Radiographs Flashcards
Diagnosis?
Melorheostosis
Benign condition of abnormal periosteal bone formation
“dripping candle wax” appearance with dense hyperostosis that flows along the cortex of the bone
How do you do a Garth View
what are you looking for?
Apical oblique
patient is seated with the arm at the side;
- cassette is placed posterior, parallel to the spine of the scapula
- beam is directed thru the glenohumeral joint toward the cassette at angle of 45 deg degrees to the plane of the thorax, and directed 45 deg caudally
Looking for anterior bankart
How do you do a True AP of shoulder?
Taken 30-40 degrees oblique to the coronal plane of the body
What is a Grashey view?
true AP of GH
On an Lat xray of forearm, the ___ and the ___ are oriented 180 degrees.
Coronoid and ulnar styloid
Findings and diagnosis?
metaphyseal cupping and fraying in the distal radius and ulna
Ricketts
Diagnosis on bottom picture
Pes planovalgus
Meary’s angle is apex plantar
Normal is 0 ± 4 degrees
What are the normal values for ankle x-rays with respect to:
Medial clearspace
tib-fib overlap
tib-fib clearspace
Medial clearspace: = 4mm
Tib-fib clearspace <6mm on AP & mortise
- This is measured 1cm above the joint line
Tib-fib overlap >6mm on AP & 1mm on mortise
How do you do a Scaphoid view?
scaphoid view
30 degree wrist extension, 20 degree ulnar deviation
What is the diagnosis and what are the characteristic x-ray findings of this diagnosis?
1) Pelvic Discontinuity
2) X-Ray findings:
- visible fracture line through the anterior and posterior columns
- medial translation and rotation of the inferior aspect of the hemipelvis relative to the superior aspect on an AP pelvic radiograph
Diagnosis?
Bone Infarct
What is the abnormality and what symptoms are usually associated?
Supracondylar Process
Associated with Pronator Syndrome
Fungal infection of the spine has what effect on disc spaces/endplates?
Destroys them Like bacterial
How do you do a tunnel view (knee)?
PA view in 30 degrees of flexion
Why do a serendipity view and how do you do it?
To asses SC joint. beam at 40 deg cephalic tilt
Diagnosis and treatment.
Adimantinoma.
(or osteofibrous dysplasia)
Treated with wide surgical excision.
How do you do a west point?
what are you looking for?
West Point AXILLARY
- pt is placed prone on x-ray table w/ involved shoulder on a pad raised 7.5 cm from the top of the table;
- head & neck are turned away from the involved side;
- w/ cassette held against the superior aspect of shoulder, x-ray beam is centered at axilla, 25 deg downward from horizontal and 25 deg medial;
- resulting x-ray is a tangential view of the anteroinferior rim of the glenoid rim of the shoulder
Looking for bankart
Achondroplasia:
What is the main surgical indication and typical surgery offered for:
a) Genu varum
b) Thoracokyphosis
c) Lumbar Stenosis
d) Foramen Magnum Stenosis
a) Failure of non-op, HTO or hemiepiphysiodesis
b) Kyphosis > 60 by age 5, anterior strut corpectomy and posterior fusion
c) Severe symptoms, failure of non-op. Multilevel decompression and fusion.
d) Cord compression, urgent decompression
Diagnosis?
Paget’s
Note lytic, sclerotic and mixed lesions in bone, representing all 3 phases of Paget’s disease
Increased bone turnover due to increased osteoclastic bone resorption and abnormal bone remodeling
Radiologic finding?
DIagnosis?
Short Lumbar Pedicles
Achondroplasia
Describe and give normal values for Bohler’s angle
On a lateral view this angle is formed by the intersection of two lines.
First: line from the upper edge of the calcaneal body posteriorly to the upper edge of the posterior articular facet of the calcaneus at the subtalar joint.
A second line from posterior edge of articular facet to the upper edge of the anterior process of the calcaneus.
Normal is 20-40 degrees
On an AP xray of forearm, the ___ and the ___ are oriented 180 degrees.
Biceps tuberosity, radial styloid
What measurement is this?
Which pic is abnormal?
Mearys angle
(angle subtended from a line drawn through axis of the talus and axis of 1st ray)
Bottom is abnormal - apex plantar therefore flatfoot
Diagnosis?
Gauchers Disease
Lysosomal storage problem - accumulation of lipids in the bone marrow.
Diagnosis?
NF1
(pseudoarthrosis)
Diagnosis?
CIND
>50% of lunate width is ulnarly translated off the lunate fossa of the radius
Briefly describe the treatment of this problem.
Valgus producing intertrochanteric osteotomy.
Convert the vertical non-union to a more horizontal position which converst shear forces to compressive forces.
Also reduces the varus deformity.
Use a blade plate.
Put the chisel for the blade plate in first to control proximal fragment.
One k-wire parallel to the chisel.
Second K-wire 30-40 degrees off of the first.
How do you do a stryker view?
what are you looking for?
the patient is supine;
- a cassette is placed under the involved shoulder
- the palm of the hand of the affected extremity is placed on top of the head with the fingers toward the back of the head;
- the beam is centered over the occur;
- coracoid process and tilted 10 deg cephalad;
Looking for Hill-Sachs
What is a good alternative x-ray view for monitoring femoral osteolysis?
Oblique posterior condylar view
Looks at posterior condylar region - very important regions
Taken with:
knee flexed to 90deg with the foot supported
(JAAOS 2015)
5 differential diagnoses?
Absent Radius
- TAR
- VACTERL
- VATER
- Holt Oram
- Fanconis Anemia
10 x-ray findings in aortic rupture
This is the actual list
widened mediastinum (more than 8 cm when supine, or more than 6 cm when upright)
indistinct or abnormal aortic contour (including the knob)
deviation of trachea to the right
deviation of NGT to the right
depression of left main bronchus
widened paraspinal stripe
left apical pleural cap/hematoma
large left haemothorax
broken-halo sign: disruption of the calcium ring of the aortic knob
1st or second rib fracture
Diagnosis and treatment?
FD
Observation.
Diagnosis?
Ricketts
(physeal cupping)
Diagnosis and treatment?
GCT
curettage with a power burr and packing with cement
Radiologic finding of pelvis?
DIagnosis?
Champagne pelvis
Achondroplasia
Describe the Critical Angle of Gissane and it’s normal values?
Angle formed between the downslope of the posterior facet and the upslope of the anterior process
Normal: 130-145
What is a greenspan view and how do you do it?
oblique lateral performed with forearm in neutral rotation and beam directed 45 degrees proximally Look at radial head
Diagnosis?
Melorheostosis
Benign condition of abnormal periosteal bone formation
“dripping candle wax” appearance with dense hyperostosis that flows along the cortex of the bone
Treat symptomatically
What’s going on here?
Long term bisphosphonate use.
(In this case for OI)
Why do a false profile and how do your do it?
1) assess anterior coverage of the femoral head
2) Standing position at an angle of 65° between the pelvis and the film
Diagnosis?
Osteopetrosis
Rugger-Jersey-Spine
How do you calculate Reimers Index?
Which radiograph best shows a lateral condyle fracture?
Internal Oblique
Describe AP Kite’s angle:
Talocalcaneal angle
Normal is 25-40 degrees - there should be some divergence
