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Image Interp II > Pelvis Hip & Femur > Flashcards

Pelvis Hip & Femur Flashcards

1
Q

What findings & type of joint disease is demonstrated here?

A
  • Non-uniform loss of joint space on left (at superior femoral-acetabular joint space)
  • Subchondral sclerosis & subchondral cysts
  • Osteophyte at the acetabular margin

Degenerative arthritis (OA or DJD)

(Recommend for possible ortho referral)

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2
Q

Degenerative joint disease of the hip is termed ____

A

Malum coxa senilis

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3
Q

T/F: There is a good correlation between radiographic features of DJD in the hip & clinical picture

A

F

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4
Q

Non-uniform joint loss is common in the hip, specfically MC where

A

Superior femoral-acetabular joint space

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5
Q

Collar type ____ around femoral head/neck junction is a common radiographic feature in DJD of hip

A

Osteophytes

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6
Q

______ aka cortical thickening along medial femoral neck is a common radiographic feature in DJD of hip

A

Buttressing

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7
Q

A common radiographic feature in DJD of hip is ____ which demonstrates one medial joint space >2mm vs. the opposite side

A nonspecific sign

A

Waldenstrom’s sign

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8
Q

What findings are demonstrated here in this case of DJD of the hip?

A

Subchondral sclerosis & collar osteophyte around femoral neck

Also buttressing

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9
Q

What findings are demonstrated here?

A
  • Bilateral & symmetric distribution
  • Decreased joint space at axial portion of femoral-acetabular joint. decreases medial & superior → uniform loss of joint space
  • Periarticular osteopenia (yellow)

Infammatory disease process (Rhuematoid Arthritis)

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10
Q

Protrusio acetabuli in the hip is MC caused bilaterally by what disease process

A

RA

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11
Q

Bilateral, symmetric narrowing of axial joint space in the hip is associated with what disease process?

A

RA

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12
Q

What disease process is likely the cause of the findings here?

A

RA

DDX = bone softening diseases such as osteomalacia, padgets

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13
Q

What findings are demonstrated here?

A
  • Normal subchondral bone, normal joint spacing at the hip
  • Ill-defined, irregular margins at pubic symphysis
  • Monoarticular inflammatory arthritis → septic arthritis (until proven otherwise) or osteitis pubis
  • Recommend medical referral, CBC w/ blood culture to r/o septic arthritis

(Osteitis pubis common in young athletes, women post-childbirth)

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14
Q

15 y.o male

What type of disease process is demonstrated here & what is the likely cause?

A

Inflammatory arthritis in kids → juvenile idiopathic arthritis or hemophilia

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15
Q

_____ (malunion/nonunion) of pelvic fractures is uncommon; _____ (malunion/nonunion) is common

A

Nonunion; Malunion

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16
Q

Stable or unstable fracture

A

Stable

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17
Q

Stable or unstable fracture

A

Unstable

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18
Q

What kind of stable fracture

A

Duyerney fraction

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19
Q

What kind of unstable fracture

A

Straddle fx

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20
Q

What kind of unstable fracture

A

Malgaigne fx

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21
Q

What kind of unstable fracture

A

Sprung pelvis

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22
Q

What kind of unstable fracture

A

Bucket handle fx

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23
Q

What hip pathology is demonstrated here?

A

AIIS avulsion fx on the left (normal growth plate on right)

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24
Q

What findings are outlined here in an adolescent patient

A
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25
Q

What findings are seen here?

A
  • Extra bone on femur = post-traumatic heterotopic ossification
  • Disruption of arcuate line of sacrum on left side (pink)
  • Disruption of cortex in superior & inferior pubic ramus (yellow)
  • Unstable pelvic fx → Malgaigne fx (fx thru sup & inf pubic rami w/ fx or dislocation posteriorly around SI jt)
  • Refer for CT for further eval
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26
Q

What type of pelvic fx is demonstrated here?

A
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27
Q

What type of pelvic fx is demonstrated here?

A
28
Q

What findings are demostrated here?

A

Abnormal Klein’s line on the left

Slipped Femoral Capital Epiphysis AKA Salter Harris Type 1 fx

(Red = growth plates)

29
Q

What are 3 major pediatric hip disorders?

A

Slipped Femoral Capital Epiphysis

Legg-Calves Perthes Disease aka AVN

Developmental Dysplasia

30
Q

_____ (intracapsular/extracapsular) femoral neck fx has a worse prognosis due to AVN

A

Intracapsular

31
Q

MC type of intracapsular fx; usually impacted, easily missed =

A

Subcapital fx

32
Q

What type of intracapsular femoral neck fx is shown here?

