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*Part IV Boards > Radiology 2 > Flashcards

Radiology 2 Flashcards

1
Q

4 forms of fractures

A

strain
stress
pathological
incomplete

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2
Q

what do we do with new fractures?

A

orthopedic referral- we don’t adjust new fractures

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3
Q

what do you do with cervical spine fractures?

A

CT- defines fracture extent and comminution
MRI will assess neuro impact
potentially neurologically unstable fractures (collar, stabilize, 911)

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4
Q

jefferson burst fracture

A

axial compression compresses C1 between and occiput and C2

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5
Q

hangman’s fracture

A

hyperextension leading to fracture at pedicles or posterior

AKA type IV spondylo

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6
Q

Type II dens fracture

A

fracture through base of dens

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7
Q

type III dens fracture

A

fracture into body of C2

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8
Q

teardrop fracture

A

usually hyperextension (avulsion), could be hyperflexion (impaction)-Rust sign

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9
Q

unilateral facet dislocation

A

perched facet
one facet goes fully in front of the facet below; the other facet stays behind the facet below, but is elevated toward the top of the facet

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10
Q

compression fracture of cervical spine

A

usually wedge-shaped, but subtle in cervical spine

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11
Q

bilateral facet dislocation

A

aren’t ambulatory most of the time (so don’t pick it!)

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12
Q

what do you do with thoracic spine fracture

A

CT will define fracture extent and comminution; MRI will asses neuro impact

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13
Q

compression fracture of thoracic spine

A

usually wedge shaped with high impact trauma; often concave with osteoporosis
if height is reduced by >30%, may be comminuted with pedicle widening (do CT)

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14
Q

how do you know the thoracic spine fracture is old or new?

A

look for step defect and/or line of trabecular impaction/condensation
new is under 3 months of age
compare with prior films
MRI evaluates presence of marrow edema in new fracture

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15
Q

how do you evaluate lumbar spine fractures?

A

CT will define the fracture extent and comminution

MRI will assess neurological impact

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16
Q

compression fracture of lumbar spine

A

same discussion as with thoracic compression fractures

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17
Q

pars defect

A

most common at L5, but any level possible

stress fracture in teen years

18
Q

type I AC tear

A

no radiographic evidence

19
Q

type II AC tear

A

AC rupture + coracoclavicular= elevation of the distal clavicle within acomion

20
Q

type III AC tear

A

AC rupture + coracoclavicular rupture= complete elevation of distal clavicle

21
Q

humeral dislocation

A

> 90% anterior and inferior

complications of Bankart and Hill-Sach’s fracture

22
Q

elbow injuries

A

may be difficult to see, so evaluate secondary indicators of fat pad elevation

23
Q

torus/buckle fracture

A

buckling of periosteum, painful but uncomplicated

24
Q

greenstick fracture

A

bend, but not full fracture

25
Q

colles fracture and smith fracture

A

both distal radius fractures, different angulation

26
Q

scaphoid fracture

A

usually at waist, risk of being occult, non-union, AVN (MRI finds them)

27
Q

lunate dislocation

A

pie, widening (dissassociation) of scapholunate space

28
Q

boxer fracture:

A

distal metacarpal head fracture with risk of healing with angulation

29
Q

gamekeeper thumb

A

avulsion of ulnar collateral ligament at first proximal phalanx base

30
Q

bennett fracture

A

fracture of first metacarpal base

31
Q

ankle fractures

A

usually avulsions of the lateral malleolar tips

32
Q

osteochondritis dessicans

A

focal AVN, most commonly at knee and talar dome; MRI finds it

33
Q

SCFE

A

salter harris fracture, usually young, overweight males

crutch the patient, get them off weight-bearing, and refer to orthopedic urgently

34
Q

salter harris fractures

A 
mnemonic (SALTR or ME ME)
type I: slipped (epiphysis off physis)
type II: above (metaphysis and physis)
type III: lower (epiphysis and physis)
type IV: through (epiphysis, physis and metaphysis)
type V: rammed (mashed the physis)
35
Q

fracture management

A

refer to orthopedist/neurologist
CT to evaluate for comminution
MRI to evaluate marrow signal and neurological compromise
lab studies for pathology (CBC, DXA, MRI)
stabilize the region
is it old or new?
re-radiograph for long bone healing/callus
do NOT THRUST until it’s healed

36
Q

avascular necrosis

A 
AKA osteonecrosis
childhood femoral head AVN (legg-calve-perthes)
adult femoral head AVN (chandler's)
lunate (keinbock's)
scaphoid (preisser's)
metatarsal head (freiberg's)
37
Q

causes of AVN

A 
most common (STARS)
steroids, trauma, alcohol, radiation, sickle cell anemia, idiopathic, clotting, pregnancy, renal disease
38
Q

AVN

A

marrow death, so MRI is best to evaluate and can find it within 24 hours of onset

39
Q

management of AVN

A

take patient off weight bearing and refer to orthopedist urgently

40
Q

myositis ossificans

A

heterotopic bone formation
biceps and quads
6 months to develop

*Part IV Boards (14 decks)

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