Radiograph review areas Flashcards
Foot radiograph
“FLAP-BES”
This stands for:
F - Freiberg’s disease
L - Lisfranc injury
A - Ankle fracture
P - Phalanx fractures
B - Base of 5th metatarsal fracture
E - Erosions
S - Stress fractures
Ankle radiograph
“FLATTENED BJ’S C”
This stands for:
F - Fibula fracture
L - Lesion (dissecans), particularly in the ankle
A - Angle (Bohler’s), related to calcaneal fractures
T - Talar dome lesion/fracture
T - Talar neck fracture
E - Epiphyseal fracture (Salter-Harris 3)
N - Neck (talar) fracture (same as above, reinforcing the importance)
E - Erosions (Brody’s abscess)
D - Dislocation (tarsal)
B - Base of 5th metatarsal fracture
J - Joint widening (indicative of ligamentous injury or fracture)
S - Stress fracture (Toddlers)
C - Calcaneal fracture
Elbow
“SCRaDLE”
This stands for:
S - Supracondylar fracture
C - CRITOL (Mnemonic for the ossification centers of the elbow: Capitellum, Radial head, Internal (medial) epicondyle, Trochlea, Olecranon, and Lateral epicondyle)
R - Radial head fracture
D - Dislocations (of the elbow)
L - Lateral epicondyle fracture
E - Effusions (often seen with intra-articular fractures or injuries)
“SCRaDLE” relates to the elbow, a joint that must be carefully managed, especially in pediatric patients, where fractures, dislocations, and effusions are common and must be cradled with care in treatment.
Knee
“SLOP”
This stands for:
S - Segond fracture (avulsion fracture of the lateral tibial plateau, often associated with ACL tears)
L - Lesions (Osteochondral lesions, which can involve cartilage and underlying bone)
O - Osteochondral lesions (specifically to emphasize the cartilage involvement)
P - Plateau fracture (tibial plateau fracture, involving the upper surface of the tibia)
Skull
S - Sella (enlarged): Enlarged sella turcica, often seen in conditions like pituitary adenomas.
C - C-spine fracture:
F - Fracture: Fracture of the skull.
F - Fracture (mandible): Fracture of the mandible, frequently associated with facial trauma.
L - Lucency (pepperpot skull): Pepperpot appearance seen in conditions like multiple myeloma, characterized by multiple small lucencies in the skull.
D - Deposits: Abnormal deposits seen in conditions such as metastasis or other diseases affecting the skull.
E - Effusion (SSFL): Subarachnoid or Subdural Fluid Level, typically seen in trauma or other pathologies.
D - Disease (Paget’s): Paget’s disease, which can cause thickening and deformity of the skull bones.
Shoulder Radiograph
“CRAP-FLEA”
This stands for:
C - Coracoid ligament dislocation: Dislocation or injury involving the coracoid ligament, typically associated with ACJ injuries.
R - Rib fractures: Fractures of the ribs, which may be visible on a shoulder radiograph.
A - ACJ dislocation: Acromioclavicular joint dislocation, a common injury in shoulder trauma.
P - Pneumothorax: Air in the pleural space, sometimes visible on shoulder radiographs, especially in trauma.
F - Fractured greater tuberosity: A fracture of the greater tuberosity of the humerus, often seen with shoulder dislocations.
L - Lung apex: Examination of the lung apex for pathologies such as pneumothorax or masses.
E - Erosions: Bone erosions, which may be seen in conditions like rheumatoid arthritis.
A - Anterior dislocation: Dislocation of the shoulder, where the humeral head is displaced anteriorly.
Thoracic spine
“SLAP-LWC”
This stands for:
S - Sclerotic bone lesions: Areas of increased bone density, often seen in metastatic disease or bone island.
L - Lung lesion / collapse: Lesions or collapse of the lung that may be visible on a thoracic spine radiograph.
A - Absent pedicle: The “winking owl” sign, often indicative of metastatic disease.
P - Paraspinal mass: Masses adjacent to the spine, which could be tumors or abscesses.
L - Lytic bone lesions: Areas of bone loss, seen in conditions such as metastases or multiple myeloma.
W - Wedge fractures: Compression fractures of the vertebral bodies, often seen in osteoporosis or trauma.
C - Cortices review: A systematic review of the cortices of the vertebrae to check for any discontinuities or abnormalities.
Face radiograph
“FLAT JAW”
This stands for:
F - Fluid levels: Seen in the sinuses, indicating fractures or bleeding.
L - Levels (fluid levels): Again emphasizing fluid levels in the sinuses or orbit.
A - Air in orbit: Air presence in the orbit, indicating orbital fractures.
T - Tripod fracture: A fracture involving the zygomatic bone, a common facial fracture.
J - Jaw fracture (Mandible fracture): Fracture of the mandible, crucial in facial trauma.
A - Air (Black eyebrow): Subcutaneous air indicating a fracture, often leading to the “black eyebrow” sign.
W - Wonky TMJ dislocation: Dislocation of the temporomandibular joint.
C spine
“FAST SASS”
This stands for:
F - Fractures: Common in the cervical spine due to trauma.
A - Atlanto-axial subluxation: Misalignment between the atlas (C1) and axis (C2), often seen in trauma or rheumatoid arthritis.
S - Subluxations: Partial dislocations of the cervical vertebrae.
T - Tissue widening (soft tissue widening): Indicative of underlying trauma, infection, or hemorrhage.
S - Skull fracture: Fractures at the base of the skull that may be seen on cervical spine radiographs.
A - Apex of lung lesion: Important to check for lesions at the lung apex that can indicate a Pancoast tumor or other pathology.
S - Sclerosis/Erosions: Vertebral erosions, which can indicate inflammatory conditions like rheumatoid arthritis.
