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Normal Radiographic Anatomy Flashcards

1
Q

What should be the limits of visualization of Lateral Cervical view?

A

Skull to T1

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2
Q

How can we visualise C7 on Lateral Cervical?

A
  • depress shoulders (weights)
  • spot view
  • swimmers lateral of cervicothoracic junction
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3
Q

Which is the best view of IVDs?

A

Lateral Cervical

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4
Q

How can you tell there is lateral flexion or rotation in Lateral Cervical view?

A

Lateral flexion:
• double facet joint lines

Rotation:
• double spinolaminar junction lines

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5
Q

What are the alignment and measurements of the Lateral Cervical view?

A
  • 4 lines
  • Cervical lordosis
  • Atlantodental interspace
  • McGregor’s line
  • Sella turcica
  • soft tissue interspaces
  • flexion-extension views
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6
Q

What are the Lines of alignment of the Lateral Cervical view?

A
  • Anterior vertebral line
  • Posterior vertebral line (George’s)
  • Spinolaminar junction line
  • Spinous process line
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7
Q

What are the possible views for Cervical spine? Which are routine?

A
  • Ap
  • APOM
  • Lateral
  • Oblique (not routine)
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8
Q

What are the possible Alignments and Measurements of Lateral Cervical view?

A
  • General skeletal architecture
  • Lines (4)
  • Lordosis
  • Atlantodental interspace
  • McG
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9
Q

What are the norma values of cervical lordosis angle?

A

35-45 degrees

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10
Q

What are the normal values for atlantodental interspace?

A

Adults: under 3mm
Kids: under 5mm

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11
Q

What is George’s line?

A

Posterior vertebral line

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12
Q

What is McGregor’s line?

A
  • line from post.sup. hard palate to inf. surface of occiput

* checks odontoid protrusion into foramen magnum

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13
Q

What are the normal values of McGregor’s line?

A

Odontoid cannot project over 4.5mm above the line

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14
Q

What is the normal size of the Sella Turcica? And what is an abnormal size?

A

Normal: 5-16mm long and 4-12mm high

Small is nbd

Larger is problem

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15
Q

Why do a Flexion-Extension view?

A
  • assess intersegmental motion and ligamentous stability
  • only do if suspecting instability
  • look at changes in ADI
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16
Q

List the prevertebral spaces in a lateral cervical view

A
  • Retropharyngeal interspace

* Retrotracheal interspace

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17
Q

What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?

A

Pharyngeal: under 7mm

Tracheal: under 21mm

Increased is athological

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18
Q

What are the borders on the AP Cervical view?

A

C3 to T2-3

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19
Q

On an AP Cervical, how can you tell the difference btw T1 and C7?

A
  • ribs
  • TVPs of T1 point superior
  • TVPs of C7 point inferior
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20
Q

What are the borders in APOM Cervical?

A

C1 and C2

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21
Q

What is the mach effect?

A

Relative lucency between 2 overlapping structures may simulate a fracture

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22
Q

What is the difference between normal and abnormal atlantoaxial alignment on APOM Cervical view?

A

Abnormal: overhang of lateral mas along with over 5 degrees lateral tilt indicate possibility of odontoid fracture

Normal: kids 4 yr old have normal overhang of atlas

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23
Q

Which Cervical view is best for observing IVFs?

A

Oblique cervical

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24
Q

What Oblique positions are the same to each other?

