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MRT Year 2 > Knee Comp > Flashcards

Knee Comp Flashcards

1
Q

What are the prominences on the intercondylar eminence called?

A

Intercondylar tubercles

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2
Q

How do the tibial plateaus slope?

A

Slope posteriorly 10-20 deg, 5 deg slope from anterior to posterior margin

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3
Q

What attaches to the tibial tuberosity?

A

Patellar tendon

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4
Q

How does the fibula sit in relation to the tibia?

A

Lateral and posterior

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5
Q

What does the fibular head articulate with?

A

Lateral posteroinferior aspect of lateral condyle

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6
Q

Parts of the fibular head?

A

Apex, head, neck

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7
Q

What is the largest sesamoid bone?

A

Patella

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8
Q

Where is patella in relation to knee joint?

A

Most distal portion (apex) is 1/2” superior to knee joint

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9
Q

Another name for the intercondylar sulcus?

A

Patellar surface, trochlear groove

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10
Q

Which condyle is more distal?

A

Medial

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11
Q

What is the surface above the intercondylar fossa (notch)?

A

Popliteal surface

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12
Q

What attaches to the adductor tubercle? Where?

A

Tendon of adductor muscle attaches to posterolateral aspect

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13
Q

Which epicondyle is more prominent?

A

Medial

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14
Q

What attaches to the epicondyles?

A

Collateral ligaments

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15
Q

What is the patella embedded in?

A

The tendon of the quadriceps femoris muscle

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16
Q

Flexion vs. Patellar position

A

45 degrees: patella pulled part way down

90 degrees: patella pulled all the way down

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17
Q

What pass over popliteal surface?

A

Popliteal blood vessels and nerves

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18
Q

Parts of the patella?

A

Base (top), apex (bottom), anterior (convex, rough) and posterior surfaces (smooth)

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19
Q

Purpose of the patella?

A
  • Protects the anterior aspect of the knee joint

- Acts as a pivot to increase the leverage of the quadriceps femoris muscle

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20
Q

What does the patella articulate with?

A

The femur

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21
Q

Major knee ligaments?

A
  • Lateral (fibular) collateral ligament (LCL) : femur to lateral proximal fibula
  • Medial (tibial) collateral ligament (MCL): femur to tibia
  • Posterior cruciate ligament (PCL): within knee joint capsule
  • Anterior cruciate ligaments (ACL): within knee joint capsule
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22
Q

What are collateral ligaments for?

A

Strong bands at sides, prevent adduction and abduction

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23
Q

What are cruciate ligaments for?

A

Strong, rounded cords that cross and attach to anterior/posterior aspects of the intercondylar eminence of tibia, prevent anterior/posterior movement

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24
Q

Where is the infrapatellar fat pad located?

A

Posterior to the patellar ligament, aids in protection of the knee joint

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25
Q

Parts of the bursa of the knee joint?

A
  • Suprapatellar bursa
  • Infrapatellar bursa

-separated by the infrapatellar fat pad

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26
Q

Menisci of the knee?

A

Medial and lateral
Fibrocartilgenous discs between the tibial plateaus and femoral condyles
Crescent shaped
Thicker at external margins, thin in middle
Shock absorbers
Produce synovial fluid along with synovial membrane

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27
Q

What are the articulating ends of the femur and tibia covered in?

A

Hyaline membrane

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28
Q

Frequent knee trauma?

A

Torn ACL and MCL associated with tear of medial meniscus

-MRI or arthrography used to visualize

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29
Q

What classification is the femorotibial joint?

A
  • Bicondylar

- flexion/extension/some gliding and rotation when knee is partially flexed

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30
Q

What classification is the patellofemoral joint?

A
  • sellar/saddle

- considered saddle because of shape and relationship of patella to anterior distal femur

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31
Q

Joints that make up the knee joint?

A

Femorotibial joint

Patellofemoral joint

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32
Q

Flexion of the knee vs patellar position on an AP knee?

A

20 degrees: patella on patellar surface
30-70 degrees: patella is demonstrated between the patellar surface and IC fossa
90 degrees: patella within the IC fossa

33
Q

Where is the patella located when it is subluxed?

A

More lateral than normal

34
Q

On an AP knee, how does flexion relate to the amount of IC fossa demonstrated?

A

More flexed = more IC fossa

35
Q

When is the IC fossa in profile?

A

Femur at 60-70 degrees to table, 20-30 degrees with CR

36
Q

How do you align the CR with a non-extendible knee?

A

Align CR perpendicular to lower leg, then decrease the angle 5 degrees
(Increased foreshortening with increased angle)

37
Q

2 types of joint space narrowing?

A

Valgus: lateral compartment narrower than medial

Varus: medial compartment narrower than lateral

38
Q

AP knee: if fibular head is foreshortened and demonstrated more than 1/2” distal to tibial plateau, what is wrong with the angle?

A

Cephalic angle too great

39
Q

Fat pads of the knee

A

-Anterior suprapatellar fat pad
-Posterior suprapatellar fat pad
Both anterior to patellar surface of femur

40
Q

What indicates joint effusion on a knee?

A

Separation of the anterior and posterior suprapetallar fat pads

41
Q

When will an AP knee be magnified?

A
  • if a curved detector is not used

- if OID is present

42
Q

What is the air gap technique?

A

Increased OID = decreased scatter caught by the IR (no grid needed) = increased contrast

43
Q

Technique for knee?

A

60-70 kVp

44
Q

How to demonstrate a subluxed patella?

A

Quadriceps femoris must be relaxed, patella could appear normal if not

45
Q

What happens if the distal femur is lower than the proximal femur when using an axial viewer?

A

Anterior soft tissue will be projected into the joint space and it will appear open, but underexposed

46
Q

What is a bone cyst?

A

A well circumscribed lucency

47
Q

What is chondromalacia patella?

A

Pathology of the femoropatellar joint space, possible misalignment of the patella

48
Q

What is chondrosarcoma?

A

Bone destruction with calcifications in cartilagenous tumours

49
Q

What is enchondroma?

A

Benign cartilagenous tumour, well defines radiolucent with thin cortex, causes pathological fractures

50
Q

What is Ewing’s sarcoma?

A

Malignant bone tumour, ill-defined area of bone, onion peel

51
Q

What is extosis?

A

Projection of bone with cartilagenous cap, grows parallel to shaft away from joint

52
Q

What is multiple myeloma?

A

Cancerous bone tumour, punched out osteolytic lesions

53
Q

What is osgood schlatters disease?

A

Detachment of the tibial tuberosity by patellar tendon

54
Q

What is osteoclastoma?

A

Radiolucent lesions with thin strips of bone

55
Q

What is osteogenic sarcoma?

A

Destructive lesion with periosteal reaction, sunburst pattern

56
Q

Osteoid osteoma?

A

Oval density with lucent center

57
Q

Osteomalacia?

A

Rickets

Decreased bone density, bowing, softening of bone

58
Q

Pagets

A

Dense, soft bone

59
Q

Reiter?

A

Erosion of the tibial tuberosity due to achilles tendon pulling

60
Q

Rosenburg method?

A

Standing PA, 45 degree flexion of knee

61
Q

CR angle for lateral knee based on pelvis size and femur length?

A

Wide pelvis and short femur = increase angle

62
Q

AP knee CR angulation based on pevis size?

A

Less than 19cm: 305 deg caudad
19-24cm: 0 deg
Greater than 24 cm: 3-5 deg cephalad

63
Q

What line is parallel to the IR for an AP knee?

A

Interepicondylar line

64
Q

If medial oblique knee is over-rotated, what happens?

A

Femoral condyles demonstrate superimposition

65
Q

Lateral oblique: fibula is demonstrated without complete tibial superimposition

A

The patient knee was rotated less than 45 degrees (under rotated)

66
Q

Lateral oblique: the fibula is seen with posterior placement on the tibia?

A

The knee was over-rotated

67
Q

X-table knee: the lateral condyle is proximal to medial and the fibular head is less than 1/2” from the tibial plateau?

A

Leg was abducted from body

68
Q

What is the IC fossa view used to demonstrate?

A

Loose bodies, split and displaced cartilage is osteochondritis dissecans, and flattening or underdevelopment of the lateral femoral condyle is congenital slipped patella

69
Q

Patella view: tibial tuberosity is demonstrate in the joint space?

A

Knee not bent enough

70
Q

Patella view: medial and lateral condyles demonstrate the same height, patella is lateral?

A

Leg is not rotated enough to place epicondyles parallel to IR (lateral condyle should be higher)

71
Q

What is a merchant view?

A

Patella
40 degrees flexion
CR 30 deg caudad
(Axial viewer?)

72
Q

Inferosuperior patella

A

AP
Pt supine, 45 degrees flexion
CR 10-15 degrees from lower leg

73
Q

Hughston patella

A

PA
55 deg flexion (greater than 45)
CR 15-20 degrees from lower leg

74
Q

Settegast method patella

A

Pt prone
90 degrees flexion
CR 15-20 degrees from lower leg

75
Q

Hobbs method patella?

A

Superoinferior

76
Q

Camp coventry method IC fossa?

A

Prone

40-50 degrees flexion

77
Q

Holmblad method IC fossa

A

Prone

60-70 deg flexion

78
Q

Beclere method IC fossa

A

Supine, AP

40-45 deg flexion

79
Q

What is best demonstrated on a x-table lateral knee?

A

joint effusion, lipohaemarthrosis, and intra-articular fracture

MRT Year 2 (18 decks)

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