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622: Human Imaging I > Hip > Flashcards

Hip Flashcards

1
Q

From an AP view, the femoral neck and head should form an angle with the diaphysis of the femur of ___° plus or minus 7°

A

125

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2
Q

What is the innominate bone?

A

The fusion of the 3 bones of the hip

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3
Q

An angle of inclination of 105° is considered coxa ____. An angle of inclination of 140° is considered coxa ____.

A

vara

valga

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4
Q

What are the 2 standard views to visualize the femoral head and neck?

A
  • Anteroposterior view (AP)

- Frog-leg view (frog-lateral)

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5
Q

In the AP view the patient is supine with the hip ____ rotated how many degrees?

A

internally

15°

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6
Q

Describe patient position for frog-leg view

A

patient supine, knees flexed, and femurs fully abducted

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7
Q

What is the purpose of the frog-leg view

A

It gives a second lateral view of the proximal femur

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8
Q

Why is the frog-leg view never used to rule out a proximal femur fracture or dislocated hip?

A

it places too much torque on hip joint

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9
Q

In the standard frog-leg view what part of the femur is pronunced?

A

the spherical shape of the femoral head

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10
Q

The iliopubic lines represent the _____ columns of the pelvis

A

anterior

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11
Q

The iliopubic lines run from where to where?

A

From the midpoint of the inner rim of the pelvis distally along the medial rim of pelvis toward pubic rami

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12
Q

The ischiopubic lines represent the _____ columns of the pelvis

A

posterior

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13
Q

The ischiopubic lines run from where to where?

A

From the midpoint of the inner rim of the pelvis distally along the medial border of “teardrop” to medial border of obturator foramen

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14
Q

In the AP view of the hip what do the “teardrops” represent?

A

The sum of shadows created by the medial acetabular walls

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15
Q

The teardrops should be an equal distance between what 2 structures?

A

In between the medial pelvic rim and the femoral heads

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16
Q

What is the angle of Wiberg?

A

The angle created when a line is drawn from the center of the femoral head vertically and another drawn from the same center point to the proximal, lateral edge of acetabular rim

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17
Q

The angle of Wiberg must be greater than __°.

A

> 25°

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18
Q

If the angle of Wiberg is less than 25° what exists?

A

dysplasia of the hip

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19
Q

What forms Shenton’s line?

A

A smooth line from the medial edge of the proximal femur metaphysis proximally and medially along the proximal rim of the obturator foramen

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20
Q

How can you determine if the femurs are equally rotated in the AP view?

A

Compare the relative size and exposure of the lesser trochanters

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21
Q

In the AP view, the anterior rim of the acetabulum is _____ and ____ to the posterior rim

A

superior and medial

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22
Q

If there is a compressive force to the femoral neck where will you see increased density on a plain film?

A

Along the superior portion of the neck

23
Q

If there is a distractive force to the femoral neck where will you see increased density on a plain film?

A

Along the inferior portion of the neck

24
Q

How can you determine if there is osteosarcoma?

A

There will be a “sunburst” pattern

25
Q

the femur develops trabechular patterns along the lines of the compressive and distractive forces in accordance with what law?

A

Wolff’s

26
Q

What are the 4 major trabechular patterns?

A

(1) principal compressive group
(2) secondary compressive group
(3) principal tensile group
(4) secondary tensile group

27
Q

What are the borders of Ward’s triangle?

A

The primary compressive trabechulae medially
The secondary compressive trabechulae laterally
The primary tensile trabechulae proximally

28
Q

Calcifications in soft tissue are the result of dystrophic (degenerative or necrotic) causes __% to __% of time

A

95 - 98%

29
Q

Hip pathologies are strongly correlated to what characteristic in a patient?

A

age

30
Q

Are congenitally dislocated hips more frequent in males or females at what ratio?

A

Females at 4:1 ratio

31
Q

__% of congenital hip dislocations are unilateral

A

80

32
Q

What are some characteristics of children with septic hip?

A

Limping
Vague pain localized to distal thigh (often mistaken for knee pain
Fever

33
Q

Legg-Calvé-PerthesDisease is found in children from the ages of _ to _ years with average diagnosis at _.

A

3 to 12

7

34
Q

What is Legg-Calvé-PerthesDisease?

A

A form of idiopathic, avascular necrosis of the proximal femoral epiphysis

35
Q

What is the most common cause of hip pain in the adolescent age group?

A

Slipped CapitalFemoral Epiphysis

36
Q

What is Slipped CapitalFemoral Epiphysis?

A

Posterior and inferior slippage of proximal femoral epiphysis on metaphysis (femoral neck), occurring through physeal plate during early adolescent growth spurt

37
Q

Other than congenital hip dislocations, what are other causes for hip dislocations?

A

traumatic

 - MVA
 - high risk sports
38
Q

What is a common cause of acetabular fracture?

A

MVA and the knee hits the dashboard causing flexed hip to move posteriorly into acetabulum

39
Q

Traumatic dislocations of hip joint can be _____, _____, or _____ (through the acetabulum).

A

anterior, posterior, or medial

40
Q

The majority of hip dislocations occur in what direction?

A

posterior

41
Q

Only __% of hip dislocations are anterior

A

13%

42
Q

Stress fractures on the ____ (compression) side of the femoral neck are more common than stress fractures on the _____ (stress) side of the femoral neck

A

inferior

superior

43
Q

When a PT is talking about “groin pain or groin strains” what are they referring to?

A

Occult hip fractures due to low impact or repetitive impact injuries

44
Q

Who is at risk for femoral neck stress fractures?

A

Any patient, regardless of age, who is involved in an “enforced” training regimen that involves weight-bearing repetitive stress

45
Q

What is the most reliable clinical symptom of an impending hip stress fracture?

A

groin pain

46
Q

What type of imaging can also be used to view stress fractures?

A

bone scans

47
Q

What is indicative of osteonecrosis of the hip in the frog-leg view?

A

A crescent-shaped radiolucency found along the superior medial edge of the femoral head

48
Q

When pieces of labrum get into the joint following dislocation, what can occur?

A

Femoroacetabular impingement

49
Q

What does a cam type of impingement result from?

A

Decreased offset between the femoral head and neck combined with retroversion of femoral head, causing impingement of anterolateral rim of acetabulum and the labrum

50
Q

How can you test for labrum impingement?

A

Position the patient supine, flex the hip more than 90°, adducted, and internally rotated.
- if groin pain is present the test is positive for labrum impingement

51
Q

What is myositis ossificans?

A

heterotopic ossification (calcification) of muscle that usually results form a blow to the quads, brachialis, or calf results in pain and swelling

52
Q

When is myositis ossificans often visible on a plain film?

A

Within 2 to 4 weeks of injury

53
Q

What is the major difference between Myositis Ossificans and an osteosarcoma?

A

Myositis ossificans calcifies from its periphery, while an osteosarcoma ossifies from the center of the lesion and “radiates” outward

622: Human Imaging I (7 decks)

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