A 
LAO = RPO
RAO = LPO
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25
Is there an Oblique thoracic view?
Nope | Just AP and lateral
26
What are the borders of AP thoracic?
C7 to L1
27
What is Cobb angle?
Angle that measures curve of a spine | Trace 2 lines on the vertebral body that would cross each other eventually
28
How do we assess vertebra rotation?
Look at pedicles NOT spinous processes | Distance from the midline
29
What are the borders of a Lateral Thoracic view?
C7 to L1
30
How can we best visualize T1-3?
Swimmers lateral
31
What are the guidelines for counting vertebrae on a Lateral Thoracic?
- use landmarks from AP view - DONT use diaphragm - see if last vertebra has a rib, if so we assume it is T12
32
What is the normal thoracic kyphosis curve value?
20-40 degree
33
What are the borders of an AP Lumbar view?
T12 to upper sacrum, including SIJs
34
What is the pars interarticularis and where do we find them in the spine?
- Only in lumbar spine - not an anatomical structure - named and identified because common area of fracture
35
What are the borders of Lateral Lumbar view?
-T12 to upper sacrum
36
Which is the best view for visualizing IVD spaces in lumbar spine?
Lateral lumbar
37
What is the best view for seeing the IVFs of lumbar spine?
Lateral lumbar
38
List the alignments and measurements of the lateral lumbar spine
1) Georgés line 2) Lordosis 3) Sacral base angle 4) Lumbosacral base angle 5) IVD angle 6) Lumbar gravity line 7) Eisenstein’s measurement
39
What is George’s line?
Line tracing posterior vertebral bodies and then into the sacral canal
40
What is a normal value of Lumbar lordosis?
50-60 degrees
41
What is the sacral base angle?
- 1 line tracing top of sacral body - 1 line horizontal to ground - angle btw them
42
What is a normal Sacral base angle? And what is abnormal?
- 26 to 57 degrees - average of 41 degrees - increased means increase anterior pelvic tilt
43
What is the Lumbosacral disc angle? And what happens when it’s abnormal?
10-15 degrees Increased =facet impaction = LBP
44
Is lumbosacral disc angle related to spondylolisthesis?
No
45
What is the IVDs angles?
Lines following top and bottom of vertebral bodies Can be done at all levels
46
What are normal values of IVDs angles?
L1 : 8 degrees | L4 : 14 degrees
47
What is the lumbar gravity line?
-Line from centre of L3 vertebral body toward straight vertical gravity
48
What are abnormal measures of lumbar gravity line?
- anterior to sacrum by over 1cm | - posterior shift
49
What is Eisensteins method measurement on lumbar lateral view?
Measures width of sacral canal
50
What are abnormal Eisensteins measures?
Under 15mm
51
When do we do an Oblique Lumbar view?
Suspect a pars fracture
52
How do we orient ourselves in oblique lumbar?
Draw line behind all vertebral bodies All to the left is left and so on
53
Which lumbar is the best view for observing the facet joints?
Oblique
54
What are the borders for AP LUMBOPELVIC.
T12 to proximal femur including ilium
55
What is a Phlebolith?
Small rounded calcification of a vein
56
What alignments do we see on AP lumbopelvic?
- Scoliosis - Pelvic obliquity - Pelvic rotation - Femoral head height - Hip alignment
57
What are the Coccyx anomalies?
• 1: curved slightly anteriorly • 2: curved more anteriorly, coccyx pointing straight forward • 3: angulated sharply anterior • 4: subluxated at sacrococcygeal/intercoccygeal joints
58
List the alignments on AP shoulder with their normal values
* GH joint space (4-5mm) * Acromiohumeral space (7-11mm) * AC joint space (2-4mm) * Coracoclavicular space (11-13mm)
59
List the shoulders views
* AP external rotation shoulder * AP internal rotation shoulder * AP neutral rotation shoulder * Scapular Y * Transthoracic lateral * Axial
60
What is the goal of a Scapular Y view?
Lateral view of the scapula | -NOT to assess GH or AC joint
61
Why do a transthoracic lateral view?
- true lateral view of humerus - trauma (pt cant rotate arm safely) - just looking for major defects or trauma
62
List the elbow epiphyses in order of appearance
* Capitulum (1 yr) * Radial head (5 yrs) * medial epicondyle (7yrs) * Trochlea (10 yrs) * Olecranon (10 yrs) * lateral epicondyle (11 yrs) (CRITOE)
63
What is the Fat pad sign?
- fat pad is lucent - normally so close to bone its not visible - indicates intra-articular swelling, probably fracture
64
List the alignments on lateral elbow view
- radiocapitellar line | - humerocapitellar line
65
Which wrist-view has a view of lateral thumb?
PA wrist and hand
66
List the alignments to observe in wrist and hand views
- Radioulnar alignment - carpal arcs - metacarpals and phalanges
67
Which view is best for observing the base of the thumb?
oblique wrist and hand
68
List the alignments to observe in an AP hip
- Shentons line (under) - Iliofemoral line (over) (Of femoral neck) - anterior acetabular wall - posterior acetabular wall - acetabular roof - iliopectineal line - ilioischial line - kohler’s tear drop - Klein’s line - hip femoral angle - fempral neck margin - teardrop distnce
69
What is coxa vara? Vs coxa valga?
Vara: femoral angle <120 degrees Valga: femoral angle >135 degrees
70
What is Teardrop distance? What’s its normal value?
Distance btw inner femoral head and Kohler’s teardrop Normal 6-11mm and <2mm difference bilaterally
71
What is the Ilioischial line?
- Kohler’s line - line taken tangentially btw outer pelvic inlet and outer obturator foramen - acetabular floor and femoral head should not cross this line
72
What is Coxa Profunda?
- acetabular floor crosses ilioischilal line | - possible femoroacetabular impingement
73
What is Protrusio acetabuli?
* femoral head crosses ilioischial line * possible femoroacetabular impingement (minor displacement) * Paget’s, osteomalacia, rheumatoid arthritis, trauma, dysplasias
74
What is the patella position measurement?
* length of patella from posterior superior corner to inferior anterior corner * should be equal to length of patella tendon from inferior patella to tibial tuberosity * patella alta
75
What is patella alta?
• patella tendon longer than patella - chondromalacia patela - swelling
76
List the views of the knee?
* AP * Lateral * Sunrise/skyline * Intercondylar (tunnel)
77
Which knee view is best to see loose bodies?
Intercondylar (tunnel) view
78
What is Boehler’s angle? What are normal values?
* on lateral ankle view * angle of intersection btw lines connecting the 3 highest points on the calcaneus * 25-40 degrees * calcaneus fracture if < 25 degrees
79
Which ankle view is best to view the tib-fib interspace?
Medial oblique ankle
80
What is the bet view to observe the lateral aspect of the metatarsals?
Medial oblique foot
81
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
82
What are the norma values of cervical lordosis angle?
35-45 degrees
83
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
84
What is George’s line?
Posterior vertebral line
85
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
86
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
87
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
88
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
89
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
90
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
91
What are the borders on the AP Cervical view?
C3 to T2-3
92
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
93
What are the borders in APOM Cervical?
C1 and C2
94
What is the mach effect?
Relative lucency between 2 overlapping structures may simulate a fracture
95
What is the difference between normal and abnormal atlantoaxial alignment on APOM Cervical view?
Abnormal: overhang of lateral mas along with over 5 degrees lateral tilt indicate possibility of odontoid fracture Normal: kids 4 yr old have normal overhang of atlas
96
Which Cervical view is best for observing IVFs?
Oblique cervical
97
What Oblique positions are the same to each other?
``` LAO = RPO RAO = LPO ```
98
Is there an Oblique thoracic view?
Nope | Just AP and lateral
99
What are the borders of AP thoracic?
C7 to L1
100
What is Cobb angle?
Angle that measures curve of a spine | Trace 2 lines on the vertebral body that would cross each other eventually
101
How do we assess vertebra rotation?
Look at pedicles NOT spinous processes | Distance from the midline
102
What are the borders of a Lateral Thoracic view?
C7 to L1
103
How can we best visualize T1-3?
Swimmers lateral
104
What are the guidelines for counting vertebrae on a Lateral Thoracic?
- use landmarks from AP view - DONT use diaphragm - see if last vertebra has a rib, if so we assume it is T12
105
What is the normal thoracic kyphosis curve value?
20-40 degree
106
What are the borders of an AP Lumbar view?
T12 to upper sacrum, including SIJs
107
What is the pars interarticularis and where do we find them in the spine?
- Only in lumbar spine - not an anatomical structure - named and identified because common area of fracture
108
What are the borders of Lateral Lumbar view?
-T12 to upper sacrum
109
Which is the best view for visualizing IVD spaces in lumbar spine?
Lateral lumbar
110
What is the best view for seeing the IVFs of lumbar spine?
Lateral lumbar
111
List the alignments and measurements of the lateral lumbar spine
1) Georgés line 2) Lordosis 3) Sacral base angle 4) Lumbosacral base angle 5) IVD angle 6) Lumbar gravity line 7) Eisenstein’s measurement
112
What is George’s line?
Line tracing posterior vertebral bodies and then into the sacral canal
113
What is a normal value of Lumbar lordosis?
50-60 degrees
114
What is the sacral base angle?
- 1 line tracing top of sacral body - 1 line horizontal to ground - angle btw them
115
What is a normal Sacral base angle? And what is abnormal?
- 26 to 57 degrees - average of 41 degrees - increased means increase anterior pelvic tilt
116
What is the Lumbosacral disc angle? And what happens when it’s abnormal?
10-15 degrees Increased =facet impaction = LBP
117
Is lumbosacral disc angle related to spondylolisthesis?
No
118
What is the IVDs angles?
Lines following top and bottom of vertebral bodies Can be done at all levels
119
What are normal values of IVDs angles?
L1 : 8 degrees | L4 : 14 degrees
120
What is the lumbar gravity line?
-Line from centre of L3 vertebral body toward straight vertical gravity
121
What are abnormal measures of lumbar gravity line?
- anterior to sacrum by over 1cm | - posterior shift
122
What is Eisensteins method measurement on lumbar lateral view?
Measures width of sacral canal
123
What are abnormal Eisensteins measures?
Under 15mm
124
When do we do an Oblique Lumbar view?
Suspect a pars fracture
125
How do we orient ourselves in oblique lumbar?
Draw line behind all vertebral bodies All to the left is left and so on
126
Which lumbar is the best view for observing the facet joints?
Oblique
127
What are the borders for AP LUMBOPELVIC.
T12 to proximal femur including ilium
128
What is a Phlebolith?
Small rounded calcification of a vein
129
What alignments do we see on AP lumbopelvic?
- Scoliosis - Pelvic obliquity - Pelvic rotation - Femoral head height - Hip alignment
130
What are the Coccyx anomalies?
• 1: curved slightly anteriorly • 2: curved more anteriorly, coccyx pointing straight forward • 3: angulated sharply anterior • 4: subluxated at sacrococcygeal/intercoccygeal joints
131
List the alignments on AP shoulder with their normal values
* GH joint space (4-5mm) * Acromiohumeral space (7-11mm) * AC joint space (2-4mm) * Coracoclavicular space (11-13mm)
132
List the shoulders views
* AP external rotation shoulder * AP internal rotation shoulder * AP neutral rotation shoulder * Scapular Y * Transthoracic lateral * Axial
133
What is the goal of a Scapular Y view?
Lateral view of the scapula | -NOT to assess GH or AC joint
134
Why do a transthoracic lateral view?
- true lateral view of humerus - trauma (pt cant rotate arm safely) - just looking for major defects or trauma
135
List the elbow epiphyses in order of appearance
* Capitulum (1 yr) * Radial head (5 yrs) * medial epicondyle (7yrs) * Trochlea (10 yrs) * Olecranon (10 yrs) * lateral epicondyle (11 yrs) (CRITOE)
136
What is the Fat pad sign?
- fat pad is lucent - normally so close to bone its not visible - indicates intra-articular swelling, probably fracture
137
List the alignments on lateral elbow view
- radiocapitellar line | - humerocapitellar line
138
Which wrist-view has a view of lateral thumb?
PA wrist and hand
139
List the alignments to observe in wrist and hand views
- Radioulnar alignment - carpal arcs - metacarpals and phalanges
140
Which view is best for observing the base of the thumb?
oblique wrist and hand
141
List the alignments to observe in an AP hip
- Shentons line (under) - Iliofemoral line (over) (Of femoral neck) - anterior acetabular wall - posterior acetabular wall - acetabular roof - iliopectineal line - ilioischial line - kohler’s tear drop - Klein’s line - hip femoral angle - fempral neck margin - teardrop distnce
142
What is coxa vara? Vs coxa valga?
Vara: femoral angle <120 degrees Valga: femoral angle >135 degrees
143
What is Teardrop distance? What’s its normal value?
Distance btw inner femoral head and Kohler’s teardrop Normal 6-11mm and <2mm difference bilaterally
144
What is the Ilioischial line?
- Kohler’s line - line taken tangentially btw outer pelvic inlet and outer obturator foramen - acetabular floor and femoral head should not cross this line
145
What is Coxa Profunda?
- acetabular floor crosses ilioischilal line | - possible femoroacetabular impingement
146
What is Protrusio acetabuli?
* femoral head crosses ilioischial line * possible femoroacetabular impingement (minor displacement) * Paget’s, osteomalacia, rheumatoid arthritis, trauma, dysplasias
147
What is the patella position measurement?
* length of patella from posterior superior corner to inferior anterior corner * should be equal to length of patella tendon from inferior patella to tibial tuberosity * patella alta
148
What is patella alta?
• patella tendon longer than patella - chondromalacia patela - swelling
149
List the views of the knee?
* AP * Lateral * Sunrise/skyline * Intercondylar (tunnel)
150
Which knee view is best to see loose bodies?
Intercondylar (tunnel) view
151
What is Boehler’s angle? What are normal values?
* on lateral ankle view * angle of intersection btw lines connecting the 3 highest points on the calcaneus * 25-40 degrees * calcaneus fracture if < 25 degrees
152
Which ankle view is best to view the tib-fib interspace?
Medial oblique ankle
153
What is the bet view to observe the lateral aspect of the metatarsals?
Medial oblique foot
154
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
155
What are the norma values of cervical lordosis angle?
35-45 degrees
156
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
157
What is George’s line?
Posterior vertebral line
158
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
159
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
160
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
161
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
162
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
163
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
164
What are the borders on the AP Cervical view?
C3 to T2-3
165
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
166
What are the borders in APOM Cervical?
C1 and C2
167
What is the mach effect?
Relative lucency between 2 overlapping structures may simulate a fracture
168
What is the difference between normal and abnormal atlantoaxial alignment on APOM Cervical view?
Abnormal: overhang of lateral mas along with over 5 degrees lateral tilt indicate possibility of odontoid fracture Normal: kids 4 yr old have normal overhang of atlas
169
Which Cervical view is best for observing IVFs?
Oblique cervical
170
What Oblique positions are the same to each other?
``` LAO = RPO RAO = LPO ```
171
Is there an Oblique thoracic view?
Nope | Just AP and lateral
172
What are the borders of AP thoracic?
C7 to L1
173
What is Cobb angle?
Angle that measures curve of a spine | Trace 2 lines on the vertebral body that would cross each other eventually
174
How do we assess vertebra rotation?
Look at pedicles NOT spinous processes | Distance from the midline
175
What are the borders of a Lateral Thoracic view?
C7 to L1
176
How can we best visualize T1-3?
Swimmers lateral
177
What are the guidelines for counting vertebrae on a Lateral Thoracic?
- use landmarks from AP view - DONT use diaphragm - see if last vertebra has a rib, if so we assume it is T12
178
What is the normal thoracic kyphosis curve value?
20-40 degree
179
What are the borders of an AP Lumbar view?
T12 to upper sacrum, including SIJs
180
What is the pars interarticularis and where do we find them in the spine?
- Only in lumbar spine - not an anatomical structure - named and identified because common area of fracture
181
What are the borders of Lateral Lumbar view?
-T12 to upper sacrum
182
Which is the best view for visualizing IVD spaces in lumbar spine?
Lateral lumbar
183
What is the best view for seeing the IVFs of lumbar spine?
Lateral lumbar
184
List the alignments and measurements of the lateral lumbar spine
1) Georgés line 2) Lordosis 3) Sacral base angle 4) Lumbosacral base angle 5) IVD angle 6) Lumbar gravity line 7) Eisenstein’s measurement
185
What is George’s line?
Line tracing posterior vertebral bodies and then into the sacral canal
186
What is a normal value of Lumbar lordosis?
50-60 degrees
187
What is the sacral base angle?
- 1 line tracing top of sacral body - 1 line horizontal to ground - angle btw them
188
What is a normal Sacral base angle? And what is abnormal?
- 26 to 57 degrees - average of 41 degrees - increased means increase anterior pelvic tilt
189
What is the Lumbosacral disc angle? And what happens when it’s abnormal?
10-15 degrees Increased =facet impaction = LBP
190
Is lumbosacral disc angle related to spondylolisthesis?
No
191
What is the IVDs angles?
Lines following top and bottom of vertebral bodies Can be done at all levels
192
What are normal values of IVDs angles?
L1 : 8 degrees | L4 : 14 degrees
193
What is the lumbar gravity line?
-Line from centre of L3 vertebral body toward straight vertical gravity
194
