Imaging criteria stuff

Question 1

How do you ascertain a good inspiration in paediatric chest imaging under 2 years old?

Answer 1

A good inspiration is shown by visualization of 6 anterior ribs above the diaphragm.

Question 2

What is the thymus and why is it important in pediatric chest imaging?

Answer 2

The thymus is a lymphatic organ in the anterior mediastinum, often visible in infants. It can mimic pathology, so MITs must differentiate it from abnormal findings.

Question 3

Radiographic signs of Pneumonia?

Answer 3

Patchy or consolidated opacities, often localized.

Question 4

Radiographic signs of Bronchiolitis?

Answer 4

Hyperinflation, flattened diaphragm, increased peribronchial markings.

Question 5

Radiographic signs of Cystic Fibrosis?

Answer 5

Hyperinflation, bronchial wall thickening, mucus plugging, possible areas of collapse or infection.

Question 6

What are bucket handle and corner fractures?

Answer 6

Metaphyseal fractures caused by shearing forces; strong indicators of non-accidental injury (NAI).

Question 7

What is the Salter-Harris classification system?

Answer 7

A system categorizing growth plate fractures (Types I–V), important for prognosis and treatment.

Question 8

Salter-Harris Type I?

Answer 8

Fracture through the growth plate only.

Question 9

Salter-Harris Type II?

Answer 9

Fracture through the growth plate and metaphysis (most common type).

Question 10

Salter-Harris Type III?

Answer 10

Fracture through the growth plate and epiphysis.

Question 11

Salter-Harris Type IV?

Answer 11

Fracture through the metaphysis, growth plate, and epiphysis.

Question 12

Salter-Harris Type V?

Answer 12

Crush injury to the growth plate, often hard to detect but serious.

Question 13

What is the most common age and location for a toddler’s fracture?

Answer 13

Age 1–3 years; spiral or oblique fracture of the distal tibia.

Question 14

Name two lines used to assess supracondylar fractures.

Answer 14

Anterior Humeral Line (should intersect capitellum) and Radiocapitellar Line (should pass through capitellum on all views).

Question 15

What is CRITOL and why is it important?

Answer 15

Mnemonic for elbow ossification centers (Capitellum, Radial Head, Internal Epicondyle, Trochlea, Olecranon, Lateral Epicondyle). Helps in assessing skeletal maturity and injury.

Question 16

SUFE/SCFE: Demographic and description?

Answer 16

Adolescents, especially overweight males. Fracture through the growth plate of femoral head.

Question 17

Legg-Calve-Perthes: Demographic and description?

Answer 17

Age 4–8 years, males > females. Avascular necrosis of the femoral head.

Question 18

DDH (Developmental Dysplasia of the Hip): Demographic and description?

Answer 18

Newborns/infants. Congenital or idiopathic abnormal hip development/dislocation.

Question 19

What is Vesico-ureteric reflux (VUR)?

Answer 19

Retrograde flow of urine from the bladder into the ureters/kidneys.

Question 20

Radiographic procedure to assess VUR?

Answer 20

Micturating Cystourethrogram (MCUG): contrast introduced via catheter, images taken during filling and voiding.

Question 21

Why is intussusception a medical emergency?

Answer 21

One part of the bowel telescopes into another, causing obstruction and ischemia. Treated with air or contrast enema, or surgery if unsuccessful.

Question 22

Most common type of idiopathic scoliosis and age group affected?

Answer 22

Adolescent idiopathic scoliosis; affects 10–18 years old.

Question 23

What is Congenital Talipes Equinovarus (CTEV)?

Answer 23

Also called clubfoot. A common developmental disorder of the lower limb affecting ~1 in 1000 births. More common in males (2:1) and Polynesians (up to 75 per 1000 births). Bilateral in 30–50% of cases.

Question 24

Types of Congenital Talipes Equinovarus?

Answer 24

Structural and Environmental.

Question 25

What are the three primary mechanisms of cervical spine injury?

Answer 25

Axial Compression Injuries, Hyperflexion Injuries, Hyperextension Injuries

Question 26

What is a Jefferson fracture?

Answer 26

A Jefferson fracture is a burst fracture of the C1 ring caused by axial loading.

Question 27

What is a Hangman’s fracture?

Answer 27

A Hangman’s fracture is a fracture through the pedicles of C2, which is unstable and typically caused by hyperextension and axial loading.

Question 28

What is an Odontoid fracture and what are the types?

Answer 28

An Odontoid fracture involves the dens of C2 and is classified as: Type I: Stable, Type II: Unstable, Type III: Unstable

Question 29

What causes a wedge fracture in the cervical spine?

Answer 29

A wedge fracture results from compression injuries, causing a wedge-shaped vertebra.

Question 30

What is a burst fracture?

Answer 30

A burst fracture involves an anterior fragment being pushed forward and a posterior fragment being pushed back into the spinal canal, which may injure the spinal cord.

Question 31

What is a Clay Shoveler’s fracture and how does it appear on imaging?

Answer 31

A Clay Shoveler’s fracture is caused by hyperflexion and rotation, usually involving C6 or C7. On an AP image, it appears as 'ghosting' of a spinous process.

Question 32

What are the three types of thoracolumbar injuries?

Answer 32

Type A: Compression injuries (e.g., Wedge and Burst Fractures), Type B: Flexion-Distraction injuries (e.g., Chance Fractures), Type C: Displacement/Dislocation injury – Highly unstable

Question 33

What are the three types of fractures in the lower spine?

Answer 33

Wedge Fractures: Compression fractures that result in a wedge-shaped vertebra. Burst Fractures: Unstable compression fractures through the entire vertebral body. Chance Fractures: Horizontal fractures through the spinous process, laminae, pedicles, and vertebral body.

Question 34

What is a Bucket-Handle fracture?

Answer 34

A Bucket-Handle fracture is a type of long bone fracture, typically seen in the distal femur or tibia, where a portion of the bone is fractured and displaced in a shape resembling a handle of a bucket. It is often associated with child abuse and can also result from traumatic injuries.

Question 35

What is the mechanism of injury for a Bucket-Handle fracture?

Answer 35

The mechanism of a Bucket-Handle fracture typically involves a combination of axial loading and rotational forces, which causes the bone to fracture in a characteristic pattern resembling the shape of a bucket handle.

Question 36

What is a Corner Fracture?

Answer 36

A Corner fracture is a type of fracture seen in the metaphyseal region of the long bones, typically in infants and young children, often associated with non-accidental injury (NAI). The fracture involves the corner of the bone, leading to a triangular or angular shape.

Question 37

What is the mechanism of injury for a Corner fracture?

Answer 37

Corner fractures are typically caused by shearing forces and abrupt traction applied to the limb, which commonly occur during violent shaking or pulling of a child, often in the context of child abuse. The shearing forces affect the growth plates, leading to this distinct fracture pattern.

Question 38

What is a Chance fracture?

Answer 38

A Chance fracture is a horizontal (flexion-distraction) fracture through the vertebral body, pedicles, and spinous process—most commonly at the thoracolumbar junction (T12–L2).

Question 39

How does a Chance fracture typically occur?

Answer 39

It is typically caused by sudden forward flexion of the spine, often from a lap belt injury in a motor vehicle accident (especially without a shoulder harness).

Question 40

What injuries may be associated with a Chance fracture?

Answer 40

It may be associated with intra-abdominal injuries, particularly to the bowel.