Imaging Flashcards
Best view for Spondylolyis?
What are you looking for?
Oblique view
Scottie Dog
Best view for Spondylolistesis?
Static view: Lateral
Dynamic: Flexion/Extension
Best view for Dens fracture?
XRay:Open mouth odontoid view and lateral C-spine
CT: Sagittal reconstructions most sensitive
Rib Fracture
XRay: Difficult to detect
Bone Scan: Most sensitive
Best view for lower cervical spine fracture?
Swimmer’s view
Best view for clavicle fracture?
Preferred study: 10 degrees cephalic tilt
Glenoid Fracture?
Bony Bankart: West Point Axillary
Scapular fractures
CT is most helpful
Best view for subacromial impingement
Scapular outlet view
AC Joint Separation
Bilateral AP XRays with both shoulders on same plane
Hill-Sachs Lesion
Preferred study: Stryker notch view & Axillary lateral view
Anterior humeral dislocation
Best: Axillary lateral view
Followed by: Scapular Y lateral view
Posterior humeral dislocation
AP and scapular Y views
*can be deceptive
Elbow fractures
XRays: AP/Lateral/Oblique of elbow
Wrist: Colles fracture
XRay: dinner fork deformity
Wrist: Smith fracture
XRay: AP/Lat/Obilique of wrist
Hand: lunate dislocation
Oblique/AP/Lateral views
Scaphoid fracture
AP/Lat/Oblique - may be negative initially
- repeat XRays in 10 days
- MRI can detect occult fracture
Hamate fracture
Most sensitive: Carpal tunnel view
*CT can be helpful
Pelvic fracture
XRays: AP/Inlet/Outlet
CT: most sensitive
Acetabular fracture
Judet views: AP/iliac/obturator view
CT: for complex fractures
Hip fracture or dislocation
AP/ cross table lateral
Patellar fracture
XRay: AP/lateral/sunrise
Lateral view most helpful
Patellar subluxation
Sunrise or merchant view
Tibial plateau fracture
XRay: AP/lateral/15 degree tilt oblique
*CT for operative planning
Osgood Schlatter’s
AP/Lateral
Lateral will show fragmentation of apophysis
Stress fracture (shin splints)
AP/Lateral
Lateral will demo cortical reaction in severe fracture
MRI: most sensitive
Bone Scan: helpful
Ankle Instability
Xray: AP/Lateral/Mortise; Stress Views
Jones fracture
Oblique View of the foot
MRI & Bone Scan utilized
Most common type of Salter Harris fracture types?
Type II
Ottawa Ankle Rules
Unable to walk 4 steps immediately or in ER
IF Ankle pain present
Tenderness over the posterior 6cm of lateral or medial mallelous
AND/OR
IF Midfoot pain is present
Tenderness over the navicular or base of the 5th metatarsal
Ottawa Knee Rules
Age >55 OR
Isolated tenderness of the patella
OR
Tenderness of head of fibula
OR
Inability to flex knee to 90 degrees
OR
Unable to bear weight immediately or in the ER
Canadian C-Spine Rules: High Risk Factors
Age >65 years old
OR
Dangerous mechanism
- fall from elevation greater than 3 feet or 5 stairs
- Axial load to the head
- MVC high speed (>100 km/hour)
- Motorized rec vechiles
- Bicycle struck or collison
OR
Paresthesias in extremities
What sign on XRay would you see in an elbow fracture?
Fat Pad displacement
- displacement of any of the fat pads may indicate an occult fracture
- displacement of the posterior olecranon pad is almost always associated with a fracture
- typically radial head fracture in adults & intracondylar fracture in children
Segond fracture
- avulsion fracture of the lateral tibia condyle
- sometimes seen on XRay after an ACL injury
What zone of a proximal 5th metatarsal is at risk for non-union?
Zone 2
Treatment:
- cast immobilization for 6-8 weeks OR
-Early fixation in some athletes
What imaging is recommended for a SLAP lesion?
MR Arthrogram
What images make a complete trauma series for shoulder dislocations?
- True AP
- Scapular Y
- Axillary
Also helpful:
- Stryker view: shows hill sachs lesion
- West Point view: shows glenoid bone loss
After an ACL injury: what may you see on XRay?
- notch width index
- Osteochondral fracture
- Segond fracture
- Bone bruise (MRI)
- most common site is over the lateral femoral condyle
Best XRay view of syndesmotic ankle sprain
Mortise view in unilateral stance