What are abnormal measures of lumbar gravity line?
- anterior to sacrum by over 1cm | - posterior shift
195
What is Eisensteins method measurement on lumbar lateral view?
Measures width of sacral canal
196
What are abnormal Eisensteins measures?
Under 15mm
197
When do we do an Oblique Lumbar view?
Suspect a pars fracture
198
How do we orient ourselves in oblique lumbar?
Draw line behind all vertebral bodies All to the left is left and so on
199
Which lumbar is the best view for observing the facet joints?
Oblique
200
What are the borders for AP LUMBOPELVIC.
T12 to proximal femur including ilium
201
What is a Phlebolith?
Small rounded calcification of a vein
202
What alignments do we see on AP lumbopelvic?
- Scoliosis - Pelvic obliquity - Pelvic rotation - Femoral head height - Hip alignment
203
What are the Coccyx anomalies?
• 1: curved slightly anteriorly • 2: curved more anteriorly, coccyx pointing straight forward • 3: angulated sharply anterior • 4: subluxated at sacrococcygeal/intercoccygeal joints
204
List the alignments on AP shoulder with their normal values
* GH joint space (4-5mm) * Acromiohumeral space (7-11mm) * AC joint space (2-4mm) * Coracoclavicular space (11-13mm)
205
List the shoulders views
* AP external rotation shoulder * AP internal rotation shoulder * AP neutral rotation shoulder * Scapular Y * Transthoracic lateral * Axial
206
What is the goal of a Scapular Y view?
Lateral view of the scapula | -NOT to assess GH or AC joint
207
Why do a transthoracic lateral view?
- true lateral view of humerus - trauma (pt cant rotate arm safely) - just looking for major defects or trauma
208
List the elbow epiphyses in order of appearance
* Capitulum (1 yr) * Radial head (5 yrs) * medial epicondyle (7yrs) * Trochlea (10 yrs) * Olecranon (10 yrs) * lateral epicondyle (11 yrs) (CRITOE)
209
What is the Fat pad sign?
- fat pad is lucent - normally so close to bone its not visible - indicates intra-articular swelling, probably fracture
210
List the alignments on lateral elbow view
- radiocapitellar line | - humerocapitellar line
211
Which wrist-view has a view of lateral thumb?
PA wrist and hand
212
List the alignments to observe in wrist and hand views
- Radioulnar alignment - carpal arcs - metacarpals and phalanges
213
Which view is best for observing the base of the thumb?
oblique wrist and hand
214
List the alignments to observe in an AP hip
- Shentons line (under) - Iliofemoral line (over) (Of femoral neck) - anterior acetabular wall - posterior acetabular wall - acetabular roof - iliopectineal line - ilioischial line - kohler’s tear drop - Klein’s line - hip femoral angle - fempral neck margin - teardrop distnce
215
What is coxa vara? Vs coxa valga?
Vara: femoral angle <120 degrees Valga: femoral angle >135 degrees
216
What is Teardrop distance? What’s its normal value?
Distance btw inner femoral head and Kohler’s teardrop Normal 6-11mm and <2mm difference bilaterally
217
What is the Ilioischial line?
- Kohler’s line - line taken tangentially btw outer pelvic inlet and outer obturator foramen - acetabular floor and femoral head should not cross this line
218
What is Coxa Profunda?
- acetabular floor crosses ilioischilal line | - possible femoroacetabular impingement
219
What is Protrusio acetabuli?
* femoral head crosses ilioischial line * possible femoroacetabular impingement (minor displacement) * Paget’s, osteomalacia, rheumatoid arthritis, trauma, dysplasias
220
What is the patella position measurement?
* length of patella from posterior superior corner to inferior anterior corner * should be equal to length of patella tendon from inferior patella to tibial tuberosity * patella alta
221
What is patella alta?
• patella tendon longer than patella - chondromalacia patela - swelling
222
List the views of the knee?
* AP * Lateral * Sunrise/skyline * Intercondylar (tunnel)
223
Which knee view is best to see loose bodies?
Intercondylar (tunnel) view
224
What is Boehler’s angle? What are normal values?
* on lateral ankle view * angle of intersection btw lines connecting the 3 highest points on the calcaneus * 25-40 degrees * calcaneus fracture if < 25 degrees
225
Which ankle view is best to view the tib-fib interspace?
Medial oblique ankle
226
What is the bet view to observe the lateral aspect of the metatarsals?
Medial oblique foot
227
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
228
What are the norma values of cervical lordosis angle?
35-45 degrees
229
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
230
What is George’s line?
Posterior vertebral line
231
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
232
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
233
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
234
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
235
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
236
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
237
What are the borders on the AP Cervical view?
C3 to T2-3
238
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
239
What are the borders in APOM Cervical?
C1 and C2
240
What is the mach effect?
Relative lucency between 2 overlapping structures may simulate a fracture
241
What is the difference between normal and abnormal atlantoaxial alignment on APOM Cervical view?
Abnormal: overhang of lateral mas along with over 5 degrees lateral tilt indicate possibility of odontoid fracture Normal: kids 4 yr old have normal overhang of atlas
242
Which Cervical view is best for observing IVFs?
Oblique cervical
243
What Oblique positions are the same to each other?
``` LAO = RPO RAO = LPO ```
244
Is there an Oblique thoracic view?
Nope | Just AP and lateral
245
What are the borders of AP thoracic?
C7 to L1
246
What is Cobb angle?
Angle that measures curve of a spine | Trace 2 lines on the vertebral body that would cross each other eventually
247
How do we assess vertebra rotation?
Look at pedicles NOT spinous processes | Distance from the midline
248
What are the borders of a Lateral Thoracic view?
C7 to L1
249
How can we best visualize T1-3?
Swimmers lateral
250
What are the guidelines for counting vertebrae on a Lateral Thoracic?
- use landmarks from AP view - DONT use diaphragm - see if last vertebra has a rib, if so we assume it is T12
251
What is the normal thoracic kyphosis curve value?
20-40 degree
252
What are the borders of an AP Lumbar view?
T12 to upper sacrum, including SIJs
253
What is the pars interarticularis and where do we find them in the spine?
- Only in lumbar spine - not an anatomical structure - named and identified because common area of fracture
254
What are the borders of Lateral Lumbar view?
-T12 to upper sacrum
255
Which is the best view for visualizing IVD spaces in lumbar spine?
Lateral lumbar
256
What is the best view for seeing the IVFs of lumbar spine?
Lateral lumbar
257
List the alignments and measurements of the lateral lumbar spine
1) Georgés line 2) Lordosis 3) Sacral base angle 4) Lumbosacral base angle 5) IVD angle 6) Lumbar gravity line 7) Eisenstein’s measurement
258
What is George’s line?
Line tracing posterior vertebral bodies and then into the sacral canal
259
What is a normal value of Lumbar lordosis?
50-60 degrees
260
What is the sacral base angle?
- 1 line tracing top of sacral body - 1 line horizontal to ground - angle btw them
261
What is a normal Sacral base angle? And what is abnormal?
- 26 to 57 degrees - average of 41 degrees - increased means increase anterior pelvic tilt
262
What is the Lumbosacral disc angle? And what happens when it’s abnormal?
10-15 degrees Increased =facet impaction = LBP
263
Is lumbosacral disc angle related to spondylolisthesis?
No
264
What is the IVDs angles?
Lines following top and bottom of vertebral bodies Can be done at all levels
265
What are normal values of IVDs angles?
L1 : 8 degrees | L4 : 14 degrees
266
What is the lumbar gravity line?
-Line from centre of L3 vertebral body toward straight vertical gravity
267
What are abnormal measures of lumbar gravity line?
- anterior to sacrum by over 1cm | - posterior shift
268
What is Eisensteins method measurement on lumbar lateral view?
Measures width of sacral canal
269
What are abnormal Eisensteins measures?
Under 15mm
270
When do we do an Oblique Lumbar view?
Suspect a pars fracture
271
How do we orient ourselves in oblique lumbar?
Draw line behind all vertebral bodies All to the left is left and so on
272
Which lumbar is the best view for observing the facet joints?
Oblique
273
What are the borders for AP LUMBOPELVIC.
T12 to proximal femur including ilium
274
What is a Phlebolith?
Small rounded calcification of a vein
275
What alignments do we see on AP lumbopelvic?
- Scoliosis - Pelvic obliquity - Pelvic rotation - Femoral head height - Hip alignment
276
What are the Coccyx anomalies?
• 1: curved slightly anteriorly • 2: curved more anteriorly, coccyx pointing straight forward • 3: angulated sharply anterior • 4: subluxated at sacrococcygeal/intercoccygeal joints
277
List the alignments on AP shoulder with their normal values
* GH joint space (4-5mm) * Acromiohumeral space (7-11mm) * AC joint space (2-4mm) * Coracoclavicular space (11-13mm)
278
List the shoulders views
* AP external rotation shoulder * AP internal rotation shoulder * AP neutral rotation shoulder * Scapular Y * Transthoracic lateral * Axial
279
What is the goal of a Scapular Y view?
Lateral view of the scapula | -NOT to assess GH or AC joint
280
Why do a transthoracic lateral view?
- true lateral view of humerus - trauma (pt cant rotate arm safely) - just looking for major defects or trauma
281
List the elbow epiphyses in order of appearance
* Capitulum (1 yr) * Radial head (5 yrs) * medial epicondyle (7yrs) * Trochlea (10 yrs) * Olecranon (10 yrs) * lateral epicondyle (11 yrs) (CRITOE)
282
What is the Fat pad sign?
- fat pad is lucent - normally so close to bone its not visible - indicates intra-articular swelling, probably fracture
283
List the alignments on lateral elbow view
- radiocapitellar line | - humerocapitellar line
284
Which wrist-view has a view of lateral thumb?
PA wrist and hand
285
List the alignments to observe in wrist and hand views
- Radioulnar alignment - carpal arcs - metacarpals and phalanges
286
Which view is best for observing the base of the thumb?
oblique wrist and hand
287
List the alignments to observe in an AP hip
- Shentons line (under) - Iliofemoral line (over) (Of femoral neck) - anterior acetabular wall - posterior acetabular wall - acetabular roof - iliopectineal line - ilioischial line - kohler’s tear drop - Klein’s line - hip femoral angle - fempral neck margin - teardrop distnce
288
What is coxa vara? Vs coxa valga?
Vara: femoral angle <120 degrees Valga: femoral angle >135 degrees
289
What is Teardrop distance? What’s its normal value?
Distance btw inner femoral head and Kohler’s teardrop Normal 6-11mm and <2mm difference bilaterally
290
What is the Ilioischial line?
- Kohler’s line - line taken tangentially btw outer pelvic inlet and outer obturator foramen - acetabular floor and femoral head should not cross this line
291
What is Coxa Profunda?
- acetabular floor crosses ilioischilal line | - possible femoroacetabular impingement
292
What is Protrusio acetabuli?
* femoral head crosses ilioischial line * possible femoroacetabular impingement (minor displacement) * Paget’s, osteomalacia, rheumatoid arthritis, trauma, dysplasias
293
What is the patella position measurement?
* length of patella from posterior superior corner to inferior anterior corner * should be equal to length of patella tendon from inferior patella to tibial tuberosity * patella alta
294
What is patella alta?
• patella tendon longer than patella - chondromalacia patela - swelling
295
List the views of the knee?
* AP * Lateral * Sunrise/skyline * Intercondylar (tunnel)
296
Which knee view is best to see loose bodies?
Intercondylar (tunnel) view
297
What is Boehler’s angle? What are normal values?
* on lateral ankle view * angle of intersection btw lines connecting the 3 highest points on the calcaneus * 25-40 degrees * calcaneus fracture if < 25 degrees
298
Which ankle view is best to view the tib-fib interspace?
Medial oblique ankle
299
What is the bet view to observe the lateral aspect of the metatarsals?
Medial oblique foot
300
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
301
What are the norma values of cervical lordosis angle?
35-45 degrees
302
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
303
What is George’s line?
Posterior vertebral line
304
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
305
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
306
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
307
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
308
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
309
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
310
What are the borders on the AP Cervical view?
C3 to T2-3
311
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
312
What are the borders in APOM Cervical?
C1 and C2
313
What is the mach effect?
Relative lucency between 2 overlapping structures may simulate a fracture
314
What is the difference between normal and abnormal atlantoaxial alignment on APOM Cervical view?
Abnormal: overhang of lateral mas along with over 5 degrees lateral tilt indicate possibility of odontoid fracture Normal: kids 4 yr old have normal overhang of atlas
315
Which Cervical view is best for observing IVFs?
Oblique cervical
316
What Oblique positions are the same to each other?
``` LAO = RPO RAO = LPO ```
317
Is there an Oblique thoracic view?
Nope | Just AP and lateral
318
What are the borders of AP thoracic?
C7 to L1
319
What is Cobb angle?
Angle that measures curve of a spine | Trace 2 lines on the vertebral body that would cross each other eventually
320
How do we assess vertebra rotation?
Look at pedicles NOT spinous processes | Distance from the midline
321
What are the borders of a Lateral Thoracic view?
C7 to L1
322
How can we best visualize T1-3?
Swimmers lateral
323
What are the guidelines for counting vertebrae on a Lateral Thoracic?
- use landmarks from AP view - DONT use diaphragm - see if last vertebra has a rib, if so we assume it is T12
324
What is the normal thoracic kyphosis curve value?
20-40 degree
325
What are the borders of an AP Lumbar view?
T12 to upper sacrum, including SIJs
326
What is the pars interarticularis and where do we find them in the spine?
- Only in lumbar spine - not an anatomical structure - named and identified because common area of fracture
327
What are the borders of Lateral Lumbar view?
-T12 to upper sacrum
328
Which is the best view for visualizing IVD spaces in lumbar spine?
Lateral lumbar
329
What is the best view for seeing the IVFs of lumbar spine?
Lateral lumbar
330
List the alignments and measurements of the lateral lumbar spine
1) Georgés line 2) Lordosis 3) Sacral base angle 4) Lumbosacral base angle 5) IVD angle 6) Lumbar gravity line 7) Eisenstein’s measurement
331
What is George’s line?
Line tracing posterior vertebral bodies and then into the sacral canal
332
What is a normal value of Lumbar lordosis?
50-60 degrees
333
What is the sacral base angle?
- 1 line tracing top of sacral body - 1 line horizontal to ground - angle btw them
334
What is a normal Sacral base angle? And what is abnormal?
- 26 to 57 degrees - average of 41 degrees - increased means increase anterior pelvic tilt
335
What is the Lumbosacral disc angle? And what happens when it’s abnormal?
10-15 degrees Increased =facet impaction = LBP
336
Is lumbosacral disc angle related to spondylolisthesis?
No
337
What is the IVDs angles?
Lines following top and bottom of vertebral bodies Can be done at all levels
338
What are normal values of IVDs angles?
L1 : 8 degrees | L4 : 14 degrees
339
What is the lumbar gravity line?
-Line from centre of L3 vertebral body toward straight vertical gravity
340
What are abnormal measures of lumbar gravity line?
- anterior to sacrum by over 1cm | - posterior shift
341
What is Eisensteins method measurement on lumbar lateral view?
Measures width of sacral canal
342
What are abnormal Eisensteins measures?
Under 15mm
343
When do we do an Oblique Lumbar view?
Suspect a pars fracture
344
How do we orient ourselves in oblique lumbar?
Draw line behind all vertebral bodies All to the left is left and so on
345
Which lumbar is the best view for observing the facet joints?
Oblique
346
What are the borders for AP LUMBOPELVIC.
T12 to proximal femur including ilium
347
What is a Phlebolith?
Small rounded calcification of a vein
348
What alignments do we see on AP lumbopelvic?
- Scoliosis - Pelvic obliquity - Pelvic rotation - Femoral head height - Hip alignment
349
What are the Coccyx anomalies?
• 1: curved slightly anteriorly • 2: curved more anteriorly, coccyx pointing straight forward • 3: angulated sharply anterior • 4: subluxated at sacrococcygeal/intercoccygeal joints
350
List the alignments on AP shoulder with their normal values
* GH joint space (4-5mm) * Acromiohumeral space (7-11mm) * AC joint space (2-4mm) * Coracoclavicular space (11-13mm)
351
List the shoulders views
* AP external rotation shoulder * AP internal rotation shoulder * AP neutral rotation shoulder * Scapular Y * Transthoracic lateral * Axial
352
What is the goal of a Scapular Y view?
Lateral view of the scapula | -NOT to assess GH or AC joint
353
Why do a transthoracic lateral view?
- true lateral view of humerus - trauma (pt cant rotate arm safely) - just looking for major defects or trauma
354
List the elbow epiphyses in order of appearance
* Capitulum (1 yr) * Radial head (5 yrs) * medial epicondyle (7yrs) * Trochlea (10 yrs) * Olecranon (10 yrs) * lateral epicondyle (11 yrs) (CRITOE)
355
What is the Fat pad sign?
- fat pad is lucent - normally so close to bone its not visible - indicates intra-articular swelling, probably fracture
356
List the alignments on lateral elbow view
- radiocapitellar line | - humerocapitellar line
357
Which wrist-view has a view of lateral thumb?
PA wrist and hand
358
List the alignments to observe in wrist and hand views
- Radioulnar alignment - carpal arcs - metacarpals and phalanges
359
Which view is best for observing the base of the thumb?
oblique wrist and hand
360
