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YEAR 4 SEMESTER 1 DIAGNOSTIC IMAGING > Lines of alignment we need to know > Flashcards

Lines of alignment we need to know Flashcards

1
Q

What is this line of alignment?

A

Angle of the Cervical Spine

Normal:
35-45 degrees normal lordosis

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2
Q

Longitudinal arch of the foot

  • measured
A

Measured:
Compare the height from the curvilinear line extending
along the horizontal arch to the base line between the
calcaneus and the base of the 1st MTP.

Normal:

150-170 degrees.

**Significance**:
Pes Planus (\>170 degrees)

Pes Cavus (<150 degrees)

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3
Q

What is this line of alignment?

A

Physiological Line of Stress (Ruth Jackson)

Normal:

Neutral: Should pass through C4/5 IVD

Flexion: Should Pass through C5/6

Extension: Should Pass through C4/5 posterior

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4
Q

Q Angle

  • measured
  • normal
  • significance
A
  • *Measured:**
  • Line taking origin from ASIS through patella midpoint.
  • Line through tibial plateau and midpoint of the patella.

Normal:
Men = 14 degrees
Women = 17 degrees

Significance: Altered in a variety of biomechanical issues and pathologies.

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5
Q

Ilio-Femoral Line

  • measured
  • normal
  • significance
A

Measured:
A line along lateral margins of the ilium should continue as an unbroken curve along the superior margins of the femoral neck.

Normal:
Even appearance bilaterally

Significance:
Congenital dysplasia, SFCE, Dislocation, #

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6
Q
A
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7
Q

What is angle A?

A

Tibial Angle (TA):
Angle between tibial shaft and tibial plateau lines.

Normal:
85-100 degrees

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8
Q

Ulman’s Line

  • measured
  • normal
A

Measured:

Line extended upwards at a 90 degree angle to the superior surface of the sacral base at its anterior
margin.

Normal:
It should clear the anterior inferior margin of the L5 body.

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9
Q

At what level is the tracheal bifurcation usually in adults?

A

T6

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10
Q

What line of alignment is this (number 3)? What method is it? What other lines of alignment are depicted in this image?

A

Lumbar curve angle method 2:

Normal: 50-60

We can also see depicted (in angle 1) the sacral base angle

Normal: 41 degrees

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11
Q

What is the angle depicted in figure 1? What is normal?

A

Q angle

Normal:
Men = 14 degrees
Women = 17 degrees

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12
Q

What is the angle signified by A?

  • normal

What is the angle signified by B?

  • normal
A

A = Tibial angle

Normal:
45-61 (average 53 degrees)

B = Fibular angle

Normal:
43-62 (average 52 degrees)

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13
Q

Cervical line of Gravity

  • measured
  • normal
A

Measured:
The Cervical Gravity Line is created by first locating the center of the tip of the Odontoid Process, then dropping a line downward, perpendicular to the bottom of the film.

Normal:
This line should just touch the anterior body of C7

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14
Q

What is this line of alignment?

A

Fergusons line of alignment

Normal:
Should strike anterior margin or anterior 1⁄4 of sacral base

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15
Q

Carpal alignment

  • measured (3 lines)
  • significance
A

1: Line curving along scaphoid, lunate, triquetrum and pisiform
2: 2nd line running along superior articulations of pisiform, lunate, scaphoid.
3: 3rd line at inferior articulation of hamate Capitate.

Significance: Altered from a variety of fractures

and pathologies.

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16
Q

What are these lines of alignment?

A

Georges line:

ALL (anterior longitudinal line)

PLL (posterior longitudinal line)

SLL (Spino laminar line)

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17
Q

Lumbar Curve Angle

  • 2 types:
  • measured
  • normal
  • significance
A

Lumbar Curve Angle (method 1)

  • *Measured**:
    1: Horizontal line to superior endplate L1.
    2: Horizontal line to inferior endplate L5.

Normal:
Upright: 35 – 45

Significance:
Muscular imbalance, Postural considerations, Nucleus pressure

  • *Lumbar Curve Angle (method 2)**
  • *Measured**:
    1: Horizontal line to superior endplate L1.
    2: Horizontal line to superior sacral base

Normal:
Upright: 50 - 60
Can vary from recumbent to upright positions.

Significance:
Muscular imbalance, Postural considerations. Nucleus pressure

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18
Q

Retropharyngeal Space

  • measured
  • normal
A

Measured:
Anterior Inferior border of C2 and posterior pharyngeal airspace.

