Imaging the Lower Limbs

Question 1

What is the triradiate cartilage?

Answer 1

• Y- shaped epiphyseal plate
• occurs at the junction where the ischium, ilium, and pubis meet
• only seen in children as this fuses when we become adults

Question 2

Label the tendon attachment sites for the following muscles:

adductors
iliopsoas
hamstrings
rectus femoris
abdominal muscles
sartorius
gluteus medius and minimus

Answer 2

1 = abdominal muscles
2 = sartorius
3 = rectus femoris
4 = gluteus medius and minimus 
5 = iliopsoas
6 = hamstrings
7 = adductors

Question 3

Are tendons or the apophyses (swelling of bone for tendon attachments) stronger?

Answer 3

• tendon

Question 4

The image below is from an 18 year old who has had a motorbike accident. What 4 problems can we see on the X-ray?

Answer 4

• right fracture of neck of femur
• widened pubis symphysis
• right inferior pubic ramus
• right sacroiliac joint

Question 5

Is the image below a normal or abnormal image of the hips?

Answer 5

• abnormal

- fracture on the iliopectineal line

Question 6

In the image below, we can see some osteoarthritic changes in the hip. Label the following:

reduced joint space
osteophytes (bony lumps)
subchondral sclerosis

Answer 6

reduced joint space = red
osteophytes = green
subchondral sclerosis = yellow

Question 7

What is the major image of choice for a major trauma where there is likely to be a complicated fracture following an initial X-ray?

1 - ultrasound
2 - MRI
3 - CT-scan
4 - PET scan

Answer 7

3 - CT-scan

- good for bone and soft tissue

Question 8

If a patient is suspected of having avascular necrosis and/or subtle fractures, what imaging modality is best?

1 - X-ray
2 - CT-scan
3 - PET scan
4 - MRI

Answer 8

4 - MRI

Question 9

What is an MRI arthrography?

Answer 9

• arthro = joint
• contrast is injected into the joint and then imaged
• good for looking at soft tissue such as cartilage and labrum tears

Question 10

What is the main damage we can see in this X-ray below?

Answer 10

• patella is composed of smaller parts (yellow)

- we know its not a fracture because they are rounded

Question 11

Label the 3 abnormalities we can see in the X-ray below:

• fibula fracture
• lateral talar shift
• fracture posterior malleolus

Answer 11

• fibula fracture = yellow
• lateral talar shift = red
• fracture posterior malleolus = green

Question 12

What is charcots foot?

Answer 12

• neuroarthropathy where nerves to the joint are damaged
• nerves dont work so foot damage and sensations are not detected
• bones and joints become deformed

Question 13

In the image below, label the correct image with the following pathology:

• RA
• osteoarthritis
• gout

Answer 13

• osteoarthritis
• RA
• gout