List the alignments to observe in an AP hip
- Shentons line (under) - Iliofemoral line (over) (Of femoral neck) - anterior acetabular wall - posterior acetabular wall - acetabular roof - iliopectineal line - ilioischial line - kohler’s tear drop - Klein’s line - hip femoral angle - fempral neck margin - teardrop distnce
361
What is coxa vara? Vs coxa valga?
Vara: femoral angle <120 degrees Valga: femoral angle >135 degrees
362
What is Teardrop distance? What’s its normal value?
Distance btw inner femoral head and Kohler’s teardrop Normal 6-11mm and <2mm difference bilaterally
363
What is the Ilioischial line?
- Kohler’s line - line taken tangentially btw outer pelvic inlet and outer obturator foramen - acetabular floor and femoral head should not cross this line
364
What is Coxa Profunda?
- acetabular floor crosses ilioischilal line | - possible femoroacetabular impingement
365
What is Protrusio acetabuli?
* femoral head crosses ilioischial line * possible femoroacetabular impingement (minor displacement) * Paget’s, osteomalacia, rheumatoid arthritis, trauma, dysplasias
366
What is the patella position measurement?
* length of patella from posterior superior corner to inferior anterior corner * should be equal to length of patella tendon from inferior patella to tibial tuberosity * patella alta
367
What is patella alta?
• patella tendon longer than patella - chondromalacia patela - swelling
368
List the views of the knee?
* AP * Lateral * Sunrise/skyline * Intercondylar (tunnel)
369
Which knee view is best to see loose bodies?
Intercondylar (tunnel) view
370
What is Boehler’s angle? What are normal values?
* on lateral ankle view * angle of intersection btw lines connecting the 3 highest points on the calcaneus * 25-40 degrees * calcaneus fracture if < 25 degrees
371
Which ankle view is best to view the tib-fib interspace?
Medial oblique ankle
372
What is the bet view to observe the lateral aspect of the metatarsals?
Medial oblique foot
373
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
374
What are the norma values of cervical lordosis angle?
35-45 degrees
375
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
376
What is George’s line?
Posterior vertebral line
377
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
378
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
379
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
380
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
381
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
382
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
383
What are the borders on the AP Cervical view?
C3 to T2-3
384
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
385
What are the borders in APOM Cervical?
C1 and C2
386
What is the mach effect?
Relative lucency between 2 overlapping structures may simulate a fracture
387
What is the difference between normal and abnormal atlantoaxial alignment on APOM Cervical view?
Abnormal: overhang of lateral mas along with over 5 degrees lateral tilt indicate possibility of odontoid fracture Normal: kids 4 yr old have normal overhang of atlas
388
Which Cervical view is best for observing IVFs?
Oblique cervical
389
What Oblique positions are the same to each other?
``` LAO = RPO RAO = LPO ```
390
Is there an Oblique thoracic view?
Nope | Just AP and lateral
391
What are the borders of AP thoracic?
C7 to L1
392
What is Cobb angle?
Angle that measures curve of a spine | Trace 2 lines on the vertebral body that would cross each other eventually
393
How do we assess vertebra rotation?
Look at pedicles NOT spinous processes | Distance from the midline
394
What are the borders of a Lateral Thoracic view?
C7 to L1
395
How can we best visualize T1-3?
Swimmers lateral
396
What are the guidelines for counting vertebrae on a Lateral Thoracic?
- use landmarks from AP view - DONT use diaphragm - see if last vertebra has a rib, if so we assume it is T12
397
What is the normal thoracic kyphosis curve value?
20-40 degree
398
What are the borders of an AP Lumbar view?
T12 to upper sacrum, including SIJs
399
What is the pars interarticularis and where do we find them in the spine?
- Only in lumbar spine - not an anatomical structure - named and identified because common area of fracture
400
What are the borders of Lateral Lumbar view?
-T12 to upper sacrum
401
Which is the best view for visualizing IVD spaces in lumbar spine?
Lateral lumbar
402
What is the best view for seeing the IVFs of lumbar spine?
Lateral lumbar
403
List the alignments and measurements of the lateral lumbar spine
1) Georgés line 2) Lordosis 3) Sacral base angle 4) Lumbosacral base angle 5) IVD angle 6) Lumbar gravity line 7) Eisenstein’s measurement
404
What is George’s line?
Line tracing posterior vertebral bodies and then into the sacral canal
405
What is a normal value of Lumbar lordosis?
50-60 degrees
406
What is the sacral base angle?
- 1 line tracing top of sacral body - 1 line horizontal to ground - angle btw them
407
What is a normal Sacral base angle? And what is abnormal?
- 26 to 57 degrees - average of 41 degrees - increased means increase anterior pelvic tilt
408
What is the Lumbosacral disc angle? And what happens when it’s abnormal?
10-15 degrees Increased =facet impaction = LBP
409
Is lumbosacral disc angle related to spondylolisthesis?
No
410
What is the IVDs angles?
Lines following top and bottom of vertebral bodies Can be done at all levels
411
What are normal values of IVDs angles?
L1 : 8 degrees | L4 : 14 degrees
412
What is the lumbar gravity line?
-Line from centre of L3 vertebral body toward straight vertical gravity
413
What are abnormal measures of lumbar gravity line?
- anterior to sacrum by over 1cm | - posterior shift
414
What is Eisensteins method measurement on lumbar lateral view?
Measures width of sacral canal
415
What are abnormal Eisensteins measures?
Under 15mm
416
When do we do an Oblique Lumbar view?
Suspect a pars fracture
417
How do we orient ourselves in oblique lumbar?
Draw line behind all vertebral bodies All to the left is left and so on
418
Which lumbar is the best view for observing the facet joints?
Oblique
419
What are the borders for AP LUMBOPELVIC.
T12 to proximal femur including ilium
420
What is a Phlebolith?
Small rounded calcification of a vein
421
What alignments do we see on AP lumbopelvic?
- Scoliosis - Pelvic obliquity - Pelvic rotation - Femoral head height - Hip alignment
422
What are the Coccyx anomalies?
• 1: curved slightly anteriorly • 2: curved more anteriorly, coccyx pointing straight forward • 3: angulated sharply anterior • 4: subluxated at sacrococcygeal/intercoccygeal joints
423
List the alignments on AP shoulder with their normal values
* GH joint space (4-5mm) * Acromiohumeral space (7-11mm) * AC joint space (2-4mm) * Coracoclavicular space (11-13mm)
424
List the shoulders views
* AP external rotation shoulder * AP internal rotation shoulder * AP neutral rotation shoulder * Scapular Y * Transthoracic lateral * Axial
425
What is the goal of a Scapular Y view?
Lateral view of the scapula | -NOT to assess GH or AC joint
426
Why do a transthoracic lateral view?
- true lateral view of humerus - trauma (pt cant rotate arm safely) - just looking for major defects or trauma
427
List the elbow epiphyses in order of appearance
* Capitulum (1 yr) * Radial head (5 yrs) * medial epicondyle (7yrs) * Trochlea (10 yrs) * Olecranon (10 yrs) * lateral epicondyle (11 yrs) (CRITOE)
428
What is the Fat pad sign?
- fat pad is lucent - normally so close to bone its not visible - indicates intra-articular swelling, probably fracture
429
List the alignments on lateral elbow view
- radiocapitellar line | - humerocapitellar line
430
Which wrist-view has a view of lateral thumb?
PA wrist and hand
431
List the alignments to observe in wrist and hand views
- Radioulnar alignment - carpal arcs - metacarpals and phalanges
432
Which view is best for observing the base of the thumb?
oblique wrist and hand
433
List the alignments to observe in an AP hip
- Shentons line (under) - Iliofemoral line (over) (Of femoral neck) - anterior acetabular wall - posterior acetabular wall - acetabular roof - iliopectineal line - ilioischial line - kohler’s tear drop - Klein’s line - hip femoral angle - fempral neck margin - teardrop distnce
434
What is coxa vara? Vs coxa valga?
Vara: femoral angle <120 degrees Valga: femoral angle >135 degrees
435
What is Teardrop distance? What’s its normal value?
Distance btw inner femoral head and Kohler’s teardrop Normal 6-11mm and <2mm difference bilaterally
436
What is the Ilioischial line?
- Kohler’s line - line taken tangentially btw outer pelvic inlet and outer obturator foramen - acetabular floor and femoral head should not cross this line
437
What is Coxa Profunda?
- acetabular floor crosses ilioischilal line | - possible femoroacetabular impingement
438
What is Protrusio acetabuli?
* femoral head crosses ilioischial line * possible femoroacetabular impingement (minor displacement) * Paget’s, osteomalacia, rheumatoid arthritis, trauma, dysplasias
439
What is the patella position measurement?
* length of patella from posterior superior corner to inferior anterior corner * should be equal to length of patella tendon from inferior patella to tibial tuberosity * patella alta
440
What is patella alta?
• patella tendon longer than patella - chondromalacia patela - swelling
441
List the views of the knee?
* AP * Lateral * Sunrise/skyline * Intercondylar (tunnel)
442
Which knee view is best to see loose bodies?
Intercondylar (tunnel) view
443
What is Boehler’s angle? What are normal values?
* on lateral ankle view * angle of intersection btw lines connecting the 3 highest points on the calcaneus * 25-40 degrees * calcaneus fracture if < 25 degrees
444
Which ankle view is best to view the tib-fib interspace?
Medial oblique ankle
445
What is the bet view to observe the lateral aspect of the metatarsals?
Medial oblique foot
446
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
447
What are the norma values of cervical lordosis angle?
35-45 degrees
448
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
449
What is George’s line?
Posterior vertebral line
450
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
451
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
452
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
453
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
454
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
455
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
456
What are the borders on the AP Cervical view?
C3 to T2-3
457
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
458
What are the borders in APOM Cervical?
C1 and C2
459
What is the mach effect?
Relative lucency between 2 overlapping structures may simulate a fracture
460
What is the difference between normal and abnormal atlantoaxial alignment on APOM Cervical view?
Abnormal: overhang of lateral mas along with over 5 degrees lateral tilt indicate possibility of odontoid fracture Normal: kids 4 yr old have normal overhang of atlas
461
Which Cervical view is best for observing IVFs?
Oblique cervical
462
What Oblique positions are the same to each other?
``` LAO = RPO RAO = LPO ```
463
Is there an Oblique thoracic view?
Nope | Just AP and lateral
464
What are the borders of AP thoracic?
C7 to L1
465
What is Cobb angle?
Angle that measures curve of a spine | Trace 2 lines on the vertebral body that would cross each other eventually
466
How do we assess vertebra rotation?
Look at pedicles NOT spinous processes | Distance from the midline
467
What are the borders of a Lateral Thoracic view?
C7 to L1
468
How can we best visualize T1-3?
Swimmers lateral
469
What are the guidelines for counting vertebrae on a Lateral Thoracic?
- use landmarks from AP view - DONT use diaphragm - see if last vertebra has a rib, if so we assume it is T12
470
What is the normal thoracic kyphosis curve value?
20-40 degree
471
What are the borders of an AP Lumbar view?
T12 to upper sacrum, including SIJs
472
What is the pars interarticularis and where do we find them in the spine?
- Only in lumbar spine - not an anatomical structure - named and identified because common area of fracture
473
What are the borders of Lateral Lumbar view?
-T12 to upper sacrum
474
Which is the best view for visualizing IVD spaces in lumbar spine?
Lateral lumbar
475
What is the best view for seeing the IVFs of lumbar spine?
Lateral lumbar
476
List the alignments and measurements of the lateral lumbar spine
1) Georgés line 2) Lordosis 3) Sacral base angle 4) Lumbosacral base angle 5) IVD angle 6) Lumbar gravity line 7) Eisenstein’s measurement
477
What is George’s line?
Line tracing posterior vertebral bodies and then into the sacral canal
478
What is a normal value of Lumbar lordosis?
50-60 degrees
479
What is the sacral base angle?
- 1 line tracing top of sacral body - 1 line horizontal to ground - angle btw them
480
What is a normal Sacral base angle? And what is abnormal?
- 26 to 57 degrees - average of 41 degrees - increased means increase anterior pelvic tilt
481
What is the Lumbosacral disc angle? And what happens when it’s abnormal?
10-15 degrees Increased =facet impaction = LBP
482
Is lumbosacral disc angle related to spondylolisthesis?
No
483
What is the IVDs angles?
Lines following top and bottom of vertebral bodies Can be done at all levels
484
What are normal values of IVDs angles?
L1 : 8 degrees | L4 : 14 degrees
485
What is the lumbar gravity line?
-Line from centre of L3 vertebral body toward straight vertical gravity
486
What are abnormal measures of lumbar gravity line?
- anterior to sacrum by over 1cm | - posterior shift
487
What is Eisensteins method measurement on lumbar lateral view?
Measures width of sacral canal
488
What are abnormal Eisensteins measures?
Under 15mm
489
When do we do an Oblique Lumbar view?
Suspect a pars fracture
490
How do we orient ourselves in oblique lumbar?
Draw line behind all vertebral bodies All to the left is left and so on
491
Which lumbar is the best view for observing the facet joints?
Oblique
492
What are the borders for AP LUMBOPELVIC.
T12 to proximal femur including ilium
493
What is a Phlebolith?
Small rounded calcification of a vein
494
What alignments do we see on AP lumbopelvic?
- Scoliosis - Pelvic obliquity - Pelvic rotation - Femoral head height - Hip alignment
495
What are the Coccyx anomalies?
• 1: curved slightly anteriorly • 2: curved more anteriorly, coccyx pointing straight forward • 3: angulated sharply anterior • 4: subluxated at sacrococcygeal/intercoccygeal joints
496
List the alignments on AP shoulder with their normal values
* GH joint space (4-5mm) * Acromiohumeral space (7-11mm) * AC joint space (2-4mm) * Coracoclavicular space (11-13mm)
497
List the shoulders views
* AP external rotation shoulder * AP internal rotation shoulder * AP neutral rotation shoulder * Scapular Y * Transthoracic lateral * Axial
498
What is the goal of a Scapular Y view?
Lateral view of the scapula | -NOT to assess GH or AC joint
499
Why do a transthoracic lateral view?
- true lateral view of humerus - trauma (pt cant rotate arm safely) - just looking for major defects or trauma
500
List the elbow epiphyses in order of appearance
* Capitulum (1 yr) * Radial head (5 yrs) * medial epicondyle (7yrs) * Trochlea (10 yrs) * Olecranon (10 yrs) * lateral epicondyle (11 yrs) (CRITOE)
501
What is the Fat pad sign?
- fat pad is lucent - normally so close to bone its not visible - indicates intra-articular swelling, probably fracture
502
List the alignments on lateral elbow view
- radiocapitellar line | - humerocapitellar line
503
Which wrist-view has a view of lateral thumb?
PA wrist and hand
504
List the alignments to observe in wrist and hand views
- Radioulnar alignment - carpal arcs - metacarpals and phalanges
505
Which view is best for observing the base of the thumb?
oblique wrist and hand
506
List the alignments to observe in an AP hip
- Shentons line (under) - Iliofemoral line (over) (Of femoral neck) - anterior acetabular wall - posterior acetabular wall - acetabular roof - iliopectineal line - ilioischial line - kohler’s tear drop - Klein’s line - hip femoral angle - fempral neck margin - teardrop distnce
507
What is coxa vara? Vs coxa valga?
Vara: femoral angle <120 degrees Valga: femoral angle >135 degrees
508
What is Teardrop distance? What’s its normal value?
Distance btw inner femoral head and Kohler’s teardrop Normal 6-11mm and <2mm difference bilaterally
509
What is the Ilioischial line?
- Kohler’s line - line taken tangentially btw outer pelvic inlet and outer obturator foramen - acetabular floor and femoral head should not cross this line
510
What is Coxa Profunda?
- acetabular floor crosses ilioischilal line | - possible femoroacetabular impingement
511
What is Protrusio acetabuli?
* femoral head crosses ilioischial line * possible femoroacetabular impingement (minor displacement) * Paget’s, osteomalacia, rheumatoid arthritis, trauma, dysplasias
512
What is the patella position measurement?
* length of patella from posterior superior corner to inferior anterior corner * should be equal to length of patella tendon from inferior patella to tibial tuberosity * patella alta
513
What is patella alta?
• patella tendon longer than patella - chondromalacia patela - swelling
514
List the views of the knee?
* AP * Lateral * Sunrise/skyline * Intercondylar (tunnel)
515
Which knee view is best to see loose bodies?
Intercondylar (tunnel) view
516
What is Boehler’s angle? What are normal values?
* on lateral ankle view * angle of intersection btw lines connecting the 3 highest points on the calcaneus * 25-40 degrees * calcaneus fracture if < 25 degrees
517
Which ankle view is best to view the tib-fib interspace?
Medial oblique ankle
518
What is the bet view to observe the lateral aspect of the metatarsals?
Medial oblique foot
519
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
520
What are the norma values of cervical lordosis angle?
35-45 degrees
521
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
522
What is George’s line?
Posterior vertebral line
523
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
524
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
525
