Imaging! Flashcards by Kirsten Gruener

are Ottawa ankle and foot rules highly sensitive or specific

sensitive

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what are the Ottawa ankle rules

-TTP to distal 6cm posterior edge of fib/lateral mall
-TTP to distal 6cm tibia/Med malleolus
-TTP base fith MT
-TTP to navicular
-inability to WB 4 steps after injury

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what position does the leg need to be in to view the mortise

in IR 15-30 degrees

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what is the Danis Weber classification

type a: below ankle joint, syndesmosis is intact
type b: at level of ankle joint, syndesmosis may be intact or partially torn
type c: above ankle joint, syndesmosis is disrupted

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what is the Lauge Hansen classification

supination with addiction
supination with ER
pronation with ABD
pronation with ER

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what is a Maisonneuve fracture

ER Force at the ankle with transmission up to the fibular head, resulting in Prox fibular fracture

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tillaux fracture

type III SH, peds, distal tibial epiphysis, anterolaterally

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what is a Lisfranc fracture

mid foot fracture of the tarsal metatarsal joint at 2nd MT and medial and middle cuneiform

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what is a hallmark sign of a lisfranc fracture

planter bruising

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what is a jones fracture, and what is the best view to see it on

5th MT and with an oblique view

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how will a shin split stress fracture appear on imaging

as a cloudy periosteum

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what is Sever’s disease

calcaneal apophysitis, must rule out avulsions

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correct order of imaging for OCD lesion

x-ray, then MRi than CT

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what type of image is best for posterior pelvic ring

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what is considered abnormal widening of the symphysis

> 1cm

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a pelvic exam in an alert patient is highly sensitive. what components are part of the exam

over 3 y/o, good cognition, no injuries seen in pelvis, no pain with compression of iliac and pubis, and no pain with hip IR/ER

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what are some signs of sxs of stress fractures and osteitis pubis

relief with NWB, insidious, local pain, swelling and tender, pubic ramus and symphysis.

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what is the most common type of hip dislocation, and which way will it go on imaging

posterior most common, will go superior ad lateral

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how does an anterior hip dislocation look on imaging

inf and medially

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what type of fracture will have a shortened leg with IR

intertrochanteric

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what are the Altman criteria for hip OA

hip pain cluster 1: hip pain, hip IR<15, hip flex < 115
cluster 2: hip IR>15, pain with IR, age over 50, morning stiff less than 60 minutes

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what is a good hip CPR

squat as aggravating factor, decreased flexion, scour test with lateral hip pain, pain with extension and IR <25 degrees.

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what is AVN of the femoral head and what ages

LCP, 4-10 y/o

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what is the best image for LCP

MRI

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which side is work for a femoral neck stress fracture

tension side is worse

what is a sunrise or merchant view on x-ray

knee to look between patella and anterior femur

what is a tunnel view x-ray

to look at tibial spine, between femoral condyles

what are the Pittsburg knee rules

trauma/fall or blunt injury under ager 12 or over age 50, and inability to walk 4 steps.

are the knee imaging rules highly sensitive or specific

sensitive

what are the ottawa knee rules

-age over 55 -patellar tenderness -TTP at fibular head -inability to flex knee 90 -inability to WB 4 steps

what is a fabella

normal bone formation in the lateral GN

is a bipartite patella pathogenic

no, the superolateral border of the patella is ok.

which way is the most common way to dislocate a patella

laterally

what is a segond fracture

lateral tibial plateau avulsion fracture, usually with ACL. lateral capsule area is where this type of fracture occurs.

which condyle is it more common to have a OCD lesion

medially in men 85%

what is Sinding Larson Johansson

inferior patella version of Osgood Schlatter's

are the Canadian c/s rules sensitive or specific

sensitive

what are the Canadian c/s rules

-high risk factors (over 65y/o, dangerous MOI (fall over 3 feet, 5 steps, axial loading, MVC, rollover, ejection, bike accident), paresthesia in extremity?) -low risk (simple rear end (rollover, oncoming traffic, hit by bus/truck), sitting position in ED, ambulatory, delayed onset neck pain, absence of midline tenderness) IF YES.... -can you rotate at least 45 degrees to L and R

what does an odontoid view look at

with an open mouth, C1-2

after fx ruled out, what type of view can be ordered to check neural foraminal narrowing and alignment of facet joints?

