Principles of Musculoskeletal Imaging: upper limb examples Flashcards
X-ray of a shoulder joint can be seen below. Which of the following can be seen in the image:
1 - normal shoulder 2 - glenohumeral dislocation 3 - humeral head break 4 - subacromial impingement 5 - lung tumour
- 2 - glenohumeral dislocation
- most common is anterior (subcoracoid), humerus moves inferior medially into the subcoracoid space
- posterior are next common and inferior are rare
Label the image below using the provided labels:
Proximal humerus Glenohumeral joint Clavicle Acromioclavicular joint Scapula Ribs Lungs
1 - Clavicle 2 - Acromioclavicular joint 3 - Scapula 4 - Lungs 5 - Ribs 6 - Proximal humerus 7 - Glenohumeral joint
X-ray of a shoulder joint can be seen below. Which of the following can be seen in the image:
1 - normal shoulder of an adult 2 - glenohumeral dislocation 3 - acromioclavicular dislocation 4 - subacromial impingement 5 - normal shoulder of a child
5 - normal shoulder of a child
- you can see the epiphysis growth plate at the head of the humerus
X-ray of a shoulder joint can be seen below. Which of the following can be seen in the image:
1 - normal shoulder of an adult 2 - glenohumeral dislocation 3 - acromioclavicular dislocation 4 - subacromial impingement 5 - normal shoulder of a child
3 - acromioclavicular dislocation
X-ray of a shoulder joint can be seen below. Which of the following can be seen in the image:
1 - normal shoulder of an adult 2 - glenohumeral dislocation 3 - acromioclavicular dislocation 4 - subacromial impingement 5 - osteoarthritic shoulder
5 - osteoarthritic shoulder
- reduced joint space, osteophytes and subchondral sclerosis are present
Below is an image comparing a CT and MRI scan. Label the 3 parts of the scan labelled using the labels provided:
glenoid
humeral head
acromioclavicular joint
1 - acromioclavicular joint
2 - humeral head
3 - glenoid
When investigating a rotator cuff tear, what is the 1st imaging modality of choice?
1 - MRI 2 - X-ray 3 - ultrasound 4 - CT 5 - PET scan
3 - ultrasound with MRI as an alternative
What is MRI arthrography?
- dye is injected into the shoulder
- MRI is then performed
- used for labrum and ligament tears
The CRITOL rule must be used when assessing a shoulder. What is CRITOL rule?
- tool used to assess for ossification centres
- there should be 6 ossification centres that begin around 6 months and should all be present b y 12 years
The CRITOL rule must be used when assessing a shoulder, which is a tool used to assess for ossification centres. There should be 6 ossification centres which can be identified and in the order they appear using the mnemonic CRITOL. What does this mnemonic stand for?
- C = Capitellum - 1st appears
- R = Radial head
- I = Internal (medial) epicondyle of humerus
- T = Trochlear
- O = Olecranon
- L = Lateral epicondyle of humerus - last to appear
Below is an X-ray of an adults elbow. What can we see in this image?
1 - radial head dislocation 2 - elbow dislocation 3 - ulnar head dislocation 4 - radial head fracture 5 - olecranon fracture
4 - radial head fracture
Below is an X-ray of an childs elbow. What can we see in this image?
1 - radial head dislocation 2 - elbow dislocation 3 - supracondylar fracture 4 - radial head fracture 5 - olecranon fracture
3 - supracondylar fracture
X-rays are generally used for fractures of the elbow, but if there is a complex fracture, what imaging modality would be used?
1 - repeated X-ray 2 - MRI 3 - CT 4 - PET scan 5 - ultrasound
3 - CT
Which image is a child and which image is an adult on the image below, and how can we tell?
- right is child
- we can see the epiphysis
If a patient presents with pain in their anatomical snuff box, which carpal is likely to be fractured?
- scaphoid bone
In the image below of the wrist what can we see?
1 - distal radial fracture 2 - scaphoid fracture 3 - distal ulnar fracture 4 - radial head fracture 5 - olecranon fracture
1 - distal radial fracture
In the image below of the wrist what can we see?
1 - distal radial fracture 2 - scaphoid fracture 3 - lunar dislocation 4 - radial head fracture 5 - olecranon fracture
3 - lunar dislocation
- should sit nicely on the radius
What can be see on the image below?
1 - distal radial fracture 2 - scaphoid fracture 3 - distal ulnar fracture 4 - lunate fracture 5 - olecranon fracture
4 - lunate fracture
What is an avulsion in the hand?
- comes from latin meaning to pull away
- fracture occurs when a small chunk of bone attached to a tendon or ligament gets pulled away from the main part of the bone.
Avulsion in the hand is when a fracture occurs and a small chunk of bone attached to a tendon or ligament gets pulled away from the main part of the bone. Mallets hand is when an avulsion occurs in the hand, what is mallets hand?
- extensor tendon from its attachment at the distal interphalangeal joint
- patient cannot extend the finger
What can we see in the image below, and why?
1 - normal hand 2 - osteoarthritis 3 - rheumatoid arthritis 4 - carpal tunnel syndrome 5 - dupuytren's disease
2 - osteoarthritis
- generally affects the distal interphalangeal joints
- osteocytes, sclerosis
- tends to be asymmetrical (only one hand)
What can we see in the image below, and why?
1 - normal hand 2 - osteoarthritis 3 - rheumatoid arthritis 4 - carpal tunnel syndrome 5 - dupuytren's disease
3 - rheumatoid arthritis
- affects metacarpophalangeal, proximal interphalangeal and carpal joints
- symmetrical, meaning both sides of body are affected
