Imaging of Extremities Flashcards
What are the 3 types of Lesions of a Long Bone?
Diaphysis Lesions
Metaphysis Lesions
Epiphysis Lesions
What are ABC’s of Plain Film X-Ray?
A: Alignment (Adequacy)
B: Bone Cortex
C: Cartilage
For the ABC’s what do we use Alignment and Adequacy for?
Detecting Fractures/Dislocations that could disrupt bone archietecture.
ALSO for Adequacy - we think about the number of views (A/P view and Lateral View) and the actual contrast.
For the ABC’s why do we evaluate the Bone Cortex?
To see any Erosionsm, Fractures, Osteophytes
For the ABC’s why do we evaluate the Cartilage?
To Evaluate Joint Space, which can be hard to see on plain film x-rays.
When looking at a Radiograph what do you want to look for in an image?
All joints pictured
Borders of main bones in that joint.
Check ENTIRE image.
(Keep in mind what may be impinged in the image)
What is the Difference between a T1/T2
T1 - Helps Visualize Anatomy (Brightens Fat Areas (in Marrow Spaces of Bone), Darkens Fluid Areas)
T2 - Helps Asses Pathology (Supresses Fat, Highlights Fluids)
In Wrist make sure you see the Radial-Carpal L.
What do you suspect is the problem in this image?
SLAP (Superior Labrum Anterior Posterior) Tear
Due to Trauma/Repetitive Use (Overhead Throwing Activities)
- notice the tear in the labrum surrounding the head of the humerus (The white line)
What do you suspect is the problem with this image?
Hill-Sachs Deformity
-after anterior dislocation / creates divet
lots of repetitive dislocations cause this
What do you suspect is the problem with this image?
Sail Sign
- displaced anterior fat pad (of the arm)
ADULT: Radial Fracture
CHILDREN: Supracondylar Fracture
cause this
What do you suspect is the problem with this image?
Hill-Sachs Deformity
What do you suspect is the problem with this image?
Patient: 10-year old girl, won’t let you touch her elbow.
Sail Sign
SUPRACONDYLAR FRACTURE
What are the two types of fractures from “Falling on an Outstrechted Hand” that you can have? what is the risk?
Smith’s Fracture
Colle’s Fracture (Dinner Fork)
NECROSIS of the Scaphoid bone - due to avascularization from fall.
What causes a Smith’s Fracture?
Wrist was flexed when you fell, dislocates Anteriorly!
What is the difference between Intra-Articular Cartilage and Extra-Articular Cartilage Distal Radial Fractures?
(Intra= LEFT, Extra=RIGHT)
Intra: Within the joint space
Extra: Not within the Joint Space
KNOW this Cross Section! What Disease do we need to keep in mind?
Carpal Tunnel Syndrome
- Causes?*
- (Rheumatoid Arthritits)*
- (Pregnancy)*
- (Lunate Dislocation)*
- Dialysis*
- Repetitive Use*
What do we need to keep in mind when we are looking at a HIP radiograph?
Look at:
- Pubis/Ischium/Ilium*
- Neck and Head of Femur*
- Lesser Trochanter*
- Greater Trochanter*
- Acetabulum*
What do we worry about with Avascular Necrosis of the Femur?
Medial Circumflex Femoral A
What disease do we worry about with avascular necrosis?
What is shown in the image?
Legg-Calve-Perthes
(an idiopathic disease - insuffiency of blood supply) presents with limp.
(Also Corticosteriods and Sickle Cell Disease)
Double Line Sign
What do we need to look for in these images?
Lipping or narrowing of the joint space
look at head of Fibular
assess platela (on Lateral view)
On an MRI of the knee we asssess what?
We asssess the Anterior/Posterior Cruciate L
ACL = Anterior Drawer
PCL= Posterior Drawer
What do we need to assess in these iamges?
Lateral and Medial Malleoli
ATFL = Anterior Drawer Test
assess Tibio-Talor articulation
Understand This:
