Radiologic Exam of the UE and LE Flashcards
Which imaging view of the knee will assess for the following:
- superimposed femoral condyles
- pateallar positions
- suprapatella bursa
- fabella (accessory bone that may be found in the lateral head of the gastrocnemius - not present in all humans)
Lateral Knee
Which type of MRI at the ankle/foot is the image?
Ankle and Hindfoot Arthogram
Which imaging view of the foot will assess for the following:
- ABCs
- shifts of phalanges and metatarsals
- seasmoid bones
- bones of midfoot
Oblique Foot
Which CT imaging plane assesses for the following at the knee:
- position of patella => high position infers torn patellar ligament, low position infers torn quad tendon
- fragmentation and ossification at inferior patella and patellar tendon as seen in Sinding-Larson-Johansson disease
Sagittal Plane CT of Knee
Which CT imaging plane assesses for the following at the knee:
- Patellofemoral articulaiton (congruence of patella in sulcus, look for osteochondral defects)
- Tibial plateau (check for depression or split fractures => second avulsion fracture at the lateral aspect is associated with ACL tears)
- Tibal tuberosity (hypertrophy or fragmentation due to Osgood-Shlatter’s traction aphophysitis)
Axial Plane CT of the Knee
Pittsburgh Knee CPR: Radiographs should be ordered after
- ___ trauma or fall mechanism AND
- age < ___ or > ____ AND/OR
- Inability to walk 4 ___ steps
- blunt trauam or fall mechanism, AND
- age < 12 or >50 yo, AND/OR
- inability to walk 4 weight-bearing steps
Which type of image is the modality of choice when radiographs are negative for stress fractures?
MRI (image is sagittal T1)
Ottowa Rules for Ankle
- Pain in the ____ zone, AND
- Tenderness at the tip of the ___ malleolus, OR
- Tenderness at the tip of the ___ malleolus, OR
- Inability to ____ both immediately and in the ER
- Pain in the maellolar zone, AND
- Tenderness at the tip of the lateral mallelous, OR
- Tenderness at the tip of the medial malleolus, OR
- Inability to bear weight both immediatley in the ER
Which MRI knee plane is described by the following:
- screening plane is parallel to the tibial plateau and extends from the quadriceps to the tibial tuberosity
- articular carilage
- medial patellofemoral ligament
- patellar retinaculum
- ACL/PCL
- joint effusion
- Baker’s Cyst
- Muscles (e.g. popliteus)
- Muscle attachment (e.g. pes anserine)
Axial MRI of the Knee
Which imaging view of the ankle will assess for the following:
- ABCs
- fibula superimposed behind tibia
- posterior rim of tibia (third malleolus)
- Talus, calcaneous, cuboid, and navicular
Lateral Ankle
- most common congenital defomrity of the LE
- Radiographs limited due to minimal ossification
- conservative treatment and rehab for several years. surgery for irreducible subluxations
- also known as clubfoot
Talipes Equinovarus
Which MRI imaging view of the ankle/foot allows visualization of the following:
- deltoid ligaments
- Calcaneofibular
- tarsal tunnel
- talar dome
- subtalar joint
- plantar fascia
Coronal MRI of Ankle and Hindfoot
Longitudinal Arch Deformities
- flat foot (can be rigid or flexible => flexible is normal in young children, usualy resolves with growth)
- high longitudinal arch (80% known cause = malunion of hindfoot fractures, sequela of burns or compartment syndromes, neurological disorders)
- talometarsal angle = intersection line along midshaft of ____ metatarsal and body of ____
- Pes Planus
- Pes Cavus
- midshaft of the 1st metatarsal and the body of the talus
Which imaging view of the foot will assess for the following:
- ABCs
- bones of the forefoot
- bones of the midfoot
- note any seasmoid bones common at the 1st, 2nd, or 3rd, met heads
- first intermetatarsal angle, 5-15 degrees
AP foot
The image is what type of CT view of the Ankle and foot?
Coronal CT
Routine Imaging series for the Knee includes which 4 views?
- AP
- Lateral
- PA Axial (intercondylar fossa)
- Tangential View (patellofemoral Joint)
Ottowa Rules for Foot
- Pain in the ____ zone, AND
- Tenderness at the ____, OR
- Tenderness at the ____, OR
- Inability to _____ both immediatley and in the ER
- Pain in the midfoot zone, AND
- Tenderness at the 5th metatarsal base, OR
- Tenderness at the navicular bone, OR
- Inability to bear weight immediately and in the ER
Which MRI knee plane is described by the following:
- meniscus
- ACL/PCL
- extensor mechanism
- articular cartilage
- bone marrow
Sagittal MRI of the Knee
Which MRI imaging view of the ankle/foot allows visualization of the following:
- achilles tendon
- Tib-fib joint
- subtalar joint
- transverse tarsal joint
- plantar fascia
- sinus tarsi
Sagittal MRI of Ankle and Hindfoot
Which type of imaging to use?
- fractures/dislocations
- instability
- complex fractures and articular depression
- meniscus, cruicate ligaments, collaterals, and soft tissues
- severe fractures, dislocations with associated vascular injury, ligament and cartilage injury
- Radiographs
- stress radiographs (ankles)
- CT
- MRI
- Arthrography
Hallux Valugs (deformity of the forefoot in which the first MT deviates medially and the great toe laterally) is assessed from the lines and angles drawn from which two imaging views?
AP and lateral views
The image is what type of CT view of the Ankle and foot?
Which imaging view of the foot will assess for the following:
- ABCs
- Bones of midfoot and hindfoot
- boehler angle, normal value 25-40 degrees
- calcaneal inclination (pitch) => normal value 20-30 degrees (the higher the more pes cavus the foot is)
Lateral Foot
Which imaging view of the knee will assess for the following:
- “tunnel appearance of the foss”
- intercondylar eminences
PA Axial (Intercondylar fossa)
Which imaging view of the knee will assess for the following:
- patellar position
- femorotibial joint space
- long axes of femur and tibia
AP Knee
Ottowa Knee CPR: radiographs should be ordered after trauma for pts with any of the following
- > ___ yo
- Tenderness _____
- isloated tenderness of _____ => inability to flex knee to ____
- inability to walk ___
- >55 yo
- tenderness fibular head
- isloated tenderness of patella => inability to flex knee to 90
- inability to walk 4 steps
The image is what type of CT view of the Ankle and foot?
Axial Oblique CT
Which imaging view of the ankle will assess for the following:
- lateral malleousl extends below medial
- medial and superior joint space is visible
- dome of talus
AP Ankle
The image is an example of which type of MRI at the knee
- distension of joint capsule via injection of contrast medium allows identification of intra-articular tissues
Knee Arthrograph
Indications for use of CT include:
- severe ___
- Fracture ____
- loose ____
- Tibial plateau _____ fractrues
- severe trauam
- fracture fragments
- loose bodies
- tibial plateau depression fractures
Which imaging view of the knee will assess for the following:
- sunrise view
- sulcus angle
- congruence angle (bottom of sulcus angle to bottom of patella)
Tangential View (Patellofemoral Joint)
MRI artography is indicated for use at the knee for:
- ____ changes
- ____ bodies
- Meniscal changes
- loose bodies
Which abnormal condition of the LE can involve the following:
- Pelvis
- lumbosarcral => scoliosis
- LE contractures
- joint deformities
- DJD
- arthroplasty
Functional Leg Length Discrepancy
Which MRI imaging view of the ankle/foot allows visualization of the following:
- Ankle tendons
- sinus tarsi
- Tibiofibular ligaments
- osseous structures
Axial MRI of Ankle and Hindfoot
Which imaging view of the ankle will assess for the following:
- ABCs
- Normal mortise wideth is 3-4 mm over the entire surface of the talus
AP Oblique (mortise)
