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Musculoskeletal Radiology > Skeletal Trauma > Flashcards

Skeletal Trauma Flashcards

1
Q

In cervical spine radiograph, line 1 pertains to the prevertebral soft tissue, it should be several mm from the first 3 or 4 vertebral bodies and then moves farther away at what level

A

level of laryngeal cartilage

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2
Q

from C3 or C4 to C7, prevertebral soft tissue line should be

A

less than one VB width from the anterior vertebral bodies and it should be smooth in contour

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3
Q

Line 2 in cervical spine radiograph wherein anterior osteophytes can enroach on this line, interruption of this line is a sign of serious injury

A

anterior vertebral bodies

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4
Q

Line 3 in cervical spine radiograph is

A

similar to anterior vertebral body line except that it connects the posterior vertebral bodies

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5
Q

Line 4 in cervical spine radiograph

A

connects the posterior junction of the lamina with the spinous processes and is called the spinolaminar line

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6
Q

spinal cord lies between what imaginary lines in cervical radiograph

A

lines 3 and 4

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7
Q

line in cervical radiograph that is not really a line so much as a collection of points– points being the posterior tips of the spinous processes

A

line 5

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8
Q

largest spinous process in cervical spine

A

C7

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9
Q

anterior arch of C1 should not be greater than __mm from the dens

A

2.5 mm

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10
Q

in children, anterior arch of C1 distance from the dens can be up to

A

5 mm

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11
Q

widened anterior arch of C1 from the dens means

A

disruption of transverse ligament between C1 and C2

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12
Q

component of degenerative disease

A

osteophytosis, sclerosis, narrowing of disc space

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13
Q

a blow to the top of the head such when an object falls directly on the apex of the skull, can cause the lateral masses of C1 to slide apart (beyond that margins of C2 body), splitting the bony ring of C1. this is called

A

Jefferson fracture

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14
Q

fracture of C6 or C7 spinous process wherein the supraspinous ligaments attached to the spinous process undergo a tremendous force pulling on the spinous process and avulsing it

A

Clay-Shoveler’s fracture

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15
Q

unstable, serious fracture of the upper cervical spine that is caused by hyperextension and distraction. fracture of the posterior elements of C2 and usually, displacement of the C2 body anterior to C3

A

Hangman’s fracture

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16
Q

True or false: patients with hangman’s fracture often escape neurologic impairment because of the fractured posterior elements of C2 that, in effect, causes a decompression and takes pressure off the injured area

A

true

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17
Q

severe flexion of the cervical spine can cause a disruption of the posterior ligaments with anterior compression of a vertebral body, this is called

A

flexion “teardrop” fracture

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18
Q

flexion “teardrop” fx is commonly associated with ____, often from the posterior portion of the VB being displaced into the central canal

A

spinal cord injury

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19
Q

severe flexion associated with some rotation can result in rupture of the apophyseal joint ligaments and facet joint dislocation. this can result in locking of facets in an overriding position that, in effect, causes some stabilization to protect against further injury. this is called

A

unilateral locked facets

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20
Q

secondary to hyperflexion at the waist. this causes distraction of the posterior elements and ligaments and anterior compression fo VB. this is secondary to a VA, while restrained by a lap belt

A

seatbelt injury

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21
Q

seatbelt injury involves what levels

A

T12, L1 or L2 level

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22
Q

fracture of the posterior body is called ____, related to seatbelt fracture

A

Smith fracture

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23
Q

fracture through the spinous process is called ______, related to seatbelt fracture

A

Chance fracture

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24
Q

break or defect in the pars interarticularis portion of the lamina

A

spondylolysis

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25
Q

nose of Scottie dog

A

transverse process

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26
Q

eye of Scottie dog

A

pedicle

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27
Q

front leg of Scottie dog

A

inferior articular facet

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28
Q

ears of scottie dog

A

superior articular facet

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29
Q

neck of scottie dog

A

pars interarticularis

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30
Q

portion of the lamina that lies between the facets

A

pars interarticularis

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31
Q

if the Scottie dog has a collar around the neck, what is its implication

A

break in the pars interarticularis, denoting spondylolysis

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32
Q

if spondylolysis is bilateral and the VB in the more cephalad position slips forward on the more caudal body, this is said to be present

