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Fall Semester PM Exam 2 > Shoulder Diagnostic Imaging > Flashcards

Shoulder Diagnostic Imaging Flashcards

1
Q

The clavicle is a long bone without a what?

A

medullary canal

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2
Q

ossification of the shoulder complex begins with what bone and when?

A

clavicle at 5 weeks gestation

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3
Q

clavicle ossification

A

the secondary center of ossification at the sternal end fuses wit hthe shaft at age 18-25. the clavicle is the last long bone to fuse.

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4
Q

Scapulothoracic bursa location

A

Scapulothoracic bursa is between SA and the ribs. Repetitive mechanical trauma to this area is the cause of snapping scapula syndrome

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5
Q

primary factor for instability of GHJ

A

labrum

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6
Q

ossification center of humeral head is present at what age

A

6 months

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7
Q

GT ossifies when

A

age 1-3

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8
Q

LT ossifies when

A

age 4-5

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9
Q

at what age do the GT and LT fuse to the humeral head?

A

age 7

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10
Q

proximal epiphysial plates of humerus fuse at what age?

A

19

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11
Q

Scapula

A

7+ centers of ossification

intramembranous ossification, not endochondral

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12
Q

coracoid age appears and age fuses to scapula

A

appears at age 3-18 months

fuses age 18-25 yrs

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13
Q

base of coracoid and upper glenoid fossa age appears and age fuses to scapula

A

appears age 7

fuses age 15-18

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14
Q

acromion age appears and age fuses to scapula

A

appears age 14-20

fuses 22-25

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15
Q

inferior angle age appears and age fuses to scapula

A

appears 15

fuses 20

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16
Q

vertebral border age appears and age fuses to scapula

A

appears 16

fuses 25

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17
Q

lower 2/3 of glenoid fossa age appears and age fuses to scapula

A

appears 10

fuses 20

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18
Q

term that refers to the failure of the acromion to fuse

A

os acromiale

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19
Q

Os Acromiale

A

failure of the acromion to fuse
should be fused by age 25
often asyptomatic but a risk factor for AC OA
can be mistaken for an acromial fracture

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20
Q

minimum required projections of shoulder according to the ACR

A
  1. AP ER
  2. AP IR
  3. Lateral (Y) (transcapular)
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21
Q

AP ER position

A

supine or upright in true anatomical position

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22
Q

position of humeral epicondyles in AP ER

A

parallel to film

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23
Q

position of AP IR

A

supine or upright with hand on abdomen (purpose is so that shoulder is in IR position)

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24
Q

A hill Sach lesion is best seen on which projection?

A

AP IR

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25
Q

Hill Sach lesion

A

anterior humeral dislocation

will see a groove-like indentation of the posterior lateral aspect of the humeral head

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26
Q

What is a Sprengel’s deformity and what other abnormalities is it associated with?

A

hypoplasia of the scapula while in utero
most common congential condition of the shoulder
often accompanied by other congenital abnormalities and developmental delays

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27
Q

T/F scapular radiographs are not commonly ordered unless the patinet has a history of trauma

A

true

28
Q

Transcapular projection also called

A

scapular y view (lateral view)

29
Q

When is a Transcapular projection ordered?

A

post trauma when a patient cannot move their shoulder

30
Q

what is imaged in a transcapular projection?

A

spine of scapula, coracoid, and acromion

proximal humeral head is seen positioned OVER the glenoid cavity

31
Q

position of transcapular projection

A

30 degrees oblique
arm at side in neutral
central ray moves PA

32
Q

which projection gives a clearer view of the ACJ?

A

Zanca ACJ projection

33
Q

ACJ

A

often involved in traumatic and non-traumatic shoulder conditions
implicated in development of impingement syndrome

34
Q

most common reason for radiographic shoulder exam?

A

joint instability (ACJ)

35
Q

when is a zanca ACJ projection ordered and what is it?

