Lower Extremity

Question 1

Hip view used in children with SCFE (slipped upper femoral epiphysis)

Answer 1

Frog leg view

Question 2

The Mortise view is used to x-ray this joint

Answer 2

Ankle

Question 3

Which joint might be examined on x-ray with a sunrise view (aka skyline or merchant)

Answer 3

Knee

Question 4

Name for bone spurs within a tendon

Answer 4

Enthesophyte

Question 5

If the femoral head is seen inferior to the acetabulum on x-ray, is the dislocation anterior or posterior?

Answer 5

Anterior

Question 6

Describe the pathogenesis of Legg-Calve-Perthes disease

Answer 6

Typically in young boys during growth spurts the femur outgrows its own blood supply leading to death of the epiphysis (femoral head)

Question 7

Ages at which the six portions of the elbow ossify

Answer 7

CRITOL 1, 3, 5, 7, 9, 11
Capitellum - 1
Radial head - 3
Internal (medial) epicondyle - 5
Trochlea - 7
Olecranon - 9
Lateral epicondyle - 11

Question 8

Describe a typical toddler’s fracture

Answer 8

Spiral fracture of the distal tibia

(normal in children learning to walk)

Question 9

Name for a fracture of the femoral neck that is immediately distal to the head

Answer 9

Subcapital neck fracture

Question 10

Do hips more commonly dislocate posteriorly or anteriorly and inferiorly or superiorly?

Answer 10

Posterior and superior most common (80%)

Question 11

Something to always consider as concurrent with a hip dislocation

Answer 11

Always think about concurrent acetabular fractures due to likely high force event

Question 12

Some broad examples of radiographic evidence of child abuse

Answer 12

• Multiple fractures at various stages of healing
• Long bone fractures in non-ambulatory children
• Injury doesn’t match the story

Question 13

Is the most proximal fracture of the 5th metatarsal zone 1, 2 or 3?

Answer 13

Zone 1 most proximal

Question 14

Something to do before and after replacing a hip dislocation

Answer 14

X-ray before and after

Question 15

Name for an injury that involves radial head subluxation in kids between 1-4 years old, usually when holding a parent’s hand

Answer 15

Nursemaid’s elbow

Question 16

Name for a proximal fibula fracture with a co-occurring unstable ankle injury (malleolar fracture)

Answer 16

Maisonneuve fracture

Question 17

A young boy going through a growth spurt presents with an atraumatic hip pain or a limp. Do you expect his x-ray to appear like an ice cream falling off it’s cone or a crushed femoral head?

Answer 17

Crushed/collapsed femoral head consistent with Legg-Calve-Perthes disease

Question 18

If the femoral head is seen superior to the acetabulum on x-ray, is the dislocation anterior or posterior?

Answer 18

Posterior

Question 19

Anatomical name for the ankle joint

Answer 19

Tibiotalar joint

Question 20

What condition is seen on x-ray as looking similar to ice cream falling off a cone?

Answer 20

Slipped capital femoral epiphysis (SCFE)

Question 21

Complication of concern in slipped capital femoral epiphysis (SCFE)

Answer 21

Avascular necrosis

(increased risk with manipulation, so move it as little as possible)

Question 22

Anatomical name for big toe arthritis

Answer 22

Hallux rigidis

Question 23

Name of sesamoid bone anatomic variation in the knee joint

Answer 23

Bipartite patella

Question 24

Where is a segond fracture likely to be seen and what type of injury is it associated with?

Answer 24

• Lateral head of tibia
• Associated with ACL tears

Question 25

Four signs of osteoarthritis on x-ray

Answer 25

• Reduced joint space
• Osteophytes
• Sclerosis
• Subchondral cysts

Question 26

A collapsed appearance of the femoral head on x-ray suggests this disease

Answer 26

Legg-Calve-Perthese disease (LCPD)