A

spondylolisthesis

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33
Q

wedge compression fracture that typically occurs 1 to 2 weeks after the initial trauma

A

Kummell disease

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34
Q

fracture at the base of the thumb into the carpometacarpal joint

A

Bennett fracture

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35
Q

tx of Bennett fracture

A

internal fixation

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36
Q

comminuted fracture of the base of the thumb that extends into the joint

A

Rolando fracture

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37
Q

fracture of the base of thumb that does not involve the joint has been called a

A

pseudo-Bennett fracture

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38
Q

avulsion injury at the base of the distal phalanx, where the extensor digitorum tendon inserts

A

Mallet finger of baseball finger

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39
Q

dense fibrocartilaginous band that covers the joint on the volar aspect and can get interposed in the joint once it is torn, often requiring surgical removal

A

volar plate

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40
Q

innocent-appearing fracture that often requires internal fixation; an avulsion on ulnar aspect of the first metacarpophalangeal joint, where the ulnar collateral ligament of thumb inserts

A

Gamekeeper’s thumb

41
Q

fall from an outstrestched arm that causes disruption of ligaments between capitate and lunate, allowing capitate to dislocate from the cup-shaped articulation of the lunate

A

Lunate/perilunate dislocation

42
Q

this dislocation if not treated promptly, can result in permanent medial nerve impairment, as it can get impinged by the volarly displaced lunate

A

Lunate/perilunate dislocation

43
Q

on AP view, lunate is triangular or pie-shaped

A

Lunate/perilunate dislocation

44
Q

normal shape of lunate on AP

A

rhomboid shape

45
Q

fracture that is most commonly associated with perilunate dislocation

A

transscaphoid fx

46
Q

other wrist bones that are also known to fracture frequently when a perilunate dislocation occurs

A

capitate, radial styloid and triquetrum

47
Q

special view to check for hook of hamate fracture

A

carpal tunnel view

48
Q

seen as a bony protuberance off the hamate on the ulnar aspect of carpal tunnel

A

hook of hamate

49
Q

commonly occurs from fall on the outstretched hand and in professional baseball, tennis and golf players

A

hook of hamate fracture

50
Q

occurs after a fall onto the outstretched hand, results into rupture of scapholunate ligament, which allows the scaphoid to rotate volarly and the lunate to tilt dorsally

A

rotary subluxation of the scaphoid

51
Q

on AP wrist radiograph, a space is seen between the scaphoid and the lunate, where ordinarily they are closely opposed. this is called

A

Terry Thomas sign

52
Q

scaphoid fx is a potentially serious injury because of high rate of

A

avascular necrosis

53
Q

what fx would you suspect if with a history of wrist trauma there is pain over the snuffbox of the wrist

A

scaphoid fx

54
Q

tx of avascular necrosis

A

surgical metallic screw fixation and bone grafting

55
Q

Terry thomas sign is seen in

A

rotatory subluxation of the scaphoid, which means the scapholunate ligament is ruptured

56
Q

what part of scaphoid fx usually undergoes necrosis and why

A

proximal fragment because the blood supply to the scaphoid begins distally and runs proximally

57
Q

increased density of the proximal pole of scaphoid compared with the remainder of carpal bones

A

avascular necrosis

58
Q

avascular necrosis is common in what other carpal bones aside from scaphoid

A

lunate

59
Q

avascular necrosis of lunate is called

A

Kienbock malacia

60
Q

if ulna is shorter than radius, it is termed

A

negative ulnar variance

61
Q

ulnar variance that has has an increased incidence of Kienbock malacia

A

negative ulnar variance

62
Q

if ulna is longer that the radius, it is termed

A

positive ulnar variance

63
Q

ulnar variance with increased incidence of triangular fibrocartilage tears

A

positive ulnar variance

64
Q

common avulsion fx in the wrist that is seen in lateral radiograph as small chip of bone off the dorsum of wrist

A

triquetral fracture

65
Q

dorsal angulation of distal forearm and wrist

A

Colles fracture

66
Q

volar angulation of distal forearm and wrist

A

Smith fracture

67
Q

sometimes, radius and ulna suffer a traumatic insult, and the force on the bones causes bending instead of a frank fracture, this is termed

A

plastic bowing deformity

68
Q

fracture of ulna with a dislocation of proximal radius

A

Monteggia fx

69
Q

fx of the radius with dislocation of the distal ulna

A

Galeazzi fx

70
Q

helpful indicator of a fracture about the elbow is

A

displaced posterior fat pad

71
Q

ordinarily, the posterior fat pad is not visible on a lateral view of the elbow because

A

it is tucked away in the olecranon fossa of the distal humerus

72
Q

in an adult with visible posterior fat pad with history of trauma, the fracture site is almost always in the

A

radial head

73
Q

in a child with visible posterior fat pad, what fracture is usually present

A

supracondylar fracture

74
Q

most common shoulder dislocation

A

anterior

75
Q

what type of shoulder dislocation is present if the humeral head is seen to lie inferiorly and medial to the glenoid

A

anterior dislocation

76
Q

in shoulder dislocation, humeral head often impacts on the inferior lip of the glenoid causing an indentation on the posterosuperior portion of the humeral head; this is called

A

Hill-Sachs deformity

77
Q

bony irregularity or fragment off the inferior glenoid, which occurs from the same mechanism as Hill-Sachs deformity is called

A

Bankart deformity

78
Q

impaction fracture on the anterior portion of the humeral head

A

reverse Hill-Sachs lesion or trough sign

79
Q

most common cause of posterior shoulder dislocation is

A

seizure

80
Q

true or false: posterior shoulder dislocation often happens bilaterally

A

true

81
Q

best way to unequivocally diagnose a dislocated shoulder radiographically is to obtain a

A

transscapular view (scapular Y-view)

82
Q

an entity that can be mistaken for a dislocated shoulder is _____, which displaces the humeral head inferolaterally, but on transscapular view, the humeral head is in its proper place

A

traumatic hemarthrosis

83
Q

seen in patients who are osteoporotic or who have undergone radiation therapy can present as patchy or linear sclerosis on the sacral ala that may or may not show cortical disruption on plain radiographs

A

sacral stress fracture

84
Q

these fractures have a characteristic appearance on radionuclide bone scans, termed the Honda sign

A

bilateral sacral stress fracture

85
Q

common sites for pelvic avulsion

A

ischium, superior and inferior anterior iliac spine and iliac crest

86
Q

true or false: pelvic avulsion fractures sometimes mimic or looks like a malignant lesion that may lead to radical treatment

A

true

87
Q

these pelvic fx typically occur as the result of an athletic injury and are benign. in adults however, isolated avulsion fx in this area usually only occur in the setting of an underlying bone lesion, such as metastasis, and should prompt inspection for an underlying lesion and further investigation for a site of primary malignancy

A

avulsion fx in the lesser trochanter of proximal femur

88
Q

lesser trochanter fractures are much more commonly seen in the setting of this fracture and in that setting are not necessarily associated with underlying malignancyt

A

comminuted intertrochanteric hip fractures

89
Q

in these joints, DJD can present as erosions

A

TMJ, acromioclavicular joint, symphysis pubis and sacroiliac joint

90
Q

stress fx, DJD or osteoarthritis in symphysis pubis are common in

A

ultramarathoners, cross-country skiers, soccer players and other athletes

91
Q

when the SI joints are involved with DJD, this can closely resemble a

A

human leukocyte antigen B27 (HLA-B27) spondyloarthropathy

92
Q

femoral insufficiency fractures commonly develops in

A

compressive or medial side of the femur

93
Q

often clinically misdiagnosed as a “heel spur” or plantar fasciitis and can be somewhat subtle radiographic finding

A

calcaneal stress fx

94
Q

this radiograph should be obtained in cases of knee trauma to look for a fat-fluid level

A

cross-table lateral

95
Q

fracture-dislocation of tarsometatarsals

A

Lisfranc fracture

96
Q

a key to normal alignment metatarsals is

A

medial border of second metatarsal should always line up with the medial border of the second (middle) cuneiform

97
Q

this fracture is seen most commonly in patients who cathc the forefoot in something such as a hole in the fround or a horseback rider falling and hanging by the forefoot in the stirrups. it is also commonly seen in neurotrophic or Charcot joint in diabetics

A

Lisfranc fracture

98
Q

normal Bohler angle

A

20 to 40 degrees

Musculoskeletal Radiology (12 decks)

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