Normal:
<5mm

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19
Q

What do these lines of alignment measure? Which method is indicated in each of the diagrams?

A

These are methods for measuring the degree of scoliosis.

On the left = Cobb method.

On the right = Risser method.

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20
Q

Meyerdings’s Classifications:

  • what is it used for
  • measured by
A

To classify a spondylolisthesis

Measured:
Sacral base is divided into 4 equal parts. The

relative slip of the vertebrae above is classified.

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21
Q

Angle of Cx. Spine

  • measured
  • normal
A

Measured:
Midpoints of anterior and posterior tubercles of the atlas and a line through inferior endplate of C7. Perpendiculars are constructed if required.

Normal:
35-45 degrees normal lordosis

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22
Q

What is this line of alignment?

A

The cervical line of gravity

Normal:
This line should just touch the anterior body of C7

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23
Q

General alignment of the wrist

  • normal
  • significance
A

1: Radioulnar articular line
2: Radial Shaft Line:
3: Radio-ulnar angle

Normal:
PA radioulnar Angles: average 83 (72-95)

Significance: Altered from a variety of fractures and pathologies.

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24
Q

What is this line of alignment?

A

Meyerdings Classification for grading of spondylolisthesis

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25
Q

Symphysis Pubis Width

  • measured
  • normal
  • significance
A

Measured:
Distance between opposing articular surfaces.

Normal:
Male: 6mm average
Female: 5mm average

Significance: Widening due to dysplasia, trauma, HPT, inflammatory (AS, Reiter’s). Decrease DJD.

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26
Q

What is this line?

  • significance
A

Kleins Line

Significance: if there is a failure of the femoral head to cut the line, then a slipped capital femoral epiphysis is suspected

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27
Q

Fergusons line

A

Measured:
Perpendicular line dropped from centre of L3.

Normal:
Should strike anterior margin or anterior 1⁄4 of sacral base.

Significance:
Variety of interruptions due to many pathologies. Spondylolisthesis.

Postural Compensation

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28
Q

McNabs Line

  • measured
  • normal
  • significance
A

Measured:
Line drawn through inferior endplate at level to be evaluated. Relationships to superior articular process of vertebrae below is then assessed.

Normal:
Line should lie above tip of adjacent sup. Articular facet.

Significance: Facet Imbrication: Mechanical influence (on IVF) Postural considerations.

Increased shearing

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29
Q

What is the angle depicted by the number 3?

A

Carrying angle

Normal:
Normally it is 5-15 degrees away from the body or 165-175 degrees towards the body

30
Q

Pedicular method of rotation

  • what are the 2 methods
  • how is it measured
A

Spinous method:
Spinous process are prone to malformations and displacement and so not optimally used.

Pedicle method:
Most accepted method.

31
Q

Georges (PLL, ALL and SLL) for all of spine

  • measured by
  • normal
  • significance
A

Measured:
Line tracing the anterior longitudinal line, Posterior longitudinal line and spino lamina line.

Normal Measurement:
Line should be smooth, regular and uninterrupted.

Significance:
Variety of interruptions due to many pathologies. Spondylolisthesis.

32
Q

What does this line help to measure?

  • what is normal?
A

Acetabular depth

Normal:
Females = 12mm average
Males = 13mm average

33
Q

How would you describe the position of this patella? How did you measure this?

A

Patella Baja

Measured the difference between patella length and patellar tendon length. A difference of more that 20% between the 2 where the tendon length is shorter than the patellar length indicates patella baja.

34
Q

What is this line of alignment? What is it used for?

A

Ulman’s Line

Used to check for spondylolisthesis

Normal:
Line should clear the anterior inferior margin of the L5 body.

35
Q

Tracheal bifurcation level in pediatric to geriatric

- what is the level of tracheal bifurcation in:

  • newborns
  • 10 year old children
  • adults
A

Newborns = T3

10 year old children = T5

Adults = T6

36
Q

What is this line of alignment?

A

McNabs Line

Normal: Line should lie above tip of adjacent sup. Articular facet.

37
Q

Physiological line of stress (Ruth Jackson)

- measured

- normal

- significance

A

Measured:
Posterior aspect of Dens and Posterior Aspect of C7

Normal:

Neutral: Should pass through C4/5 IVD

Flexion: Should Pass through C5/6

Extension: Should Pass through C4/5 posterior

Significance:
Biomechanical compensation

38
Q

What is this line? What is normal?

A

Skinner’s Line

Normal: Relationships to the fovea is assessed and fovea should lie above or at the level of the level of the trochanteric line.

39
Q

What are the black arrows pointing to? What should this space be in cm?

What are the white arrows pointing to? What should this space be in cm?

A

Black arrows: retro-pharyngeal space/line

= <5mm

White arrows: retro-tracheal space/line

= <20mm

40
Q

Atlanto-dental Interspace

  • measured
  • normal
  • significance
A

Measured:
Anterior aspect of dens and posterior aspect of anterior tubercle.

Normal:

1-3mm adults
1-5mm children

Significance:
PARRS, Down Syndrome

41
Q

What is this line of alignment?

A

The atlanto-dental interspace

Normal:

1-3mm adults
1-5mm children

42
Q

Knee Tibial angle

A

Measure:
Angle between tibial shaft and tibial plateau lines.

Normal:
85-100 degrees

Significance:
Altered in a variety of biomechanical issues and pathologies

43
Q

Bohlers Angle

  • measured
  • normal
  • signifiance
A

Measured:
line tangent to upper contour calcaneus tuberosity with line at posterior aspect superior surfaces of calcaneus

Normal:
28-40 degrees

Significance:
Fracture, Congenital

44
Q

What is this angle?

  • normal
A

The femoral angle

Normal:
120-130 degrees

45
Q

Patellar position

A

Measure:
Often taken in semi flexed position as greatest distance recorded of PT (patella tendon length)

Normal: Patella length and patella tendon usually equal (20% variance accepted)

Significance:
More than 20% = patella alta, may be seen in CMP. Less that 20% = patella baja, may indicate polio, Achondroplasia, JRA.

46
Q

Skinner’s Line

  • measured
  • normal
  • significance
A

Measured:
Line drawn through and parallel to axis of
femoral shaft. 2nd line at right angle to the shaft line
is constructed tangential to the tip of the greater trochanter.

Normal: Relationships to the fovea is assessed and fovea should lie above or at the level of the level of the trochanteric line.

Significance:
Conditions causing Coxa Vara #

47
Q

Glenohumeral joint width space

  • measured
  • normal
  • significance
A

Measure:
Superior, middle and inferior aspect of glenoid. Combined and averaged.

Normal:
4-5mm

Significance:
DJD, CPPD, arthritis, acromegaly, trauma

48
Q

What is this line of alignment?

A

The sacral base angle

Normal:

41 deg. (26 - 57)

Can vary by 8-12 degrees from recumbent to upright positions.

49
Q

Shenton’s Line

  • measured
  • normal
  • significance
A

Measured:
Curvilinear line traced along undersurface of femoral neck and continued across the joint to the inferior margin of the superior pubic ramus..

Normal:
Line should be smooth and uninterrupted. (occasionally a portion of the femoral head may slightly cross the line)

Significance:
Interrupted or discontinuous line is useful in detecting hip dislocations, fem neck #, SFCE.

50
Q

Klein’s Line

  • measured
  • normal
  • significance
A

Measured:
Line drawn tangential to the superior margins of the femoral neck. Bilateral examinations should be made.

Normal:
If there is a failure of the femoral head to cut the line drawn, then SFCE suspected.

Significance:
Dysplasia
SFCE
Perthes
Destructive conditions

51
Q

What is this line of alignment?

A

The thoracic curve angle

Normal:
Varied angles approx. 20-50degrees common

52
Q

Femoral angle

  • measured
  • normal
  • significance
A

Measured:
Angle formed by the axis of the neck and the long axis of the shaft of femur.

Normal:
120-130 degree’s

Significance:
< 120 Coxa Vara

> 130 Coxa Valga

53
Q

Axial relationship of the elbow:

  • lines
  • angles
  • normal
  • signifiance
A

Lines:
Humeral Shaft line
Ulnar Shaft Line
Humeral Articular Line
(trochlea and capitulum)

Angles
Carrying angle: CA
Humeral angle: HA
Ulnar angle: UA

Normal:
Humeral avg. 85
Ulna avg. 84
Carrying avg. 169

Significance:
Altered from a variety of fractures and pathologies.

54
Q

Sacro-vertebral and Lumbar Body Angles

A

Measured:
Lines drawn through and parallel to each lumbar bony endplate, lines being extended posteriorly until they intersect.

Normal:
L1 8 degrees
L2 10
L3 12
L4 14
L5/S1 14 (10-25)

Significance:
Muscular imbalance Postural considerations.

Facet syndromes show increase Herniations show decrease

55
Q

What is this line of alignment? Which method is it?

A

Lumbar curve angle method 1

Normal: 35 – 45

56
Q

What is this line?

A

Shenton’s Line

57
Q

Fibular Angle

  • normal
A

The angle is formed laterally between the lateral malleolus line (A line is drawn tangential to the articular surface of the lateral malleolus) and the talus line (A line drawn tangential to the articular surface of the talar dome).

Normal:
43-62 (average 52 degrees)

58
Q

Sacral Base Angle

  • measured
  • normal
  • significance
A
  • *Measured**:
    1: Horizontal line to bottom of film.
    2: Line drawn parallel to sacral base.

Normal:
Upright: Avg. 41 deg. 26 - 57
Can vary by 8-12 degrees from recumbent to upright positions.

Significance:
Muscular imbalance
Postural considerations
Increased shearing

59
Q

What is this line?

In this image, does the line indicate whether this person’s hip is normal or abnormal?

A

Ilio-femoral line

This persons hips are normal as the line is relatively continuous and is the same bilaterally.

60
Q

Carrying Angle

  • measured
  • normal
  • significance
A

Measured:
Between the humeral shaft line and the ulnar shaft line.

Normal:
Carrying avg. 169

61
Q

Retrotracheal space

  • measured by
  • normal
  • indications
A

Measured:
Anterior Inferior border of C6 and posterior tracheal airspace.

Normal:
<20mm

Indications:
Haematoma, Trauma, Suppuration

62
Q

What is the angle signified by the yellow line?

A

Bohlers angle

Normal:
28-40 degrees

63
Q

Hip joint distance.

  • normal
  • significance
A

Normal:
Superior: 3-6mm (average 4mm)
Axial: 3-7 (average 4mm)
Medial: 6-11mm (average 8mm)

Significance:

Medial Teardrop distance: if exceeds 11mm or > 2mm discrepancy from side to side then hip disease is most likely present. (even 1mm difference can indicate disease).

64
Q

What is this line?

A

Kohlers Line

65
Q

Foot/ankle Tibial Angle

  • normal
A

Angle is formed medially between medial malleolus line (A line drawn tangential to articular surface of the medial malleolus) and talus line (A line drawn tangential to the articular surface of the talar dome)

Normal:
45-61 (average 53 degrees)

66
Q

Protrusio Acetabuli/ Kohlers Line

  • measured
  • normal
  • significance
A

Measured:
Line tangential to cortical margin of pelvic inlet and outer border of obturator foramen. Relationships to acetabular floor is assessed.

Normal:
Acetabular floor should not cross this line and usually lies lateral to it.

Significance:
Inflammatory arthritides (RA, PS) Pagets
F Fibrous dysplasia

67
Q

Thoracic curve angle

  • measured
  • normal
A

Measured:
Draw parallel lines to the superior endplate of T1 (T4) and straight line through inferior endplate of T12 (T9). Drop perpendicular lines to measure appropriate angle.

If superior and inferior vertebrae not clear T4 and T9 can be taken for apices.

Normal:
Varied angles approx. 20-50degrees common

68
Q

What are the 2 systems for measuring scoliosis?

A

Cobb Lippman Method:
A line is drawn along superior border of cephalad (top) vertebrae. A line is drawn along inferior of caudad (bottom) vertebrae.
If endplates not visible then bottoms and tops of pedicles used.
Perpendicular lines are then drawn from each horizontal line, and the angle of their intersection measured.
Seven groups: 1: 0-20 degrees, 2: 21-30 degrees,3: 31-50 degrees,4: 51-75 degrees,5: 76- 100 degrees, 6: 101-125 degrees, 7: 126 and above,
Cobb method gives larger measurements then Risser technique by average of 25% or about 10 degrees.

Risser-Ferguson Method:

The centres of the end (top and bottom) and apical vertebral bodies are identified. These points are then connected and the angle of intersection measured.

69
Q

Acetabular Depth

  • measured
  • normal
  • significance
A

Measured:
A line drawn from the superior margin of the pubis at the symphysis joint to upper outer acetabular margin. The greatest distance from this line to the acetabular floor is measured.

Normal:
Male: 7 - 18mm (average 13mm)
Female: 9 - 18mm (average 12mm)

Significance:
< 9mm considered shallow and dysplastic.

70
Q

How would you describe the position of this patella? How did you measure this?

A

Patella Alta

Measured the difference between patella length and patellar tendon length. A difference of more that 20% between the 2 where the tendon length is longer than the patellar length indicates patella alta

YEAR 4 SEMESTER 1 DIAGNOSTIC IMAGING (21 decks)

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