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
526
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
527
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
528
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
529
What are the borders on the AP Cervical view?
C3 to T2-3
530
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
531
What are the borders in APOM Cervical?
C1 and C2
532
What is the mach effect?
Relative lucency between 2 overlapping structures may simulate a fracture
533
What is the difference between normal and abnormal atlantoaxial alignment on APOM Cervical view?
Abnormal: overhang of lateral mas along with over 5 degrees lateral tilt indicate possibility of odontoid fracture Normal: kids 4 yr old have normal overhang of atlas
534
Which Cervical view is best for observing IVFs?
Oblique cervical
535
What Oblique positions are the same to each other?
``` LAO = RPO RAO = LPO ```
536
Is there an Oblique thoracic view?
Nope | Just AP and lateral
537
What are the borders of AP thoracic?
C7 to L1
538
What is Cobb angle?
Angle that measures curve of a spine | Trace 2 lines on the vertebral body that would cross each other eventually
539
How do we assess vertebra rotation?
Look at pedicles NOT spinous processes | Distance from the midline
540
What are the borders of a Lateral Thoracic view?
C7 to L1
541
How can we best visualize T1-3?
Swimmers lateral
542
What are the guidelines for counting vertebrae on a Lateral Thoracic?
- use landmarks from AP view - DONT use diaphragm - see if last vertebra has a rib, if so we assume it is T12
543
What is the normal thoracic kyphosis curve value?
20-40 degree
544
What are the borders of an AP Lumbar view?
T12 to upper sacrum, including SIJs
545
What is the pars interarticularis and where do we find them in the spine?
- Only in lumbar spine - not an anatomical structure - named and identified because common area of fracture
546
What are the borders of Lateral Lumbar view?
-T12 to upper sacrum
547
Which is the best view for visualizing IVD spaces in lumbar spine?
Lateral lumbar
548
What is the best view for seeing the IVFs of lumbar spine?
Lateral lumbar
549
List the alignments and measurements of the lateral lumbar spine
1) Georgés line 2) Lordosis 3) Sacral base angle 4) Lumbosacral base angle 5) IVD angle 6) Lumbar gravity line 7) Eisenstein’s measurement
550
What is George’s line?
Line tracing posterior vertebral bodies and then into the sacral canal
551
What is a normal value of Lumbar lordosis?
50-60 degrees
552
What is the sacral base angle?
- 1 line tracing top of sacral body - 1 line horizontal to ground - angle btw them
553
What is a normal Sacral base angle? And what is abnormal?
- 26 to 57 degrees - average of 41 degrees - increased means increase anterior pelvic tilt
554
What is the Lumbosacral disc angle? And what happens when it’s abnormal?
10-15 degrees Increased =facet impaction = LBP
555
Is lumbosacral disc angle related to spondylolisthesis?
No
556
What is the IVDs angles?
Lines following top and bottom of vertebral bodies Can be done at all levels
557
What are normal values of IVDs angles?
L1 : 8 degrees | L4 : 14 degrees
558
What is the lumbar gravity line?
-Line from centre of L3 vertebral body toward straight vertical gravity
559
What are abnormal measures of lumbar gravity line?
- anterior to sacrum by over 1cm | - posterior shift
560
What is Eisensteins method measurement on lumbar lateral view?
Measures width of sacral canal
561
What are abnormal Eisensteins measures?
Under 15mm
562
When do we do an Oblique Lumbar view?
Suspect a pars fracture
563
How do we orient ourselves in oblique lumbar?
Draw line behind all vertebral bodies All to the left is left and so on
564
Which lumbar is the best view for observing the facet joints?
Oblique
565
What are the borders for AP LUMBOPELVIC.
T12 to proximal femur including ilium
566
What is a Phlebolith?
Small rounded calcification of a vein
567
What alignments do we see on AP lumbopelvic?
- Scoliosis - Pelvic obliquity - Pelvic rotation - Femoral head height - Hip alignment
568
What are the Coccyx anomalies?
• 1: curved slightly anteriorly • 2: curved more anteriorly, coccyx pointing straight forward • 3: angulated sharply anterior • 4: subluxated at sacrococcygeal/intercoccygeal joints
569
List the alignments on AP shoulder with their normal values
* GH joint space (4-5mm) * Acromiohumeral space (7-11mm) * AC joint space (2-4mm) * Coracoclavicular space (11-13mm)
570
List the shoulders views
* AP external rotation shoulder * AP internal rotation shoulder * AP neutral rotation shoulder * Scapular Y * Transthoracic lateral * Axial
571
What is the goal of a Scapular Y view?
Lateral view of the scapula | -NOT to assess GH or AC joint
572
Why do a transthoracic lateral view?
- true lateral view of humerus - trauma (pt cant rotate arm safely) - just looking for major defects or trauma
573
List the elbow epiphyses in order of appearance
* Capitulum (1 yr) * Radial head (5 yrs) * medial epicondyle (7yrs) * Trochlea (10 yrs) * Olecranon (10 yrs) * lateral epicondyle (11 yrs) (CRITOE)
574
What is the Fat pad sign?
- fat pad is lucent - normally so close to bone its not visible - indicates intra-articular swelling, probably fracture
575
List the alignments on lateral elbow view
- radiocapitellar line | - humerocapitellar line
576
Which wrist-view has a view of lateral thumb?
PA wrist and hand
577
List the alignments to observe in wrist and hand views
- Radioulnar alignment - carpal arcs - metacarpals and phalanges
578
Which view is best for observing the base of the thumb?
oblique wrist and hand
579
List the alignments to observe in an AP hip
- Shentons line (under) - Iliofemoral line (over) (Of femoral neck) - anterior acetabular wall - posterior acetabular wall - acetabular roof - iliopectineal line - ilioischial line - kohler’s tear drop - Klein’s line - hip femoral angle - fempral neck margin - teardrop distnce
580
What is coxa vara? Vs coxa valga?
Vara: femoral angle <120 degrees Valga: femoral angle >135 degrees
581
What is Teardrop distance? What’s its normal value?
Distance btw inner femoral head and Kohler’s teardrop Normal 6-11mm and <2mm difference bilaterally
582
What is the Ilioischial line?
- Kohler’s line - line taken tangentially btw outer pelvic inlet and outer obturator foramen - acetabular floor and femoral head should not cross this line
583
What is Coxa Profunda?
- acetabular floor crosses ilioischilal line | - possible femoroacetabular impingement
584
What is Protrusio acetabuli?
* femoral head crosses ilioischial line * possible femoroacetabular impingement (minor displacement) * Paget’s, osteomalacia, rheumatoid arthritis, trauma, dysplasias
585
What is the patella position measurement?
* length of patella from posterior superior corner to inferior anterior corner * should be equal to length of patella tendon from inferior patella to tibial tuberosity * patella alta
586
What is patella alta?
• patella tendon longer than patella - chondromalacia patela - swelling
587
List the views of the knee?
* AP * Lateral * Sunrise/skyline * Intercondylar (tunnel)
588
Which knee view is best to see loose bodies?
Intercondylar (tunnel) view
589
What is Boehler’s angle? What are normal values?
* on lateral ankle view * angle of intersection btw lines connecting the 3 highest points on the calcaneus * 25-40 degrees * calcaneus fracture if < 25 degrees
590
Which ankle view is best to view the tib-fib interspace?
Medial oblique ankle
591
What is the bet view to observe the lateral aspect of the metatarsals?
Medial oblique foot
592
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
593
What are the norma values of cervical lordosis angle?
35-45 degrees
594
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
595
What is George’s line?
Posterior vertebral line
596
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
597
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
598
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
599
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
600
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
601
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
602
What are the borders on the AP Cervical view?
C3 to T2-3
603
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
604
What are the borders in APOM Cervical?
C1 and C2
605
What is the mach effect?
Relative lucency between 2 overlapping structures may simulate a fracture
606
What is the difference between normal and abnormal atlantoaxial alignment on APOM Cervical view?
Abnormal: overhang of lateral mas along with over 5 degrees lateral tilt indicate possibility of odontoid fracture Normal: kids 4 yr old have normal overhang of atlas
607
Which Cervical view is best for observing IVFs?
Oblique cervical
608
What Oblique positions are the same to each other?
``` LAO = RPO RAO = LPO ```
609
Is there an Oblique thoracic view?
Nope | Just AP and lateral
610
What are the borders of AP thoracic?
C7 to L1
611
What is Cobb angle?
Angle that measures curve of a spine | Trace 2 lines on the vertebral body that would cross each other eventually
612
How do we assess vertebra rotation?
Look at pedicles NOT spinous processes | Distance from the midline
613
What are the borders of a Lateral Thoracic view?
C7 to L1
614
How can we best visualize T1-3?
Swimmers lateral
615
What are the guidelines for counting vertebrae on a Lateral Thoracic?
- use landmarks from AP view - DONT use diaphragm - see if last vertebra has a rib, if so we assume it is T12
616
What is the normal thoracic kyphosis curve value?
20-40 degree
617
What are the borders of an AP Lumbar view?
T12 to upper sacrum, including SIJs
618
What is the pars interarticularis and where do we find them in the spine?
- Only in lumbar spine - not an anatomical structure - named and identified because common area of fracture
619
What are the borders of Lateral Lumbar view?
-T12 to upper sacrum
620
Which is the best view for visualizing IVD spaces in lumbar spine?
Lateral lumbar
621
What is the best view for seeing the IVFs of lumbar spine?
Lateral lumbar
622
List the alignments and measurements of the lateral lumbar spine
1) Georgés line 2) Lordosis 3) Sacral base angle 4) Lumbosacral base angle 5) IVD angle 6) Lumbar gravity line 7) Eisenstein’s measurement
623
What is George’s line?
Line tracing posterior vertebral bodies and then into the sacral canal
624
What is a normal value of Lumbar lordosis?
50-60 degrees
625
What is the sacral base angle?
- 1 line tracing top of sacral body - 1 line horizontal to ground - angle btw them
626
What is a normal Sacral base angle? And what is abnormal?
- 26 to 57 degrees - average of 41 degrees - increased means increase anterior pelvic tilt
627
What is the Lumbosacral disc angle? And what happens when it’s abnormal?
10-15 degrees Increased =facet impaction = LBP
628
Is lumbosacral disc angle related to spondylolisthesis?
No
629
What is the IVDs angles?
Lines following top and bottom of vertebral bodies Can be done at all levels
630
What are normal values of IVDs angles?
L1 : 8 degrees | L4 : 14 degrees
631
What is the lumbar gravity line?
-Line from centre of L3 vertebral body toward straight vertical gravity
632
What are abnormal measures of lumbar gravity line?
- anterior to sacrum by over 1cm | - posterior shift
633
What is Eisensteins method measurement on lumbar lateral view?
Measures width of sacral canal
634
What are abnormal Eisensteins measures?
Under 15mm
635
When do we do an Oblique Lumbar view?
Suspect a pars fracture
636
How do we orient ourselves in oblique lumbar?
Draw line behind all vertebral bodies All to the left is left and so on
637
Which lumbar is the best view for observing the facet joints?
Oblique
638
What are the borders for AP LUMBOPELVIC.
T12 to proximal femur including ilium
639
What is a Phlebolith?
Small rounded calcification of a vein
640
What alignments do we see on AP lumbopelvic?
- Scoliosis - Pelvic obliquity - Pelvic rotation - Femoral head height - Hip alignment
641
What are the Coccyx anomalies?
• 1: curved slightly anteriorly • 2: curved more anteriorly, coccyx pointing straight forward • 3: angulated sharply anterior • 4: subluxated at sacrococcygeal/intercoccygeal joints
642
List the alignments on AP shoulder with their normal values
* GH joint space (4-5mm) * Acromiohumeral space (7-11mm) * AC joint space (2-4mm) * Coracoclavicular space (11-13mm)
643
List the shoulders views
* AP external rotation shoulder * AP internal rotation shoulder * AP neutral rotation shoulder * Scapular Y * Transthoracic lateral * Axial
644
What is the goal of a Scapular Y view?
Lateral view of the scapula | -NOT to assess GH or AC joint
645
Why do a transthoracic lateral view?
- true lateral view of humerus - trauma (pt cant rotate arm safely) - just looking for major defects or trauma
646
List the elbow epiphyses in order of appearance
* Capitulum (1 yr) * Radial head (5 yrs) * medial epicondyle (7yrs) * Trochlea (10 yrs) * Olecranon (10 yrs) * lateral epicondyle (11 yrs) (CRITOE)
647
What is the Fat pad sign?
- fat pad is lucent - normally so close to bone its not visible - indicates intra-articular swelling, probably fracture
648
List the alignments on lateral elbow view
- radiocapitellar line | - humerocapitellar line
649
Which wrist-view has a view of lateral thumb?
PA wrist and hand
650
List the alignments to observe in wrist and hand views
- Radioulnar alignment - carpal arcs - metacarpals and phalanges
651
Which view is best for observing the base of the thumb?
oblique wrist and hand
652
List the alignments to observe in an AP hip
- Shentons line (under) - Iliofemoral line (over) (Of femoral neck) - anterior acetabular wall - posterior acetabular wall - acetabular roof - iliopectineal line - ilioischial line - kohler’s tear drop - Klein’s line - hip femoral angle - fempral neck margin - teardrop distnce
653
What is coxa vara? Vs coxa valga?
Vara: femoral angle <120 degrees Valga: femoral angle >135 degrees
654
What is Teardrop distance? What’s its normal value?
Distance btw inner femoral head and Kohler’s teardrop Normal 6-11mm and <2mm difference bilaterally
655
What is the Ilioischial line?
- Kohler’s line - line taken tangentially btw outer pelvic inlet and outer obturator foramen - acetabular floor and femoral head should not cross this line
656
What is Coxa Profunda?
- acetabular floor crosses ilioischilal line | - possible femoroacetabular impingement
657
What is Protrusio acetabuli?
* femoral head crosses ilioischial line * possible femoroacetabular impingement (minor displacement) * Paget’s, osteomalacia, rheumatoid arthritis, trauma, dysplasias
658
What is the patella position measurement?
* length of patella from posterior superior corner to inferior anterior corner * should be equal to length of patella tendon from inferior patella to tibial tuberosity * patella alta
659
What is patella alta?
• patella tendon longer than patella - chondromalacia patela - swelling
660
List the views of the knee?
* AP * Lateral * Sunrise/skyline * Intercondylar (tunnel)
661
Which knee view is best to see loose bodies?
Intercondylar (tunnel) view
662
What is Boehler’s angle? What are normal values?
* on lateral ankle view * angle of intersection btw lines connecting the 3 highest points on the calcaneus * 25-40 degrees * calcaneus fracture if < 25 degrees
663
Which ankle view is best to view the tib-fib interspace?
Medial oblique ankle
664
What is the bet view to observe the lateral aspect of the metatarsals?
Medial oblique foot
665
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
666
What are the norma values of cervical lordosis angle?
35-45 degrees
667
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
668
What is George’s line?
Posterior vertebral line
669
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
670
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
671
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
672
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
673
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
674
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
675
What are the borders on the AP Cervical view?
C3 to T2-3
676
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
677
What are the borders in APOM Cervical?
C1 and C2
678
What is the mach effect?
Relative lucency between 2 overlapping structures may simulate a fracture
679
What is the difference between normal and abnormal atlantoaxial alignment on APOM Cervical view?
Abnormal: overhang of lateral mas along with over 5 degrees lateral tilt indicate possibility of odontoid fracture Normal: kids 4 yr old have normal overhang of atlas
680
Which Cervical view is best for observing IVFs?
Oblique cervical
681
What Oblique positions are the same to each other?
``` LAO = RPO RAO = LPO ```
682
Is there an Oblique thoracic view?
Nope | Just AP and lateral
683
What are the borders of AP thoracic?
C7 to L1
684
What is Cobb angle?
Angle that measures curve of a spine | Trace 2 lines on the vertebral body that would cross each other eventually
685
How do we assess vertebra rotation?
Look at pedicles NOT spinous processes | Distance from the midline
686
What are the borders of a Lateral Thoracic view?
C7 to L1
687
How can we best visualize T1-3?
Swimmers lateral
688
What are the guidelines for counting vertebrae on a Lateral Thoracic?
- use landmarks from AP view - DONT use diaphragm - see if last vertebra has a rib, if so we assume it is T12
689
What is the normal thoracic kyphosis curve value?
20-40 degree
690
What are the borders of an AP Lumbar view?
T12 to upper sacrum, including SIJs
691
What is the pars interarticularis and where do we find them in the spine?
- Only in lumbar spine - not an anatomical structure - named and identified because common area of fracture
692
What are the borders of Lateral Lumbar view?
-T12 to upper sacrum
693
Which is the best view for visualizing IVD spaces in lumbar spine?
Lateral lumbar
694
What is the best view for seeing the IVFs of lumbar spine?
Lateral lumbar
695
List the alignments and measurements of the lateral lumbar spine
1) Georgés line 2) Lordosis 3) Sacral base angle 4) Lumbosacral base angle 5) IVD angle 6) Lumbar gravity line 7) Eisenstein’s measurement
696
What is George’s line?
