Imaging of the Musculoskeletal System - Upper Limb

Question 1

What should the angle between the line through the humerus and a line perpendicular with the anatomical neck be?

Answer 1

140 degrees

Question 2

How could you tell if there was pathology in the rotator cuff on an x-ray?

Answer 2

loss of joint space

Question 3

Where should the cortical bone be thickest?

Answer 3

in the midshaft

Question 4

What different shoulder projections are usually taken?

Answer 4

AP, lateral, internal and external rotation, axillary

Question 5

What would you take a lateral view for?

Answer 5

to see a dislocation - the humeral head should be directly over the glenoid

Question 6

What would you take an internal rotation view for?

Answer 6

to see if the posterolateral margin of the humeral head is fractured

Question 7

What would you take an external rotation for?

Answer 7

to see if the greater tuberosity is fractured

Question 8

What would you take an axillary view for?

Answer 8

to look for fractures at the base of the coracoid

Question 9

What ossification centres are located at the shoulder joint?

Answer 9

lesser and greater tuberosities, humeral head, glenoid, 3 in the acromion and 1 at the outer end of the clavicle

Question 10

What is the relatively lucent part of the distal humerus in an elbow AP film?

Answer 10

the coronoid fossa and the olecranon fossa

Question 11

In a lateral elbow film what projects the most posterior?

Answer 11

the medial epicondyle

Question 12

In a lateral elbow film which is higher the capitulum or the trochlea?

Answer 12

the capitulum

Question 13

What is a good indication of a joint fracture before you see it?

Answer 13

joint effusion - look at the fat pads in the elbow

Question 14

When does the ossification centre at the capitulum appear?

Answer 14

1 year

Question 15

When does the ossification centre for the radial head appear?

Answer 15

5 years

Question 16

When does the ossification centre for the trochlea, olecranon and lateral epicondyle appear?

Answer 16

10 years

Question 17

When do the medial and lateral epicondyle, radial head and olecranon fuse?

Answer 17

15 to 20 years

Question 18

How can you tell if a line is a fracture or an epiphyses?

Answer 18

look for joint effusion

Question 19

What should the angle between a one perpendicular to the long axis of radius a line through the styloid process of radius and ulna be?

Answer 19

15 degrees

Question 20

How is the alignment of the carpal bones maintained in ulnar and radial deviation?

Answer 20

carpal ligaments

Question 21

What feature can be seen on the hamate?

Answer 21

a ring - this is the hook of hamate

Question 22

What are the main carpal bones that can be seen in a lateral view of the wrist?

Answer 22

lunate, capitate and scaphoid

Question 23

In a lateral view, at what angle should scaphoid be in relationship to the long axis?

Answer 23

30 to 60 degrees

Question 24

When is the glenoid commonly fractured?

Answer 24

post dislocation

Question 25

What are the 4 layers of the shoulder joint

Answer 25

labrum, capsule and ligamentous thickenings, tendon of long head of biceps and rotator cuff muscles, coracoid and acromion and coraco-acromial arch

Question 26

Why would you get an MRI of the shoulder joint?

Answer 26

to look for rotator cuff tear