oblique

swimmers view?

c7-T1

describe atlantodental interval meanings

>3.5mm instability 7 mm: disrupted transverse ligament >9-10: neurologic injury

what is the george line

should align with vertebrate with flex and ext

cervical gravity line

pass through 7th vert

prevertebral soft tissue should not be over what spacing in C2-5 then C5-7

c2-5 not over 7mm c5-7 not over 20mm

what are the most common c/s fractures

c1-2 c5-7 T9-L1

what is a jefferson fracture

burst of c1, from axial loading

what is a odontoid fracture

hangman fracture

posterior c2, hyperextension injury,

clay shoveler fracture

SP c6,7,T1,2 from hyperflexion

how does CSF look in T1 vs T2 weighted

T1 CSF will be dark T2 CSF will be white

what is the single most important question/feature of elbow injury that has a high sensitivity of needing an x-ray

inability to extend the elbow fully

what is the most important elbow view

lateral bent at 90 degrees

what is a fat pad sign/sail sign

means trauma, maybe dislocation, definitely joint effusion

what is the most common site of fracture in the elbow

the radial head

what is a nightstick fracture

mid shaft fracture of either ulna or radius

monteggia fracture

proximal ulna fracture with dislocated radial head

galeazzi fracture

fracture of distal radius with ulnar head dislocation

greenstsick fracture

from kids with soft bones, one side fractures and possible other side that just bends

little league elbow happens at which part of elbow

medial epiocondyle

what is the new orleans criteria

CT needed when you have headache, over 60 years old, NV, drug or alcohol involved and trauma above the calvicle and possible seizures

is ultrasound highly accurate for full or partial thickness RTC tears

full

what view of the shoulder can view a bony Bankart or hill sachs

axillary/west point view

mercedes shoulder view

like a scap y view

stryer view can visualize a

hill sachs

what view looks at the AC joint

zanca view

what is teh direction of most common shoulder dislocation

anterior and inferior

what is the Quebec decision rule for imaging following shoulder dislocation

???

hill sachs vs bankart

hill sachs on humeral head, bankart on inferior glenoid rim

HAGL lesion:

humeral avulsion of the Glenohumeral ligament

ALPSA lesion

anterior labroligamentous periosteal sleeve avulsion

Sprengel Deformity

scapula does not descend

what image is best for labral lesions

mRA

what wrist deviation do you use to image for scaphoid trauma

carpal views are needed for what type of wrist fracture

hamate

arch lines of carpals is called...

gilugli lines

hamate fractrues with what types of activities

golf, baseball

terry Thomas sign

S-L dissociation

what is the second line of imaging in wrist

MRI

Keinboch's

AVN lunate

most common forearm fracture

Colles : distal radius with dorsal angulation of the distal fragment

smith fracture

reverse Colles. distal fragment is dislocated palmery/volarly

Torus fracture

bucks fracture, compression, in kids

is imaging always (+) for scaphoid fracture

if scaphoid fx possible, and initial x-ray (-), what is course of treatment

stabilize the wrist and repeat imaging in 2 weeks

what part of scaphoid fractures

middle (waist)

signs of scaphoid fracture

TTP at snuffbox, scaphoid tubercle, compression with first metacarpal into carpals

scapoid fracture will be painful with what deviation at wrist

radial

signet ring sign is a sign of

scaphoid fracture

Keinboch's disease,

lunate AVN, males over females, x-ray than MRi

boxers fracture

5th metacarpal

rolando fracture

thumb, base first metacarpal in 3 pieces interarticular

bennet fracture

thumb, base of first metacarpal in 2 pieces interarticular

gamekeepers fracture

avulsion in thumb, UCL is ruptured, and like skiers, cannot grip things

steners lesion

rupture UCL and it reflects out of aponeurosis