Line tracing posterior vertebral bodies and then into the sacral canal
697
What is a normal value of Lumbar lordosis?
50-60 degrees
698
What is the sacral base angle?
- 1 line tracing top of sacral body - 1 line horizontal to ground - angle btw them
699
What is a normal Sacral base angle? And what is abnormal?
- 26 to 57 degrees - average of 41 degrees - increased means increase anterior pelvic tilt
700
What is the Lumbosacral disc angle? And what happens when it’s abnormal?
10-15 degrees Increased =facet impaction = LBP
701
Is lumbosacral disc angle related to spondylolisthesis?
No
702
What is the IVDs angles?
Lines following top and bottom of vertebral bodies Can be done at all levels
703
What are normal values of IVDs angles?
L1 : 8 degrees | L4 : 14 degrees
704
What is the lumbar gravity line?
-Line from centre of L3 vertebral body toward straight vertical gravity
705
What are abnormal measures of lumbar gravity line?
- anterior to sacrum by over 1cm | - posterior shift
706
What is Eisensteins method measurement on lumbar lateral view?
Measures width of sacral canal
707
What are abnormal Eisensteins measures?
Under 15mm
708
When do we do an Oblique Lumbar view?
Suspect a pars fracture
709
How do we orient ourselves in oblique lumbar?
Draw line behind all vertebral bodies All to the left is left and so on
710
Which lumbar is the best view for observing the facet joints?
Oblique
711
What are the borders for AP LUMBOPELVIC.
T12 to proximal femur including ilium
712
What is a Phlebolith?
Small rounded calcification of a vein
713
What alignments do we see on AP lumbopelvic?
- Scoliosis - Pelvic obliquity - Pelvic rotation - Femoral head height - Hip alignment
714
What are the Coccyx anomalies?
• 1: curved slightly anteriorly • 2: curved more anteriorly, coccyx pointing straight forward • 3: angulated sharply anterior • 4: subluxated at sacrococcygeal/intercoccygeal joints
715
List the alignments on AP shoulder with their normal values
* GH joint space (4-5mm) * Acromiohumeral space (7-11mm) * AC joint space (2-4mm) * Coracoclavicular space (11-13mm)
716
List the shoulders views
* AP external rotation shoulder * AP internal rotation shoulder * AP neutral rotation shoulder * Scapular Y * Transthoracic lateral * Axial
717
What is the goal of a Scapular Y view?
Lateral view of the scapula | -NOT to assess GH or AC joint
718
Why do a transthoracic lateral view?
- true lateral view of humerus - trauma (pt cant rotate arm safely) - just looking for major defects or trauma
719
List the elbow epiphyses in order of appearance
* Capitulum (1 yr) * Radial head (5 yrs) * medial epicondyle (7yrs) * Trochlea (10 yrs) * Olecranon (10 yrs) * lateral epicondyle (11 yrs) (CRITOE)
720
What is the Fat pad sign?
- fat pad is lucent - normally so close to bone its not visible - indicates intra-articular swelling, probably fracture
721
List the alignments on lateral elbow view
- radiocapitellar line | - humerocapitellar line
722
Which wrist-view has a view of lateral thumb?
PA wrist and hand
723
List the alignments to observe in wrist and hand views
- Radioulnar alignment - carpal arcs - metacarpals and phalanges
724
Which view is best for observing the base of the thumb?
oblique wrist and hand
725
List the alignments to observe in an AP hip
- Shentons line (under) - Iliofemoral line (over) (Of femoral neck) - anterior acetabular wall - posterior acetabular wall - acetabular roof - iliopectineal line - ilioischial line - kohler’s tear drop - Klein’s line - hip femoral angle - fempral neck margin - teardrop distnce
726
What is coxa vara? Vs coxa valga?
Vara: femoral angle <120 degrees Valga: femoral angle >135 degrees
727
What is Teardrop distance? What’s its normal value?
Distance btw inner femoral head and Kohler’s teardrop Normal 6-11mm and <2mm difference bilaterally
728
What is the Ilioischial line?
- Kohler’s line - line taken tangentially btw outer pelvic inlet and outer obturator foramen - acetabular floor and femoral head should not cross this line
729
What is Coxa Profunda?
- acetabular floor crosses ilioischilal line | - possible femoroacetabular impingement
730
What is Protrusio acetabuli?
* femoral head crosses ilioischial line * possible femoroacetabular impingement (minor displacement) * Paget’s, osteomalacia, rheumatoid arthritis, trauma, dysplasias
731
What is the patella position measurement?
* length of patella from posterior superior corner to inferior anterior corner * should be equal to length of patella tendon from inferior patella to tibial tuberosity * patella alta
732
What is patella alta?
• patella tendon longer than patella - chondromalacia patela - swelling
733
List the views of the knee?
* AP * Lateral * Sunrise/skyline * Intercondylar (tunnel)
734
Which knee view is best to see loose bodies?
Intercondylar (tunnel) view
735
What is Boehler’s angle? What are normal values?
* on lateral ankle view * angle of intersection btw lines connecting the 3 highest points on the calcaneus * 25-40 degrees * calcaneus fracture if < 25 degrees
736
Which ankle view is best to view the tib-fib interspace?
Medial oblique ankle
737
What is the bet view to observe the lateral aspect of the metatarsals?
Medial oblique foot
738
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
739
What are the norma values of cervical lordosis angle?
35-45 degrees
740
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
741
What is George’s line?
Posterior vertebral line
742
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
743
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
744
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
745
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
746
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
747
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
748
What are the borders on the AP Cervical view?
C3 to T2-3
749
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
750
What are the borders in APOM Cervical?
C1 and C2
751
What is the mach effect?
Relative lucency between 2 overlapping structures may simulate a fracture
752
What is the difference between normal and abnormal atlantoaxial alignment on APOM Cervical view?
Abnormal: overhang of lateral mas along with over 5 degrees lateral tilt indicate possibility of odontoid fracture Normal: kids 4 yr old have normal overhang of atlas
753
Which Cervical view is best for observing IVFs?
Oblique cervical
754
What Oblique positions are the same to each other?
``` LAO = RPO RAO = LPO ```
755
Is there an Oblique thoracic view?
Nope | Just AP and lateral
756
What are the borders of AP thoracic?
C7 to L1
757
What is Cobb angle?
Angle that measures curve of a spine | Trace 2 lines on the vertebral body that would cross each other eventually
758
How do we assess vertebra rotation?
Look at pedicles NOT spinous processes | Distance from the midline
759
What are the borders of a Lateral Thoracic view?
C7 to L1
760
How can we best visualize T1-3?
Swimmers lateral
761
What are the guidelines for counting vertebrae on a Lateral Thoracic?
- use landmarks from AP view - DONT use diaphragm - see if last vertebra has a rib, if so we assume it is T12
762
What is the normal thoracic kyphosis curve value?
20-40 degree
763
What are the borders of an AP Lumbar view?
T12 to upper sacrum, including SIJs
764
What is the pars interarticularis and where do we find them in the spine?
- Only in lumbar spine - not an anatomical structure - named and identified because common area of fracture
765
What are the borders of Lateral Lumbar view?
-T12 to upper sacrum
766
Which is the best view for visualizing IVD spaces in lumbar spine?
Lateral lumbar
767
What is the best view for seeing the IVFs of lumbar spine?
Lateral lumbar
768
List the alignments and measurements of the lateral lumbar spine
1) Georgés line 2) Lordosis 3) Sacral base angle 4) Lumbosacral base angle 5) IVD angle 6) Lumbar gravity line 7) Eisenstein’s measurement
769
What is George’s line?
Line tracing posterior vertebral bodies and then into the sacral canal
770
What is a normal value of Lumbar lordosis?
50-60 degrees
771
What is the sacral base angle?
- 1 line tracing top of sacral body - 1 line horizontal to ground - angle btw them
772
What is a normal Sacral base angle? And what is abnormal?
- 26 to 57 degrees - average of 41 degrees - increased means increase anterior pelvic tilt
773
What is the Lumbosacral disc angle? And what happens when it’s abnormal?
10-15 degrees Increased =facet impaction = LBP
774
Is lumbosacral disc angle related to spondylolisthesis?
No
775
What is the IVDs angles?
Lines following top and bottom of vertebral bodies Can be done at all levels
776
What are normal values of IVDs angles?
L1 : 8 degrees | L4 : 14 degrees
777
What is the lumbar gravity line?
-Line from centre of L3 vertebral body toward straight vertical gravity
778
What are abnormal measures of lumbar gravity line?
- anterior to sacrum by over 1cm | - posterior shift
779
What is Eisensteins method measurement on lumbar lateral view?
Measures width of sacral canal
780
What are abnormal Eisensteins measures?
Under 15mm
781
When do we do an Oblique Lumbar view?
Suspect a pars fracture
782
How do we orient ourselves in oblique lumbar?
Draw line behind all vertebral bodies All to the left is left and so on
783
Which lumbar is the best view for observing the facet joints?
Oblique
784
What are the borders for AP LUMBOPELVIC.
T12 to proximal femur including ilium
785
What is a Phlebolith?
Small rounded calcification of a vein
786
What alignments do we see on AP lumbopelvic?
- Scoliosis - Pelvic obliquity - Pelvic rotation - Femoral head height - Hip alignment
787
What are the Coccyx anomalies?
• 1: curved slightly anteriorly • 2: curved more anteriorly, coccyx pointing straight forward • 3: angulated sharply anterior • 4: subluxated at sacrococcygeal/intercoccygeal joints
788
List the alignments on AP shoulder with their normal values
* GH joint space (4-5mm) * Acromiohumeral space (7-11mm) * AC joint space (2-4mm) * Coracoclavicular space (11-13mm)
789
List the shoulders views
* AP external rotation shoulder * AP internal rotation shoulder * AP neutral rotation shoulder * Scapular Y * Transthoracic lateral * Axial
790
What is the goal of a Scapular Y view?
Lateral view of the scapula | -NOT to assess GH or AC joint
791
Why do a transthoracic lateral view?
- true lateral view of humerus - trauma (pt cant rotate arm safely) - just looking for major defects or trauma
792
List the elbow epiphyses in order of appearance
* Capitulum (1 yr) * Radial head (5 yrs) * medial epicondyle (7yrs) * Trochlea (10 yrs) * Olecranon (10 yrs) * lateral epicondyle (11 yrs) (CRITOE)
793
What is the Fat pad sign?
- fat pad is lucent - normally so close to bone its not visible - indicates intra-articular swelling, probably fracture
794
List the alignments on lateral elbow view
- radiocapitellar line | - humerocapitellar line
795
Which wrist-view has a view of lateral thumb?
PA wrist and hand
796
List the alignments to observe in wrist and hand views
- Radioulnar alignment - carpal arcs - metacarpals and phalanges
797
Which view is best for observing the base of the thumb?
oblique wrist and hand
798
List the alignments to observe in an AP hip
- Shentons line (under) - Iliofemoral line (over) (Of femoral neck) - anterior acetabular wall - posterior acetabular wall - acetabular roof - iliopectineal line - ilioischial line - kohler’s tear drop - Klein’s line - hip femoral angle - fempral neck margin - teardrop distnce
799
What is coxa vara? Vs coxa valga?
Vara: femoral angle <120 degrees Valga: femoral angle >135 degrees
800
What is Teardrop distance? What’s its normal value?
Distance btw inner femoral head and Kohler’s teardrop Normal 6-11mm and <2mm difference bilaterally
801
What is the Ilioischial line?
- Kohler’s line - line taken tangentially btw outer pelvic inlet and outer obturator foramen - acetabular floor and femoral head should not cross this line
802
What is Coxa Profunda?
- acetabular floor crosses ilioischilal line | - possible femoroacetabular impingement
803
What is Protrusio acetabuli?
* femoral head crosses ilioischial line * possible femoroacetabular impingement (minor displacement) * Paget’s, osteomalacia, rheumatoid arthritis, trauma, dysplasias
804
What is the patella position measurement?
* length of patella from posterior superior corner to inferior anterior corner * should be equal to length of patella tendon from inferior patella to tibial tuberosity * patella alta
805
What is patella alta?
• patella tendon longer than patella - chondromalacia patela - swelling
806
List the views of the knee?
* AP * Lateral * Sunrise/skyline * Intercondylar (tunnel)
807
Which knee view is best to see loose bodies?
Intercondylar (tunnel) view
808
What is Boehler’s angle? What are normal values?
* on lateral ankle view * angle of intersection btw lines connecting the 3 highest points on the calcaneus * 25-40 degrees * calcaneus fracture if < 25 degrees
809
Which ankle view is best to view the tib-fib interspace?
Medial oblique ankle
810
What is the bet view to observe the lateral aspect of the metatarsals?
Medial oblique foot
811
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
812
What are the norma values of cervical lordosis angle?
35-45 degrees
813
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
814
What is George’s line?
Posterior vertebral line
815
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
816
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
817
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
818
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
819
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
820
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
821
What are the borders on the AP Cervical view?
C3 to T2-3
822
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
823
What are the borders in APOM Cervical?
C1 and C2
824
What is the mach effect?
Relative lucency between 2 overlapping structures may simulate a fracture
825
What is the difference between normal and abnormal atlantoaxial alignment on APOM Cervical view?
Abnormal: overhang of lateral mas along with over 5 degrees lateral tilt indicate possibility of odontoid fracture Normal: kids 4 yr old have normal overhang of atlas
826
Which Cervical view is best for observing IVFs?
Oblique cervical
827
What Oblique positions are the same to each other?
``` LAO = RPO RAO = LPO ```
828
Is there an Oblique thoracic view?
Nope | Just AP and lateral
829
What are the borders of AP thoracic?
C7 to L1
830
What is Cobb angle?
Angle that measures curve of a spine | Trace 2 lines on the vertebral body that would cross each other eventually
831
How do we assess vertebra rotation?
Look at pedicles NOT spinous processes | Distance from the midline
832
What are the borders of a Lateral Thoracic view?
C7 to L1
833
How can we best visualize T1-3?
Swimmers lateral
834
What are the guidelines for counting vertebrae on a Lateral Thoracic?
- use landmarks from AP view - DONT use diaphragm - see if last vertebra has a rib, if so we assume it is T12
835
What is the normal thoracic kyphosis curve value?
20-40 degree
836
What are the borders of an AP Lumbar view?
T12 to upper sacrum, including SIJs
837
What is the pars interarticularis and where do we find them in the spine?
- Only in lumbar spine - not an anatomical structure - named and identified because common area of fracture
838
What are the borders of Lateral Lumbar view?
-T12 to upper sacrum
839
Which is the best view for visualizing IVD spaces in lumbar spine?
Lateral lumbar
840
What is the best view for seeing the IVFs of lumbar spine?
Lateral lumbar
841
List the alignments and measurements of the lateral lumbar spine
1) Georgés line 2) Lordosis 3) Sacral base angle 4) Lumbosacral base angle 5) IVD angle 6) Lumbar gravity line 7) Eisenstein’s measurement
842
What is George’s line?
Line tracing posterior vertebral bodies and then into the sacral canal
843
What is a normal value of Lumbar lordosis?
50-60 degrees
844
What is the sacral base angle?
- 1 line tracing top of sacral body - 1 line horizontal to ground - angle btw them
845
What is a normal Sacral base angle? And what is abnormal?
- 26 to 57 degrees - average of 41 degrees - increased means increase anterior pelvic tilt
846
What is the Lumbosacral disc angle? And what happens when it’s abnormal?
10-15 degrees Increased =facet impaction = LBP
847
Is lumbosacral disc angle related to spondylolisthesis?
No
848
What is the IVDs angles?
Lines following top and bottom of vertebral bodies Can be done at all levels
849
What are normal values of IVDs angles?
L1 : 8 degrees | L4 : 14 degrees
850
What is the lumbar gravity line?
-Line from centre of L3 vertebral body toward straight vertical gravity
851
What are abnormal measures of lumbar gravity line?
- anterior to sacrum by over 1cm | - posterior shift
852
What is Eisensteins method measurement on lumbar lateral view?
Measures width of sacral canal
853
What are abnormal Eisensteins measures?
Under 15mm
854
When do we do an Oblique Lumbar view?
Suspect a pars fracture
855
How do we orient ourselves in oblique lumbar?
Draw line behind all vertebral bodies All to the left is left and so on
856
Which lumbar is the best view for observing the facet joints?
Oblique
857
What are the borders for AP LUMBOPELVIC.
T12 to proximal femur including ilium
858
What is a Phlebolith?
Small rounded calcification of a vein
859
What alignments do we see on AP lumbopelvic?
- Scoliosis - Pelvic obliquity - Pelvic rotation - Femoral head height - Hip alignment
860
What are the Coccyx anomalies?
• 1: curved slightly anteriorly • 2: curved more anteriorly, coccyx pointing straight forward • 3: angulated sharply anterior • 4: subluxated at sacrococcygeal/intercoccygeal joints
861
List the alignments on AP shoulder with their normal values
* GH joint space (4-5mm) * Acromiohumeral space (7-11mm) * AC joint space (2-4mm) * Coracoclavicular space (11-13mm)
862
List the shoulders views
* AP external rotation shoulder * AP internal rotation shoulder * AP neutral rotation shoulder * Scapular Y * Transthoracic lateral * Axial
863
What is the goal of a Scapular Y view?
Lateral view of the scapula | -NOT to assess GH or AC joint