A

ordered if a bilateral AP projection of the ACJ is inadequate
AP projection with central ray tilted up 10-15 degrees

36
Q

purpose of zanca aCJ projection?

A

provides clear unobstructed view of ACJ

37
Q

AP projection with central ray tilted up 10-15 degrees = which projection?

A

Zanca ACJ

38
Q

Bilateral ACJ projection (plane)

A

AC joint is planar, meaning it offers limited stability

39
Q

cause of ACJ pathology

A

overuse, leading to degenerative changes

examine aCJ via standard radiographic views

40
Q

when is a bilateral AP projection of the ACJ done?

A

if instability is suspected

41
Q

what type of radiograph helps us determine the level of ACJ instability?

A

stress radiograph: 10-15 lb weight attached to patients hand “WB” vs “NWB”
WB and NWB help us determine level of instability!!!

42
Q

what are we looked at/for in a stress radiograph of the ACJ?

A

the position of the clavicle in relationship to the acromion and the coracoid. this is used to determine ACJ stability

43
Q

proper acromial-clavicular distance

A

0.3-0.8 cm

44
Q

proper coracoclavicular distance

A

1.0-1.3cm

45
Q

SCJ

A

more stable than ACJ
susceptible to similar degenerative changes and inflammatory conditions as ACJ
trauma is more likely to cause clavicular fracture than SCJ disruption

46
Q

which view is used if fracture or dislocation of SCJ is suspected?

A

serendipity view: AP projection with central ray tilted up 40 degrees

47
Q

AP IR projection: greater tuberosity is located where

A

GT is superimposed on lateral aspect of humeral head

48
Q

AP IR projection: psoition of LT

A

LT is on medial side of humeral head

49
Q

AP IR projection: medial humeral head position

A

medial humeral head can be superimposed on glenoid fossa. LT can also be superimposed on fossa.

50
Q

AP IR projection: acromion and ACJ

A

acromion and ACJ are clearly visible above GHJ

51
Q

AP IR projection: coracoid process

A

coracoid process below the clavicle

52
Q

location of humeral head in transcapular projection

A

humeral head positioned over the glenoid

53
Q

AP views (IR and ER) allow for excellent visualization of what 2 joints?

A

GHJ and ACJ as well as adjacent osseous structures including distal clavicle and scapula

54
Q

AP views are good for?

A

acute trauma to evaluate fracture or dislocation

also helpful for bursitis or ACJ arthritis

55
Q

Position of Glenohumeral “True” AP (grashey) view

A

patient is rotated posteriorly 35-45 deg so the plane of the scapula is parallel to the film

56
Q

Glenohumeral “True” AP (grashey) view

A

allows for evaluation of GHJ space, shows superior or inferior movement of humeral head seen with instability, and detects joint space narrowing (arthritis)

57
Q

Axillary lateral view patient position

A

supine

arm abducted to 90

58
Q

Axillary lateral view

A

centered over mid GHJ and directed in a distal to proximal direction while tilted 15-30 degrees towards the spine

59
Q

Axillary lateral view good for

A

anterior or posterior GH subluxation

bankart fractures

60
Q

Scapular Y view position

A

pateint upright or prone with afftected side roated 30-45 degrees

61
Q

scapular y view good for

A

anterior or posterior dislocation, as well as fractures of coracoid, scapula, acromion, and proximal huemral shaft

62
Q

view useful for finding hill-sach’s deformity

A

Stryker notch view (arm overhead, elbow flexed, hand supported by back of head)

63
Q

proximal humeral fractures are most common in which age group?

A

age 50+

one-part fractures are most common

64
Q

Soft tissue injuries of the capusule and labrum are best evaluated with what?

A

MRI

65
Q

Y view helpful for

A

impingment because it views the acromion – differnt acromion types can cause impingement

66
Q

best type of xray for arthritis

A

conventional radiography

67
Q

imaging type for amyloid arthropathy and deposits

A

MRI

Fall Semester PM Exam 2 (1 decks)

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