A

Subcapital fx

33
Q

Transverse fx through mid-neck = what type of intracapsular femoral neck fx

A

Midcervical fx

34
Q

Transverse fx @ base of neck; pathologic fx’s occur here = what type of intracapsular femoral neck fx

A

Basicervical fx

35
Q

What type of femoral neck fx is demonstrated here?

A

Subcapital fx

36
Q

What type of femoral neck fx is demonstrated here?

A

Midcervical fx

37
Q

What type of femoral neck fx is demonstrated here?

A

Basicervical fx

38
Q

What type of femoral neck fx’s raises alarm bells for thinking there may be an underlying pathology for this fx?

A

Basicervical (intracapsular) & Subtrochanteric (extracapsular)

39
Q

What are the 2 types of extracapsular femoral neck fxs?

A

Intertrochanteric

Subtrochanteric

40
Q

What type of extracapsular femoral neck fx is demonstrated here?

A
41
Q

What type of extracapsular femoral neck fx is demonstrated here?

A

Subtrochanteric

42
Q

What pathology is demonstrated here

A

Posterior hip dislocation (refer out for CT)

43
Q

What are the 3 ddx based on the age & aggressive appearence of the lesion in this case?

A
  • Ewing’s Sarcoma
  • Osteosarcoma
  • Osteomyelitis
44
Q

MC cause & location of osteomyelitis/septic arthritis?

A

Staph Aureus

Femur

45
Q

This case demonstrates a chronic case of ____

A
46
Q

Phemister’s triad consists of:

And is associated with what condition

A
  • Gradual loss of joint space (key for diff. from other inflamm processes)
  • Juxta-articular osteoporosis
  • Articular erosions

Tuberculous Arthritis

47
Q

What condition is demonstrated here?

A
48
Q

An oval lucency (greater than 1cm) surrounded by sclerosis

A

(due to ankylosing of the joint, think infection therefore brodies vs. osteoid osteoma or osteoblastoma)

49
Q

What are the most likely differentials of this aggressive process in the left ilium of this 65 y.o pt?

A
  • Metastasis
  • Myeloma
  • Lymphoma
50
Q

_____ seen below can be a ddx for blastic metastasis

A

Enostoma (“bone island”)

51
Q

What condition is associated with the findings seen here?

A
  • Increased density, accentuated & enlarged trabeculae patterns on right
  • Filled in Kohler’s teardrop

→ likely Paget’s disease

52
Q

What condition is likely the cause of the findings seen here?

A

red = blade of glass or flame sign (well demarcated border between normal & affected bone)

53
Q

What condition is likely the cause of the findings seen here?

A

Fibrous Dysplasia

Usually leave me alone lesion, may want ortho referral

54
Q

What condition is likely the cause of the findings seen here?

A

Polyostotic fibrous dysplasia

55
Q

What are the possible differentials associated with these findings?

A
  • Small lucency (aka lucent nidus) surrounded by area of sclerosis
  • Osteoid Osteoma (usually smaller lucency therefore most likely)
  • Brodie’s Abcess
  • Osteoblastoma
56
Q

These findings are likely caused by what condition

A

Osteoid Osteoma

57
Q

What condition is likely the cause of the findings seen here?

A

DDX: Osteosarcoma, Ewing’s Sarcoma & Osteomyelitis

58
Q

What condition is likely the cause of these findings?

A

AVN of femoral head bilaterally

59
Q

What is the gold standard for dx of AVN?

A

MRI

60
Q

Features of ____ include:

  • Sclerosis with cystic areas w/ generalized osteopenia of all surrounding osseus features
  • Linear subchondral lucency of femoral head known as crescent sign
  • Femoral head deformity
A

AVN

61
Q

What condition is likely the cause of these findings?

A

Crescent sign outlined

62
Q

What condition is likely the cause of these findings?

A
  • Smaller, flattened, fragmented, sclerotic femoral head

Legg-Calve-Perthes disease

63
Q

What condition is likely the cause of these findings?

A

Widening of SI joints = hyperparathyroidism

64
Q

What condition is likely the cause of these findings?

A

Putti’s Triad:

  • Small femoral head
  • Laterally displaced femoral head
  • Increased acetabular angle

DX: Developmental dysplasia of the hip

65
Q

What condition is likely the cause of these findings?

A

Developmental dysplasia of the hip

66
Q

What condition is likely the cause of these findings?

A

Tri-radiate pelvis → osteogenesis imperfecta

Image Interp II (10 decks)

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