864
Why do a transthoracic lateral view?
- true lateral view of humerus - trauma (pt cant rotate arm safely) - just looking for major defects or trauma
865
List the elbow epiphyses in order of appearance
* Capitulum (1 yr) * Radial head (5 yrs) * medial epicondyle (7yrs) * Trochlea (10 yrs) * Olecranon (10 yrs) * lateral epicondyle (11 yrs) (CRITOE)
866
What is the Fat pad sign?
- fat pad is lucent - normally so close to bone its not visible - indicates intra-articular swelling, probably fracture
867
List the alignments on lateral elbow view
- radiocapitellar line | - humerocapitellar line
868
Which wrist-view has a view of lateral thumb?
PA wrist and hand
869
List the alignments to observe in wrist and hand views
- Radioulnar alignment - carpal arcs - metacarpals and phalanges
870
Which view is best for observing the base of the thumb?
oblique wrist and hand
871
List the alignments to observe in an AP hip
- Shentons line (under) - Iliofemoral line (over) (Of femoral neck) - anterior acetabular wall - posterior acetabular wall - acetabular roof - iliopectineal line - ilioischial line - kohler’s tear drop - Klein’s line - hip femoral angle - fempral neck margin - teardrop distnce
872
What is coxa vara? Vs coxa valga?
Vara: femoral angle <120 degrees Valga: femoral angle >135 degrees
873
What is Teardrop distance? What’s its normal value?
Distance btw inner femoral head and Kohler’s teardrop Normal 6-11mm and <2mm difference bilaterally
874
What is the Ilioischial line?
- Kohler’s line - line taken tangentially btw outer pelvic inlet and outer obturator foramen - acetabular floor and femoral head should not cross this line
875
What is Coxa Profunda?
- acetabular floor crosses ilioischilal line | - possible femoroacetabular impingement
876
What is Protrusio acetabuli?
* femoral head crosses ilioischial line * possible femoroacetabular impingement (minor displacement) * Paget’s, osteomalacia, rheumatoid arthritis, trauma, dysplasias
877
What is the patella position measurement?
* length of patella from posterior superior corner to inferior anterior corner * should be equal to length of patella tendon from inferior patella to tibial tuberosity * patella alta
878
What is patella alta?
• patella tendon longer than patella - chondromalacia patela - swelling
879
List the views of the knee?
* AP * Lateral * Sunrise/skyline * Intercondylar (tunnel)
880
Which knee view is best to see loose bodies?
Intercondylar (tunnel) view
881
What is Boehler’s angle? What are normal values?
* on lateral ankle view * angle of intersection btw lines connecting the 3 highest points on the calcaneus * 25-40 degrees * calcaneus fracture if < 25 degrees
882
Which ankle view is best to view the tib-fib interspace?
Medial oblique ankle
883
What is the bet view to observe the lateral aspect of the metatarsals?
Medial oblique foot
884
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
885
What are the norma values of cervical lordosis angle?
35-45 degrees
886
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
887
What is George’s line?
Posterior vertebral line
888
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
889
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
890
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
891
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
892
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
893
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
894
What are the borders on the AP Cervical view?
C3 to T2-3
895
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
896
What are the borders in APOM Cervical?
C1 and C2
897
What is the mach effect?
Relative lucency between 2 overlapping structures may simulate a fracture
898
What is the difference between normal and abnormal atlantoaxial alignment on APOM Cervical view?
Abnormal: overhang of lateral mas along with over 5 degrees lateral tilt indicate possibility of odontoid fracture Normal: kids 4 yr old have normal overhang of atlas
899
Which Cervical view is best for observing IVFs?
Oblique cervical
900
What Oblique positions are the same to each other?
``` LAO = RPO RAO = LPO ```
901
Is there an Oblique thoracic view?
Nope | Just AP and lateral
902
What are the borders of AP thoracic?
C7 to L1
903
What is Cobb angle?
Angle that measures curve of a spine | Trace 2 lines on the vertebral body that would cross each other eventually
904
How do we assess vertebra rotation?
Look at pedicles NOT spinous processes | Distance from the midline
905
What are the borders of a Lateral Thoracic view?
C7 to L1
906
How can we best visualize T1-3?
Swimmers lateral
907
What are the guidelines for counting vertebrae on a Lateral Thoracic?
- use landmarks from AP view - DONT use diaphragm - see if last vertebra has a rib, if so we assume it is T12
908
What is the normal thoracic kyphosis curve value?
20-40 degree
909
What are the borders of an AP Lumbar view?
T12 to upper sacrum, including SIJs
910
What is the pars interarticularis and where do we find them in the spine?
- Only in lumbar spine - not an anatomical structure - named and identified because common area of fracture
911
What are the borders of Lateral Lumbar view?
-T12 to upper sacrum
912
Which is the best view for visualizing IVD spaces in lumbar spine?
Lateral lumbar
913
What is the best view for seeing the IVFs of lumbar spine?
Lateral lumbar
914
List the alignments and measurements of the lateral lumbar spine
1) Georgés line 2) Lordosis 3) Sacral base angle 4) Lumbosacral base angle 5) IVD angle 6) Lumbar gravity line 7) Eisenstein’s measurement
915
What is George’s line?
Line tracing posterior vertebral bodies and then into the sacral canal
916
What is a normal value of Lumbar lordosis?
50-60 degrees
917
What is the sacral base angle?
- 1 line tracing top of sacral body - 1 line horizontal to ground - angle btw them
918
What is a normal Sacral base angle? And what is abnormal?
- 26 to 57 degrees - average of 41 degrees - increased means increase anterior pelvic tilt
919
What is the Lumbosacral disc angle? And what happens when it’s abnormal?
10-15 degrees Increased =facet impaction = LBP
920
Is lumbosacral disc angle related to spondylolisthesis?
No
921
What is the IVDs angles?
Lines following top and bottom of vertebral bodies Can be done at all levels
922
What are normal values of IVDs angles?
L1 : 8 degrees | L4 : 14 degrees
923
What is the lumbar gravity line?
-Line from centre of L3 vertebral body toward straight vertical gravity
924
What are abnormal measures of lumbar gravity line?
- anterior to sacrum by over 1cm | - posterior shift
925
What is Eisensteins method measurement on lumbar lateral view?
Measures width of sacral canal
926
What are abnormal Eisensteins measures?
Under 15mm
927
When do we do an Oblique Lumbar view?
Suspect a pars fracture
928
How do we orient ourselves in oblique lumbar?
Draw line behind all vertebral bodies All to the left is left and so on
929
Which lumbar is the best view for observing the facet joints?
Oblique
930
What are the borders for AP LUMBOPELVIC.
T12 to proximal femur including ilium
931
What is a Phlebolith?
Small rounded calcification of a vein
932
What alignments do we see on AP lumbopelvic?
- Scoliosis - Pelvic obliquity - Pelvic rotation - Femoral head height - Hip alignment
933
What are the Coccyx anomalies?
• 1: curved slightly anteriorly • 2: curved more anteriorly, coccyx pointing straight forward • 3: angulated sharply anterior • 4: subluxated at sacrococcygeal/intercoccygeal joints
934
List the alignments on AP shoulder with their normal values
* GH joint space (4-5mm) * Acromiohumeral space (7-11mm) * AC joint space (2-4mm) * Coracoclavicular space (11-13mm)
935
List the shoulders views
* AP external rotation shoulder * AP internal rotation shoulder * AP neutral rotation shoulder * Scapular Y * Transthoracic lateral * Axial
936
What is the goal of a Scapular Y view?
Lateral view of the scapula | -NOT to assess GH or AC joint
937
Why do a transthoracic lateral view?
- true lateral view of humerus - trauma (pt cant rotate arm safely) - just looking for major defects or trauma
938
List the elbow epiphyses in order of appearance
* Capitulum (1 yr) * Radial head (5 yrs) * medial epicondyle (7yrs) * Trochlea (10 yrs) * Olecranon (10 yrs) * lateral epicondyle (11 yrs) (CRITOE)
939
What is the Fat pad sign?
- fat pad is lucent - normally so close to bone its not visible - indicates intra-articular swelling, probably fracture
940
List the alignments on lateral elbow view
- radiocapitellar line | - humerocapitellar line
941
Which wrist-view has a view of lateral thumb?
PA wrist and hand
942
List the alignments to observe in wrist and hand views
- Radioulnar alignment - carpal arcs - metacarpals and phalanges
943
Which view is best for observing the base of the thumb?
oblique wrist and hand
944
List the alignments to observe in an AP hip
- Shentons line (under) - Iliofemoral line (over) (Of femoral neck) - anterior acetabular wall - posterior acetabular wall - acetabular roof - iliopectineal line - ilioischial line - kohler’s tear drop - Klein’s line - hip femoral angle - fempral neck margin - teardrop distnce
945
What is coxa vara? Vs coxa valga?
Vara: femoral angle <120 degrees Valga: femoral angle >135 degrees
946
What is Teardrop distance? What’s its normal value?
Distance btw inner femoral head and Kohler’s teardrop Normal 6-11mm and <2mm difference bilaterally
947
What is the Ilioischial line?
- Kohler’s line - line taken tangentially btw outer pelvic inlet and outer obturator foramen - acetabular floor and femoral head should not cross this line
948
What is Coxa Profunda?
- acetabular floor crosses ilioischilal line | - possible femoroacetabular impingement
949
What is Protrusio acetabuli?
* femoral head crosses ilioischial line * possible femoroacetabular impingement (minor displacement) * Paget’s, osteomalacia, rheumatoid arthritis, trauma, dysplasias
950
What is the patella position measurement?
* length of patella from posterior superior corner to inferior anterior corner * should be equal to length of patella tendon from inferior patella to tibial tuberosity * patella alta
951
What is patella alta?
• patella tendon longer than patella - chondromalacia patela - swelling
952
List the views of the knee?
* AP * Lateral * Sunrise/skyline * Intercondylar (tunnel)
953
Which knee view is best to see loose bodies?
Intercondylar (tunnel) view
954
What is Boehler’s angle? What are normal values?
* on lateral ankle view * angle of intersection btw lines connecting the 3 highest points on the calcaneus * 25-40 degrees * calcaneus fracture if < 25 degrees
955
Which ankle view is best to view the tib-fib interspace?
Medial oblique ankle
956
What is the bet view to observe the lateral aspect of the metatarsals?
Medial oblique foot
957
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
958
What are the norma values of cervical lordosis angle?
35-45 degrees
959
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
960
What is George’s line?
Posterior vertebral line
961
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
962
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
963
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
964
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
965
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
966
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
967
What are the borders on the AP Cervical view?
C3 to T2-3
968
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
969
What are the borders in APOM Cervical?
C1 and C2
970
What is the mach effect?
Relative lucency between 2 overlapping structures may simulate a fracture
971
What is the difference between normal and abnormal atlantoaxial alignment on APOM Cervical view?
Abnormal: overhang of lateral mas along with over 5 degrees lateral tilt indicate possibility of odontoid fracture Normal: kids 4 yr old have normal overhang of atlas
972
Which Cervical view is best for observing IVFs?
Oblique cervical
973
What Oblique positions are the same to each other?
``` LAO = RPO RAO = LPO ```
974
Is there an Oblique thoracic view?
Nope | Just AP and lateral
975
What are the borders of AP thoracic?
C7 to L1
976
What is Cobb angle?
Angle that measures curve of a spine | Trace 2 lines on the vertebral body that would cross each other eventually
977
How do we assess vertebra rotation?
Look at pedicles NOT spinous processes | Distance from the midline
978
What are the borders of a Lateral Thoracic view?
C7 to L1
979
How can we best visualize T1-3?
Swimmers lateral
980
What are the guidelines for counting vertebrae on a Lateral Thoracic?
- use landmarks from AP view - DONT use diaphragm - see if last vertebra has a rib, if so we assume it is T12
981
What is the normal thoracic kyphosis curve value?
20-40 degree
982
What are the borders of an AP Lumbar view?
T12 to upper sacrum, including SIJs
983
What is the pars interarticularis and where do we find them in the spine?
- Only in lumbar spine - not an anatomical structure - named and identified because common area of fracture
984
What are the borders of Lateral Lumbar view?
-T12 to upper sacrum
985
Which is the best view for visualizing IVD spaces in lumbar spine?
Lateral lumbar
986
What is the best view for seeing the IVFs of lumbar spine?
Lateral lumbar
987
List the alignments and measurements of the lateral lumbar spine
1) Georgés line 2) Lordosis 3) Sacral base angle 4) Lumbosacral base angle 5) IVD angle 6) Lumbar gravity line 7) Eisenstein’s measurement
988
What is George’s line?
Line tracing posterior vertebral bodies and then into the sacral canal
989
What is a normal value of Lumbar lordosis?
50-60 degrees
990
What is the sacral base angle?
- 1 line tracing top of sacral body - 1 line horizontal to ground - angle btw them
991
What is a normal Sacral base angle? And what is abnormal?
- 26 to 57 degrees - average of 41 degrees - increased means increase anterior pelvic tilt
992
What is the Lumbosacral disc angle? And what happens when it’s abnormal?
10-15 degrees Increased =facet impaction = LBP
993
Is lumbosacral disc angle related to spondylolisthesis?
No
994
What is the IVDs angles?
Lines following top and bottom of vertebral bodies Can be done at all levels
995
What are normal values of IVDs angles?
L1 : 8 degrees | L4 : 14 degrees
996
What is the lumbar gravity line?
-Line from centre of L3 vertebral body toward straight vertical gravity
997
What are abnormal measures of lumbar gravity line?
- anterior to sacrum by over 1cm | - posterior shift
998
What is Eisensteins method measurement on lumbar lateral view?
Measures width of sacral canal
999
What are abnormal Eisensteins measures?
Under 15mm
1000
When do we do an Oblique Lumbar view?
Suspect a pars fracture
1001
How do we orient ourselves in oblique lumbar?
Draw line behind all vertebral bodies All to the left is left and so on
1002
Which lumbar is the best view for observing the facet joints?
Oblique
1003
What are the borders for AP LUMBOPELVIC.
T12 to proximal femur including ilium
1004
What is a Phlebolith?
Small rounded calcification of a vein
1005
What alignments do we see on AP lumbopelvic?
- Scoliosis - Pelvic obliquity - Pelvic rotation - Femoral head height - Hip alignment
1006
What are the Coccyx anomalies?
• 1: curved slightly anteriorly • 2: curved more anteriorly, coccyx pointing straight forward • 3: angulated sharply anterior • 4: subluxated at sacrococcygeal/intercoccygeal joints
1007
List the alignments on AP shoulder with their normal values
* GH joint space (4-5mm) * Acromiohumeral space (7-11mm) * AC joint space (2-4mm) * Coracoclavicular space (11-13mm)
1008
List the shoulders views
* AP external rotation shoulder * AP internal rotation shoulder * AP neutral rotation shoulder * Scapular Y * Transthoracic lateral * Axial
1009
What is the goal of a Scapular Y view?
Lateral view of the scapula | -NOT to assess GH or AC joint
1010
Why do a transthoracic lateral view?
- true lateral view of humerus - trauma (pt cant rotate arm safely) - just looking for major defects or trauma
1011
List the elbow epiphyses in order of appearance
* Capitulum (1 yr) * Radial head (5 yrs) * medial epicondyle (7yrs) * Trochlea (10 yrs) * Olecranon (10 yrs) * lateral epicondyle (11 yrs) (CRITOE)
1012
What is the Fat pad sign?
- fat pad is lucent - normally so close to bone its not visible - indicates intra-articular swelling, probably fracture
1013
List the alignments on lateral elbow view
- radiocapitellar line | - humerocapitellar line
1014
Which wrist-view has a view of lateral thumb?
PA wrist and hand
1015
List the alignments to observe in wrist and hand views
- Radioulnar alignment - carpal arcs - metacarpals and phalanges
1016
Which view is best for observing the base of the thumb?
oblique wrist and hand
1017
List the alignments to observe in an AP hip
- Shentons line (under) - Iliofemoral line (over) (Of femoral neck) - anterior acetabular wall - posterior acetabular wall - acetabular roof - iliopectineal line - ilioischial line - kohler’s tear drop - Klein’s line - hip femoral angle - fempral neck margin - teardrop distnce
1018
What is coxa vara? Vs coxa valga?
Vara: femoral angle <120 degrees Valga: femoral angle >135 degrees
1019
What is Teardrop distance? What’s its normal value?
Distance btw inner femoral head and Kohler’s teardrop Normal 6-11mm and <2mm difference bilaterally
1020
What is the Ilioischial line?
- Kohler’s line - line taken tangentially btw outer pelvic inlet and outer obturator foramen - acetabular floor and femoral head should not cross this line
1021
What is Coxa Profunda?
- acetabular floor crosses ilioischilal line | - possible femoroacetabular impingement
1022
What is Protrusio acetabuli?
* femoral head crosses ilioischial line * possible femoroacetabular impingement (minor displacement) * Paget’s, osteomalacia, rheumatoid arthritis, trauma, dysplasias
1023
What is the patella position measurement?
* length of patella from posterior superior corner to inferior anterior corner * should be equal to length of patella tendon from inferior patella to tibial tuberosity * patella alta
1024
What is patella alta?
• patella tendon longer than patella - chondromalacia patela - swelling
1025
List the views of the knee?
