Imaging

Question 1

What is a Hill Sach deformity and Bankart lesion?

Answer 1

Anterior dislocation of gleno-humeral joint
→ impact injury of humeral head (Hill Sach deformity) against glenoid fossa (Bankart lesion)

Question 2

What does a “light bulb” sign on a shoulder Xray indicate?

Answer 2

Posterior dislocation of glenohumeral joint

Question 3

What are 2 causes of abnormal bony protuberance?

Answer 3

1) Exostosis
2) Osteochondroma

Question 4

What is a possible physiological cause of a line of radiolucency within a adolescent’s bone on a radiograph.

Answer 4

Growth plate

Question 5

What is a possible of easy fractures that show abnormal radiolucency of underlying bone?

Answer 5

Pathological fracture with cancerous replacement of bone matrix/material

Question 6

What does a “fat pad” sign (presence of radiolucent shadows anterior and posterior to humerus) on an elbow xray indicate?

Answer 6

Elbow joint effusion

Question 7

What is a “nightstick” fracture?

Answer 7

Fracture to ulnar shaft

Question 8

What is a “Galeazzi fracture”.

Answer 8

Fracture @ distal 1/3 of radius
- a/w subluxation of distal radio-ulnar joint

Question 9

What is “Colle’s fracture”?

Answer 9

Fracture of distal radius with dorsal displacement of wrist and hand
- presents with “Dinner fork deformity” of forearm

Question 10

How does a scaphoid fracture lead to avascular necrosis?

Answer 10

Fracture → compression of radial artery → death of bone (avascular necrosis)
- chronic pain + l.o.f

Question 11

What is the most commonly torn ligament in a rotator cuff tear?

Answer 11

Supraspinatus

Question 12

How does a torn supraspinatus tendon differ from a normal one on ultrasound?

Answer 12

Normal tendon → hyperechoic

Tear → Fluid → Hypoechoic

Question 13

What is a “Terry Thomas” sign?

Answer 13

Widening of Scaphoid-Lunate gap → Scapholunate ligament injury

Question 14

What is an open mouth Xray used to assess?

Answer 14

C1 and 2 vertebrae

Question 15

What is an EOS?

Answer 15

Low-dose, weight bearing X-ray
- can take whole body frontal and lateral images
- less radiation than conventional xray
- can produce both 2D and 3D images
- poor demonstration of bony features

Question 16

What are 4 common imaging modalities used for back pain?

Answer 16

1) Radiograph
- good for 1st line

2) MRI
- good for soft tissue

3) CT
- goof for bony details

4) Nuclear medicine - bone scan
- good for bone metastasis

Question 17

How is a T1-weighted MRI sequence differentiated from a T2-weighted MRI sequence?

Answer 17

T1: fluid is dark
T2: fluid is white

Question 18

What is a bone scan?

Answer 18

Radioisotope injected IV → tracer incorporated into bone

• hot spots → ↑bone growth/repair
• cold spots → decreased/no uptake

Question 19

When is imaging indicated for a suspected cervical spine trauma?

Answer 19

N - Neurological deficit
S - Spinal tenderness
A - Altered mental status
I - Intoxication
D - Distracting injury

Question 20

How does one discern if there is an unstable injury after a suspected cervical spine injury?

Answer 20

All 4 lines of the neck vertebrae are straight/smooth.

1) Anterior vertebral
2) Posterior vertebral
3) Spinolaminar
4) Posterior spinous

Question 21

Which imaging modality is most suited for a suspected cervical spine trauma?

Answer 21

CT

Question 22

What are the 3 most common fractures of the thoracolumbar spine?

Answer 22

1) Compression
2) Burst
3) Chance

Question 23

What are 2 common degenerative conditions of the thoracolumbar spine?

Answer 23

1) Spondylosis
2) Disc disease

Question 24

What does an uneven iliopectineal or ilioischial line on a Xray pelvis indicated?

Answer 24

Hip fracture (relevant medial surface)

Question 25

What is an “open book” fracture?

Answer 25

pelvic fracture is a specific type of open pelvic fracture where a person has: pelvic bones broken into two or more separate pieces.

Question 26

What are the muscles visibile at the level of the anterior superior iliac spine?

Answer 26

Gluteal:
1) Gluteus maximus
2) Gluteus medius
3) Gluteus minimus

Pelvic:
4) Iliacus
5) Psoas
6) Iliopsoas

Question 27

Where is the highest level at which the hip joint in which the 3 thigh compartments can be seen?

Answer 27

Hip joint at greater trochanter

Question 28

What are the muscles visible at the level of the lesser trochanter?

Answer 28

Medial compartment:
1-3) Adductor group (longus, brevis, magnus
4) Gracilis
5) Obturator externus
6) Pectineus

Question 29

What are the the muscles are visible at the level of the proximal femur?

Answer 29

Posterior compartment (Hamstrings):
1) Semimembranosus
2) Semitendinosus
3) Biceps femoris

Anterior compartment:
4) Iliopsoas
5) Tensor fascia lata
6) Sartorius
7) Quadriceps femoris

Medial compartment:
8-10) Adductor group (longus, brevis, magnus)
11) Gracilis
12) Obturator externus
13) Pectineus

Question 30

What are the arrangements of the muscles of the knee from medial to lateral?

Answer 30

1) Sartorius tendon
2) Gracilis tendon
3) Semimembranosus
4) Semitendinosus tendon
5) Gastrocnemius (Medial then lateral)
6) Biceps femoris

Question 31

What are the structures at the level of the ankle?

Answer 31

Anterior group:
1) Tibialis anterior
2) Extensor Hallucis Longus
3) Dorsalis pedis Artery
4) Deep peroneal nerve
5) Extensor Digitorum longus

Posterior group:
6) Tibialis posterior
7) Flexor digitorum longus
8) Posterior tibial artery
9) Flexor Hallucis Longus

Question 32

What are 4 imaging modalities that are used to visualise the lower limb arteries and veins?

Answer 32

1) US
2) CT angiogram
3) MR angiogram
4) Formal angiogram (invasive and allows intervention)

Question 33

The sciatic nerve divides into the __________ at the ______________.

Answer 33

Common peroneal and tibial nerve at popliteal fossa

Question 34

What are 2 imaging methods used to visualise the lower limb lymphatics?

Answer 34

1) PET
2) CT