Prior learning Flashcards
Cervical X-Ray angles
"Davis series" AP open mouth: C1 and C2 AP lower cervical R and L lateral R and L oblique posterior \+ stress related views (e.g. in flexion, in extension)
Levels of osteopoenia
MRI: 1-5% of bone loss
CT: 10-20% bone loss
X-Ray: 40-70% bone loss
System of reading x-rays
ALL ABCs
ALL: all films are there, all bones are present, patient identifiers (e.g. skeletally immature/ mature), artefacts
A- Alignment
B- Bone quality: look at medulla, cortex, periosteum.
C- Cartilage: joint space and symmetry
S- Soft tissue
Calcification of cartilage
Initially hyaline cartilage with an outside layer of perichondrium (everywhere but where the bone articulates) > Blood vessels supply the perichondrium, and osteoblasts start to form a woven bone collar with periosteal layer > Chondrocytes start to hypertrophy in the diaphysis and the ECM starts to mineralise > Chondrocytes die leaving lacunae in the calcified matrix
Primary ossification
Blood vessels invade lacunae and bring in osteoblasts and osteoclasts > Osteoblasts produce bone trabeculae therefore cancellous bone in diaphysis (primary ossification centre) > Medullary cavity is formed as osteoclasts move bone from diaphysis
Secondary ossification
Established in the epiphysis of the long bones, appear in late foetal development and continues up until 18-20 years old (medial clavicle), has no medullary cavity
Lines of alignment cervical
Anterior longitudinal line
Posterior longitudinal line (George’s line)
Spino laminar line (posterior margin of spinal cord)
Measurements in cervical
Spinal canal width: SLL to PLL, <12mm stenosis
Cervical angle: apex of C2 to ant/sup aspect of C7, 35-45 deg.
Physiological line of stress/ COG: posterior dens to posterior c7, should pass through c4/5 IVD
Atlanto dental interspace: anterior dens to posterior anterior tubercle 1-3mm adults, 1-5 mm children
Thoracic standard views
AP, lateral and rib views
AP thoracic view
These are the things you can see in AP tx view:
interpeduncular distance > 14mm
Pedicle method: see rotation of the vertebrae
Tracheal deviation/ level
Scoliosis: Cobb method, same as determining tx kyphosis OR risser ferguson method, centre of the vertebare
Lateral thoracic view
These are the things you can see in Tx lateral:
ALL, PLL, ALL
Angle of the thoracic spine kyphosis: 20-50 deg. Draw a line superiot end plate of T1 (or T4) and inferior enT12 (T9). Then draw perpendicular lines
Lumbosacral normal views
AP (15 degree tilt)
Lateral
Oblique
L5/S1 spot AP and Lateral
Lumbosacral lines of alignment
ALL, PLL, SLL<
Lumbar curve: superior end plate L1, inferior endplate L 5, 35-45 deg OR superior sacral base 50-60 deg.
Ferguson’s line: perpendicular line drawn straight down centre of L3, should strike anterior 1/4 of sacral base
Interpeduncular distance >20 mm
Pelvis and hip views
AP
Spot AP hip
Frogleg
Lateral
Measurements for the pelvis
Hip joint width (teardrop): measured superiorly, medially and laterally to acetabular notch
Acetabular depth: line from superior margin of pubic symph to end of acetabilum and then measure depth
Pubic symph width
Measurements for the hip
Femoral angle: line through the head/neck of femur and shaft, angle is taken on inside 120-130 deg
Iliofemoral line: Line along the illim to the femoral head and neck
Shentons line: curved line under femoral neck to inferior margin of superior pubic ramus
Knee normal X-Ray views
AP, Lateral, intercondylar, skyline and medial oblique
Knee X-ray measurements
Femoral shaft line, tibial shaft line, Femoral condyle line, tibial condyle line, femoral angle, tibial angle
Q line: line through ASIS and mid patella and then line through tibial plateau to mid patella 14 degrees men, 17 degrees women
Patella positon
Ankle normal views
AP, lateral, Oblique
Normal foot views
Dorsal plantar, lateral and oblique medial
SHoulder normal views
AP, AP IR, AP ER, Axial , Scapular Y, AC joint spot
Elbow normal views
AP, lateral, Medial oblique, and supination/ pronation AP
Wrist normal views
PA, lateral, lateral oblique PA, medial oblique PA and scaphoid
Chest normal X-ray views
PA and lateral
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