type of spinal fx

A

compression fx

95
Q

MC region for spinal fx

and cause

A

cervical spine

MCC= trauma

96
Q

2nd MC region of spine injured in fxs

A

thoracolumbar junction

b/w T11-L4

97
Q

NEXUS criteria (5)

A
  • absence of midline cervical tenderness
  • absence of focal neruo deficits
  • normal level of consciousness/alert
  • no evidence of intoxication
  • absence of painful distracting injury
98
Q

CCR criteria

A

age >65, dangerous MOI

99
Q

what is most imp view for c-spine

A

lateral

100
Q

what do we do if we cannot visualize C7-T1

A

obtain swimmers view—taken with one arm over head

101
Q

compression fx of the bony ring of C1

+lateral masses splitting

A

Jefferson fx

unstable

***AP open mouth image***

102
Q

MOA for Jefferson fx

A

axial (loading) blow to the vertex of head

-diving injury for ex

103
Q

fxs through pars interarticularis of the axis (C2) separates posterior aspects of C2 vertebral body from anterior aspect of C2

A

Hangman fx

104
Q

MOA for hangman fx

A

hyperextension/compresion injury—forced extension of an already flexed neck

EX: MVA—chin hits dashboard

105
Q

which view is hangmans fx best seen on

A

lateral

106
Q

is hangmans fx associted with neuro deficits

A

no—even tho it is an unstable fx

107
Q

hangman fx leads to ??

A

overall widening of the spinal canal

108
Q

another term for compression fx

A

burst fx

109
Q

multiple noncontiguous thoracic fractures are assoc with?

A

burst fracture in nearly 50%— so finding a fx should make one continue to look for another

110
Q

what can also be present with throacic spine fx

A

rib rx

111
Q

describe the Y view

A

humeral head should be at the center of the Y of the scapula

*used with shoulder dislocations

112
Q

MC site for fx in shoulder

A

surgical neck

113
Q

anterior dislocation

  • describe
  • MOI
  • best view to see dislocaiton
  • assoc with?
A
  • displacement of humeral head anterior to the glenoid cavity
  • MOI: indirect force to the arm thru combination of abduction, extension and external rotation

>95% of all shoulder dislocations

  • axillary view is best to visualize
  • assoc with Hills-Sachs defect
114
Q

Hills-sachs defect

  • define
  • assoc with
A

assoc with anterior shoulder dislocation

-posterolateral humeral head depression fx–resulting from impactiong with the anterior glenoid rim

115
Q
A

Hills-sachs defect

*assoc with anterior shoulder dislocation

116
Q

in anterior shoulder dislocation, where does humeral head lie

A

under the anterior coracoid process of scapula

117
Q

posterior shoulder dislocation

  • MOI
  • best view on image
A

MOI=direct force to the anterior shoulder–or indirect force appliced to the arm combining adduction, extension and internal rotation

*standard axillary projection and/or AP projection with PT rotated 40 degrees toward affected side is best way to image

+light bulb sign******

118
Q

Y view xray shows the humeral head lateral to the glenoid in which dislocation

A

posterior

119
Q

posterior dislocation, the humeral head is fixed in ____ rotation

A

internal

120
Q

where do most clavicular fx occur

A

mid portion or distal third of clavicle

121
Q

ulnar fx with dislocation of radial head

A

Monteggia fx

122
Q

radius fx with dislocation of distal radioulnar joint

A

Galeazzi fx

123
Q

supracondylar fx of distal humerus

  • produce?
  • how does the anterior humoral line lie?
A

produces posterior displacement of distal humerus

**the anterior humoral line lies more anteriorly–> + posterior fat pad sign

124
Q

+posterior fat pad sign

A

Radial head fx

125
Q

colles fracture describe

  • assoc with?
  • MOA
  • MC seen in?
A

fx of distal radius with dorsal angulation of the distal radial fx fragment

*assoc with fx of the ulnar styloid

*FOOSH

MC in elderly women with osteroporotic bone that sustain a low energy fall

126
Q

repeated microfractures to the foot from trauma

A

march fx

127
Q

march fx

  • type of fx
  • MC affecting?
A

stress fx

MC affects the shafts of the second and third metatarsals

128
Q

transverse fx of the 5th metatarsal about 1-2 cm from its base

A

jones fx

129
Q

jones fx

  • describe
  • moi
  • complication
A

*transverse fx

*5th metatarsal 1-2 cm from base

*MOI: plantar flexion of the foot and inversion of ankle

-if not immobilized– nonunion can develop

130
Q

what takes longer to heal—jones fx or avulsion fx of 5th metatarsal

A

jones fx

131
Q
A

jones fx

132
Q

list the six fx or dislocations not to miss

A
  1. scaphoid fx
  2. buckle fx of radius and/or ulna in kids
  3. radial head fx
  4. supracondylar fx of distal humerus in kids
  5. posterior dislocation of shouldder
  6. hip fx in eldery
133
Q

tenderness of anatomic snuff box after falling on outstretched hand

A

scaphoid fx

134
Q

acute and sudden angulation of cortext near the wrisrt

A

buckle fx

135
Q

thumb gets pulled backwards-commonly while skiing and ski pole gets stuck in snow

A

gamekeeper’s thumb

136
Q

pathologic fx

  • occur in?
  • MC locations? (3)
A

*occur in bone with preexisting abnormality–>metastasis, osteoporosis

*ribs, spine, proximal appendicular skeleton (esp humerus and femur)

*

137
Q

Ottawa Ankle Rules

  • descr what?
    1. ankle image is requried only when there is pain in the ___ ___ and 3 of the following?
    2. foot xray is req only when there is pain in the ___ ___ and 3 of the following?
A

describe the requirements for plain x-rays within clinical context of ankle injury

  1. ankle radiograph is required ONLY if there is pain in the “malleolar zone” + any of these:

–>bone tenderness at posterior edge/tip of lateral malleolus

–>bone tenderness at the posterior edge/tip of medical malleolus

–>inability to weight bare, both immediately and after

  1. A foot x-ray is required ONLY if there is pain in the “mid-foot zone” AND any of these:

–>bone tenderness at the base of 5th metatarsal——Jones fx

–>Bone tenderness at the navicular—-navicular or mortis fx

–>inability to weight bare both immed and after

138
Q
A

jones fx

139
Q

which salter fx can develop arthritic changes or asymmetric growth plate fusion

A

3

140
Q

which salter is more likely to develop early fusion of the growth plate with angular deformities and shortening of bone

A

4 and 5

141
Q

Fracture of the Epiphyseal plate alone

A

salter 1

142
Q

which salter produces a corner sign

A

2

143
Q

which salter is MC

A

2

144
Q

Fracture of the epiphyseal plate and fracture of the metaphysis

A

salter 2

145
Q

Fracture of the Epiphyseal plate and the epiphysis itself

A

salter 3

146
Q

Fracture of the epiphyseal plate, metaphysis and epiphysis

A

salter 4

147
Q

Crush type of fracture of the epiphyseal plate

A

salter 5

148
Q

Slipped capital femoral epiphysis

A

produces inferior, medial and posterior slippage of the proximal femoral epiphysis relative to the neck of the femur

**salter harris 1 fx**

+growth plate damage

Radiology (4 decks)

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