Radiology

Question 1

how can assessment of the femoral neck alongside the superior pubic ramus on a hip X-ray help decide if there is a hip fracture?

Answer 1

can look for Shenton’s line= formed by medial edge of femoral neck and inferior edge of superior pubic ramus. loss of contour is a sign of fractured neck of femur, but isn’t always present in this case.

Question 2

indications on AP view hip X-ray of an intracapsular hip fracture?

Answer 2

disruption of Shenton’s line
displacement- impaction, shenton’s line disrupted, trabeculae disrupted
lesser trochanter more prominent due to external rotation of femur
fracture line?
increased bone density- overlapping bone with impaction
femoral neck shortened
loss of cortical bone integrity

Question 3

what should be considered if femoral shaft fracture on X-ray but no history of high force impact trauma?

Answer 3

pathological fracture- malignancy, infection or metabolic e.g. osteoporosis, osteomalacia

Question 4

what radiograph view is more likely to show a patella fracture?

Answer 4

lateral view

Question 5

on a lateral view radiograph of the knee, what might increased density above the patella suggest in the context of a fracture?

Answer 5

a joint effusion e.g. leakage of blood (haemarthrosis) in a fracture

Question 6

on what view of the knee is a patella dislocation obvious?

Answer 6

skyline view

Question 7

what is a fabella?

Answer 7

a normal sesamoid bone of the lateral head of gastrocnemius tendon - not to be mistaken for a fracture or loose body

Question 8

what name is given to a normal variant of the patella in which the patella is in 2 parts?

Answer 8

a bipartite patella

Question 9

characteristics of ptnt history if tibial stress fracture?

Answer 9

history of chronic tibial pain, worsened by activity

Question 10

standard views of calcaneus?

Answer 10

lateral and axial

Question 11

apophyses can be mistaken for fractures on radiographs, what are they?

Answer 11

a normal developmental outgrowth of a bone which arises from a separate ossification centre, and fuses to the bone later in development

Question 12

how is radiograph described if there isn’t more than 1 fracture piece?

Answer 12

non-comminuted

Question 13

standard wrist views?

Answer 13

PA

lateral

Question 14

in assessing the wrist, alignment of which bones should be looked for on lateral radiograph?

Answer 14

radius, lunate, capitate

Question 15

2 extra views added to normal views in suspected scaphoid fracture (history of post-traumatic wrist pain with tenderness over anatomical snuffbox)?

Answer 15

oblique

PA with ulnar deviation

Question 16

on what view is a hamate fracture best seen?

Answer 16

oblique view

Question 17

most commonly injured carpal ligament?

Answer 17

scapholunate

injury best seen on radiograph when wrist stressed in ulnar deviation

Question 18

sign on radiograph when scapholunate ligament tear injury?

Answer 18

Terry Thomas sign (gap tooth sign)-widening of scapholunate distance

Question 19

the most common dislocations of the wrist involve which carpal bone?

Answer 19

lunate

Question 20

name for when capitate is not congruent with lunate?

Answer 20

peri-lunate dislocation

if luante dislocated from radius, then lunate dislocation is used

Question 21

standard views of hand and fingers?

Answer 21

PA
oblique
lateral

Question 22

what on a radiograph is often a useful sign of a finger fracture?

Answer 22

soft tissue swelling

Question 23

most common metacarpal fracture?

Answer 23

boxer’s fracture- 5th metacarpal fracture (at neck)

Question 24

what is a Bennett’s fracture?

Answer 24

intra-articular fracture of thumb metacarpal base, with subluxation/dislocation of metacarpal base
occurs with forced abduction of thumb

Question 25

what is a Mallet finger injury?

Answer 25

flexion deformity of distal IPJ of finger due to injury to extensor tendon to distal phalanx
can be tendinous or bony injury, depending on if there is avulsion of the bone with the tendon
usually result of traumatic impaction blow to finger, which forces DIPJ into flexion

Question 26

in which direction does displacement of distal fragment of clavicle occur in clavicle fractures?

Answer 26

inferior

trapezius unable to hold up weight of upper limb

Question 27

what are posterior dislocations of the shoulder associated with?

Answer 27

electric shocks and epileptic seizures

Question 28

what is a bony bankart lesion?

Answer 28

visible injury to bony glenoid on a radiograph

occurs with shoulder dislocation

Question 29

order of elbow ossification centre development?

Answer 29

CRITOL:
capitulum
radial head
internal (medial) epicondyle
trochlea
olecranon
lateral epicondyle

Question 30

relvance of posterior fat pad being visible on radiograph of elbow?

Answer 30

always ABNORMAL

Question 31

another name for the midline of the radial shaft?

Answer 31

radiocapitellar line

this should always pass through middle of capitulum

Question 32

what name is given to an ulnar shaft fracture with shortening, and radius dislocation at its point of wkness at the elbow?

Answer 32

Monteggia fracture-dislocation

Question 33

what is a Galeazzi fracture-dislocation?

Answer 33

radius fracture with shortening, and ulna dislocation at its point of wkness at distal RU joint

Question 34

what happens to the ulnocarpal space in a Colle’s fracture?

Answer 34

it is narrowed due to shortening

Question 35

name given to a distal radius fracture in which there is palmar (volar) angulation and displacement, and radial shortening?

Answer 35

Smith’s fracture

Question 36

what is a Barton’s fracture?

Answer 36

fracture involving the articular surface of wrist (between radius and scaphoid and lunate) with dorsal displacement of the wrist bones

Question 37

what is a Greenstick fracture?

Answer 37

occurs in children where bones more compliant

on a radiograph, there is a visible fracture in the cortex on one side with buckling on the other

Question 38

what is a torus fracture?

Answer 38

buckling without a visible fracture line

Question 39

X-ray appearance in infection?

Answer 39

perisoteal reaction- increased bone density around cortex
soft tissue swelling

take 1 week to appear