Pelvis radiograph
“SPARROWS”
This stands for:
S - SCFE (Slipped Capital Femoral Epiphysis): A condition where the femoral head slips off the neck at the growth plate.
P - Perthes: Legg-Calvé-Perthes disease, a condition involving avascular necrosis of the femoral head.
A - AVN (Avascular Necrosis): Necrosis of the femoral head, which can be seen in various conditions.
R - Rami fracture: Fractures of the pubic rami, commonly seen in pelvic trauma.
R - Rami (avulsions): Avulsion fractures of the pelvic rami, often seen in athletes.
O - Osteomalacia: Softening of the bones due to vitamin D deficiency, leading to characteristic pelvic changes.
W - Widening of SIJ: Changes in the sacroiliac joints, which can be seen in conditions like ankylosing spondylitis.
S - SIJ (Sacroiliac Joint): Pathology involving the sacroiliac joints, such as inflammation or sclerosis.
Lumber spine
“SPINAL BOW”
This stands for:
S - Spondylolisthesis: The forward slippage of a vertebra over the one below it.
P - Pars defect: A defect in the pars interarticularis, commonly leading to spondylolisthesis.
I - Inflammation (Sacroiliitis): Inflammation of the sacroiliac joints, often seen in conditions like ankylosing spondylitis.
N - No pedicles (Absent pedicles): Indicative of metastatic disease, often seen as the “winking owl” sign.
A - Absent pedicles: Again, emphasizing the importance of recognizing this sign in the spine.
L - Lumbar wedge fractures: Compression fractures that often occur in the lumbar spine due to trauma or osteoporosis.
B - Bone dysplasias: Developmental abnormalities affecting the spine’s structure.
O - Osteomyelitis: Infection of the vertebral bones, which can cause serious complications if untreated.
W - Widened psoas: An enlarged psoas shadow, potentially indicating an abscess, hematoma, or mass.
Abdomen
P - Pneumoperitoneum: Free air in the abdomen, indicating a potential perforation.
O - Obstruction: Bowel obstruction, identified by dilated loops of bowel and air-fluid levels.
W - Widened psoas: Widening of the psoas shadow, which could indicate a mass, abscess, or hemorrhage.
D - Dermoid calcification: Calcifications in a dermoid cyst, often found in the ovaries.
E - Ectopic calcifications: Abnormal calcifications that may be seen in various abdominal organs or masses.
R - Renal stones: Kidney stones, visible as calcifications in the kidneys or ureters.
C - Colitis: Thickening of the colon wall due to inflammation, as seen in colitis.
R - Rib fractures: Fractures that may be visible on an abdominal radiograph, especially in the lower ribs.
A - Aneurysm (calcified): Calcified abdominal aortic aneurysm.
C - Calcified pancreatitis: Calcifications within the pancreas, indicative of chronic pancreatitis.
K - Kidney stones: Another reference to renal stones, highlighting their importance.
S - Stones (gallstones): Calcified gallstones, often visible on abdominal radiographs.
Wrist radiograph
“TWELFTH CARPAL”
This stands for:
T - Terry Thomas sign: The gap between the scaphoid and lunate, indicating scapholunate dissociation.
W - Wrist (Distal radius fracture): A fracture of the distal radius, a common wrist injury.
E - Erosions: Bone erosions seen in conditions like rheumatoid arthritis.
L - Lunate dislocation: Dislocation of the lunate bone, often associated with perilunate dislocations.
F - Fourth and fifth metacarpal dislocation: Dislocation of the 4th and 5th metacarpals, commonly seen with trauma.
T - Triquetral fracture: Fracture of the triquetral bone, one of the smaller carpal bones.
H - Hook of hamate fracture: Fracture of the hamate, particularly its hook, often seen in sports injuries.
C - Carpal fracture: Fracture of any of the carpal bones, like the scaphoid or lunate.
A - Avulsion fractures: Often seen around the carpal bones or metacarpals.
R - Radioulnar dislocation: Dislocation of the distal radioulnar joint, a critical injury to recognize.
P - Physis (Torus fracture): Referring to torus (buckle) fractures, which typically affect the distal radius in children.
A - Another fracture: Emphasizing the importance of recognizing additional fractures like carpal or metacarpal fractures.
L - Lunate dislocation: Again emphasizing this critical dislocation.
Chest radiograph
“THORACIC SHIELD”
This stands for:
T - Thyroid mass: Enlarged thyroid or goiter that can cause tracheal deviation or be visible on a chest radiograph.
H - Hidden areas: Critical areas that might be overlooked, such as the apices, behind the heart, or below the diaphragm.
O - Obscured silhouette sign: The loss of the normal borders between structures, indicating pathology like lobar collapse or consolidation.
R - Ribs: Evaluating for rib fractures or abnormalities.
A - Air (pneumoperitoneum): Free air under the diaphragm indicating pneumoperitoneum.
C - Coarctation of the aorta: Noting the rib notching or other signs of aortic coarctation.
I - Interlobar collapse: Collapse of a lung lobe, leading to volume loss and shift of structures.
C - Clavicle and shoulder fractures: Assessing the shoulder girdle and clavicle for fractures.
S - Silhouette sign: Loss of the normal borders, indicating pathology in the lung or mediastinum.
H - Hilar nodes: Enlarged lymph nodes at the hila, which can be seen in infections, malignancies, or sarcoidosis.
I - Intervertebral bodies: Check for abnormalities in the vertebral bodies that might indicate pathology.
E - Effusion (pneumothorax): Presence of a pneumothorax or pleural effusion.
L - Lymph nodes (paratracheal): Enlarged paratracheal lymph nodes, which could indicate infection, malignancy, or sarcoidosis.
D - Dermoid cysts or paraspinal masses: Masses near the spine or other abnormal findings in the paraspinal area.