* AP * Lateral * Sunrise/skyline * Intercondylar (tunnel)
1026
Which knee view is best to see loose bodies?
Intercondylar (tunnel) view
1027
What is Boehler’s angle? What are normal values?
* on lateral ankle view * angle of intersection btw lines connecting the 3 highest points on the calcaneus * 25-40 degrees * calcaneus fracture if < 25 degrees
1028
Which ankle view is best to view the tib-fib interspace?
Medial oblique ankle
1029
What is the bet view to observe the lateral aspect of the metatarsals?
Medial oblique foot
1030
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
1031
What are the norma values of cervical lordosis angle?
35-45 degrees
1032
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
1033
What is George’s line?
Posterior vertebral line
1034
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
1035
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
1036
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
1037
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
1038
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
1039
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
1040
What are the borders on the AP Cervical view?
C3 to T2-3
1041
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
1042
What are the borders in APOM Cervical?
C1 and C2
1043
What is the mach effect?
Relative lucency between 2 overlapping structures may simulate a fracture
1044
What is the difference between normal and abnormal atlantoaxial alignment on APOM Cervical view?
Abnormal: overhang of lateral mas along with over 5 degrees lateral tilt indicate possibility of odontoid fracture Normal: kids 4 yr old have normal overhang of atlas
1045
Which Cervical view is best for observing IVFs?
Oblique cervical
1046
What Oblique positions are the same to each other?
``` LAO = RPO RAO = LPO ```
1047
Is there an Oblique thoracic view?
Nope | Just AP and lateral
1048
What are the borders of AP thoracic?
C7 to L1
1049
What is Cobb angle?
Angle that measures curve of a spine | Trace 2 lines on the vertebral body that would cross each other eventually
1050
How do we assess vertebra rotation?
Look at pedicles NOT spinous processes | Distance from the midline
1051
What are the borders of a Lateral Thoracic view?
C7 to L1
1052
How can we best visualize T1-3?
Swimmers lateral
1053
What are the guidelines for counting vertebrae on a Lateral Thoracic?
- use landmarks from AP view - DONT use diaphragm - see if last vertebra has a rib, if so we assume it is T12
1054
What is the normal thoracic kyphosis curve value?
20-40 degree
1055
What are the borders of an AP Lumbar view?
T12 to upper sacrum, including SIJs
1056
What is the pars interarticularis and where do we find them in the spine?
- Only in lumbar spine - not an anatomical structure - named and identified because common area of fracture
1057
What are the borders of Lateral Lumbar view?
-T12 to upper sacrum
1058
Which is the best view for visualizing IVD spaces in lumbar spine?
Lateral lumbar
1059
What is the best view for seeing the IVFs of lumbar spine?
Lateral lumbar
1060
List the alignments and measurements of the lateral lumbar spine
1) Georgés line 2) Lordosis 3) Sacral base angle 4) Lumbosacral base angle 5) IVD angle 6) Lumbar gravity line 7) Eisenstein’s measurement
1061
What is George’s line?
Line tracing posterior vertebral bodies and then into the sacral canal
1062
What is a normal value of Lumbar lordosis?
50-60 degrees
1063
What is the sacral base angle?
- 1 line tracing top of sacral body - 1 line horizontal to ground - angle btw them
1064
What is a normal Sacral base angle? And what is abnormal?
- 26 to 57 degrees - average of 41 degrees - increased means increase anterior pelvic tilt
1065
What is the Lumbosacral disc angle? And what happens when it’s abnormal?
10-15 degrees Increased =facet impaction = LBP
1066
Is lumbosacral disc angle related to spondylolisthesis?
No
1067
What is the IVDs angles?
Lines following top and bottom of vertebral bodies Can be done at all levels
1068
What are normal values of IVDs angles?
L1 : 8 degrees | L4 : 14 degrees
1069
What is the lumbar gravity line?
-Line from centre of L3 vertebral body toward straight vertical gravity
1070
What are abnormal measures of lumbar gravity line?
- anterior to sacrum by over 1cm | - posterior shift
1071
What is Eisensteins method measurement on lumbar lateral view?
Measures width of sacral canal
1072
What are abnormal Eisensteins measures?
Under 15mm
1073
When do we do an Oblique Lumbar view?
Suspect a pars fracture
1074
How do we orient ourselves in oblique lumbar?
Draw line behind all vertebral bodies All to the left is left and so on
1075
Which lumbar is the best view for observing the facet joints?
Oblique
1076
What are the borders for AP LUMBOPELVIC.
T12 to proximal femur including ilium
1077
What is a Phlebolith?
Small rounded calcification of a vein
1078
What alignments do we see on AP lumbopelvic?
- Scoliosis - Pelvic obliquity - Pelvic rotation - Femoral head height - Hip alignment
1079
What are the Coccyx anomalies?
• 1: curved slightly anteriorly • 2: curved more anteriorly, coccyx pointing straight forward • 3: angulated sharply anterior • 4: subluxated at sacrococcygeal/intercoccygeal joints
1080
List the alignments on AP shoulder with their normal values
* GH joint space (4-5mm) * Acromiohumeral space (7-11mm) * AC joint space (2-4mm) * Coracoclavicular space (11-13mm)
1081
List the shoulders views
* AP external rotation shoulder * AP internal rotation shoulder * AP neutral rotation shoulder * Scapular Y * Transthoracic lateral * Axial
1082
What is the goal of a Scapular Y view?
Lateral view of the scapula | -NOT to assess GH or AC joint
1083
Why do a transthoracic lateral view?
- true lateral view of humerus - trauma (pt cant rotate arm safely) - just looking for major defects or trauma
1084
List the elbow epiphyses in order of appearance
* Capitulum (1 yr) * Radial head (5 yrs) * medial epicondyle (7yrs) * Trochlea (10 yrs) * Olecranon (10 yrs) * lateral epicondyle (11 yrs) (CRITOE)
1085
What is the Fat pad sign?
- fat pad is lucent - normally so close to bone its not visible - indicates intra-articular swelling, probably fracture
1086
List the alignments on lateral elbow view
- radiocapitellar line | - humerocapitellar line
1087
Which wrist-view has a view of lateral thumb?
PA wrist and hand
1088
List the alignments to observe in wrist and hand views
- Radioulnar alignment - carpal arcs - metacarpals and phalanges
1089
Which view is best for observing the base of the thumb?
oblique wrist and hand
1090
List the alignments to observe in an AP hip
- Shentons line (under) - Iliofemoral line (over) (Of femoral neck) - anterior acetabular wall - posterior acetabular wall - acetabular roof - iliopectineal line - ilioischial line - kohler’s tear drop - Klein’s line - hip femoral angle - fempral neck margin - teardrop distnce
1091
What is coxa vara? Vs coxa valga?
Vara: femoral angle <120 degrees Valga: femoral angle >135 degrees
1092
What is Teardrop distance? What’s its normal value?
Distance btw inner femoral head and Kohler’s teardrop Normal 6-11mm and <2mm difference bilaterally
1093
What is the Ilioischial line?
- Kohler’s line - line taken tangentially btw outer pelvic inlet and outer obturator foramen - acetabular floor and femoral head should not cross this line
1094
What is Coxa Profunda?
- acetabular floor crosses ilioischilal line | - possible femoroacetabular impingement
1095
What is Protrusio acetabuli?
* femoral head crosses ilioischial line * possible femoroacetabular impingement (minor displacement) * Paget’s, osteomalacia, rheumatoid arthritis, trauma, dysplasias
1096
What is the patella position measurement?
* length of patella from posterior superior corner to inferior anterior corner * should be equal to length of patella tendon from inferior patella to tibial tuberosity * patella alta
1097
What is patella alta?
• patella tendon longer than patella - chondromalacia patela - swelling
1098
List the views of the knee?
* AP * Lateral * Sunrise/skyline * Intercondylar (tunnel)
1099
Which knee view is best to see loose bodies?
Intercondylar (tunnel) view
1100
What is Boehler’s angle? What are normal values?
* on lateral ankle view * angle of intersection btw lines connecting the 3 highest points on the calcaneus * 25-40 degrees * calcaneus fracture if < 25 degrees
1101
Which ankle view is best to view the tib-fib interspace?
Medial oblique ankle
1102
What is the bet view to observe the lateral aspect of the metatarsals?
Medial oblique foot
1103
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
1104
What are the norma values of cervical lordosis angle?
35-45 degrees
1105
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
1106
What is George’s line?
Posterior vertebral line
1107
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
1108
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
1109
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
1110
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
1111
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
1112
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
1113
What are the borders on the AP Cervical view?
C3 to T2-3
1114
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
1115
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
1116
What are the norma values of cervical lordosis angle?
35-45 degrees
1117
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
1118
What is George’s line?
Posterior vertebral line
1119
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
1120
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
1121
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
1122
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
1123
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
1124
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
1125
What are the borders on the AP Cervical view?
C3 to T2-3
1126
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
1127
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
1128
What are the norma values of cervical lordosis angle?
35-45 degrees
1129
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
1130
What is George’s line?
Posterior vertebral line
1131
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
1132
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
1133
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
1134
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
1135
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
1136
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
1137
What are the borders on the AP Cervical view?
C3 to T2-3
1138
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
1139
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
1140
What are the norma values of cervical lordosis angle?
35-45 degrees
1141
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
1142
What is George’s line?
Posterior vertebral line
1143
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
1144
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
1145
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
1146
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
1147
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
1148
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
1149
What are the borders on the AP Cervical view?
C3 to T2-3
1150
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
1151
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
1152
What are the norma values of cervical lordosis angle?
35-45 degrees
1153
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
1154
What is George’s line?
Posterior vertebral line
1155
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
1156
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
1157
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
1158
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
1159
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
1160
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
1161
What are the borders on the AP Cervical view?
C3 to T2-3
1162
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
1163
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
1164
What are the norma values of cervical lordosis angle?
35-45 degrees
1165
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
1166
What is George’s line?
Posterior vertebral line
1167
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
1168
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
1169
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
1170
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
1171
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
1172
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
1173
What are the borders on the AP Cervical view?
C3 to T2-3
1174
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
1175
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
1176
What are the norma values of cervical lordosis angle?
35-45 degrees
1177
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
1178
What is George’s line?
Posterior vertebral line
1179
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
1180
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
1181
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
1182
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
1183
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
1184
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
1185
What are the borders on the AP Cervical view?
C3 to T2-3
1186
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
1187
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
1188
What are the norma values of cervical lordosis angle?
35-45 degrees
1189
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
1190
What is George’s line?
Posterior vertebral line
1191
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
1192
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
1193
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
1194
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
1195
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
1196
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
1197
What are the borders on the AP Cervical view?
C3 to T2-3
1198
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
1199
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
1200
What are the norma values of cervical lordosis angle?
35-45 degrees
1201
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
1202
What is George’s line?
Posterior vertebral line
1203
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
1204
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
1205
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
1206
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
1207
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
1208
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
1209
What are the borders on the AP Cervical view?
C3 to T2-3
1210
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
1211
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
1212
What are the norma values of cervical lordosis angle?
35-45 degrees
1213
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
1214
What is George’s line?
Posterior vertebral line
1215
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
1216
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
1217
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
1218
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
1219
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
1220
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
1221
What are the borders on the AP Cervical view?
C3 to T2-3
1222
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
1223
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
1224
What are the norma values of cervical lordosis angle?
35-45 degrees
1225
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
1226
What is George’s line?
Posterior vertebral line
1227
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
1228
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
1229
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
1230
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
1231
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
1232
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
1233
What are the borders on the AP Cervical view?
C3 to T2-3
1234
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
1235
What are the possible Alignments and Measurements of Lateral Cervical view?
* General skeletal architecture * Lines (4) * Lordosis * Atlantodental interspace * McG
1236
What are the norma values of cervical lordosis angle?
35-45 degrees
1237
What are the normal values for atlantodental interspace?
Adults: under 3mm Kids: under 5mm
1238
What is George’s line?
Posterior vertebral line
1239
What is McGregor’s line?
* line from post.sup. hard palate to inf. surface of occiput | * checks odontoid protrusion into foramen magnum
1240
What are the normal values of McGregor’s line?
Odontoid cannot project over 4.5mm above the line
1241
What is the normal size of the Sella Turcica? And what is an abnormal size?
Normal: 5-16mm long and 4-12mm high Small is nbd Larger is problem
1242
Why do a Flexion-Extension view?
* assess intersegmental motion and ligamentous stability * only do if suspecting instability * look at changes in ADI
1243
List the prevertebral spaces in a lateral cervical view
* Retropharyngeal interspace | * Retrotracheal interspace
1244
What are the normal values of Retropharyngeal interspace and Retrotracheal interspace? What is an abnormal value?
Pharyngeal: under 7mm Tracheal: under 21mm Increased is athological
1245
What are the borders on the AP Cervical view?
C3 to T2-3
1246
On an AP Cervical, how can you tell the difference btw T1 and C7?
* ribs * TVPs of T1 point superior * TVPs of C7 point inferior
1247
What could cause a disrupted Anterior Vertebral Body line?
``` • Fracture • Dislocation • Ligamentous laxity (anterolisthesis/retrolisthesis) • Degeneration (osteophytes) • Vertebral body destruction (infection, tumour) • Vertebral body expansion ```

Diagnostic Imaging (4 decks)

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