Spondys & Fractures Flashcards
An impaction of the appendicular skeleton or skull will result in a _____ fracture.
Depression fracture
The name of the fracture in any bone that is weakened by localized or systemic disease.
Pathologic fracture
The name of the sign used to describe a lucent gap between a single vertebral body is ____.
Empty Vertebra sign
(Note: Marchiori terms this as Ghost Vertebra)
A fracture which gives clinical signs of its presence without any radiographic evidence.
Occult fracture
The name of the sign that occurs at the proximal tibial plateau due to an impaction fracture which helps aid in diagnosis. It refers to fluid seen on cross-table lateral knee x-rays.
Fat-Blood Interface sign
(aka = FBI sign)
A condition known to cause joint mice of the distal femur and is a form of osteochondral fracture with unknown etiology is _____.
Osteochondritis Dissecans
(OCD)
A calcified MCL of the knee or an abnormal bone growth adjacent to the medial condyle of the knee would be an indication of _______
Pellegrini-Stieda disease
(aka = Pellegrini disease)
A collapse of a vertebral body due to pathologic bone destruction is called _____
Pathologic Compression Fracture
MC location for “Perched Facets” are in which part of the spine?
C-spine
Which vertebral endplate is more commonly fractured?
Superior
This fracture occurs when a portion of bone is driven into its adjacent segment.
Impact or Impaction fracture
The yellow line is called _______
What is normal?
What is abnormal & what does that mean?
Iliofemoral Line
Normal is smooth along the out wing of the ilium down around the superior femoral head as drawn.
Abnormal is not smooth and suggests dislocation of the femur.
An isolated fracture through bone growth plate
Salter Harris I
The blue dotted line is an example of what?
What is normal?
What is abnormal & what does it mean?
Shenton’s Line (blue dots)
Normal = smooth line
Abnormal = broken line, not smooth. Indicates hip dislocation.
This is an example of drawing _____ line.
Ullman’s Line
What is the name of the fracture which is incomplete where bone is bent without gross cortical disruption?
Where is the MC location for these?
Bowing fracture
(aka = plastic fracture)
MC location = Radius or Ulna, sometimes Tibia
MC segments fractured in T/L spine
T12-L1
A lateral patella dislocation is seen with an associated osteochondral fracture. This fractured piece is called a ____ fracture.
Flake fracture
A physeal fracture that passes through the epiphysis, growth plate, and metaphysis.
Salter-Harris IV
An iliac wing fracture is also known as ____
Duverny’s Fracture
In the absense of fracture lines, a calcaneal compression fracture may be indicated when ______ is less than 28 degrees.
Bohler’s Angle
If bone trabeculae appears to be microfractured and there is associated edema and hemorrhage. This is called a ____.
Bone bruise
(aka = trabecular compression fracture)
What 2 forces combine to create a Burst Fracture?
Axial compression + flexion
What is the name of the fracture in which compressive forces cause the cortex to bulge outward (on one or both sides of the involved bone)?
Torus Fracture
(aka = buckling fracture)
The name of the most common type of physeal injury is ___.
Salter Harris II
A radiograph in which the femoral head is superiorly displaced relative to the acetabulum suggests what?
Posterior hip dislocation
4 Radiographic signs of Vertebral compression fracture
- Anterior step defect
- wedging
- zone of condensation
- displaced or disrupted endplate
Which x-ray view is best to view a lumbar pars fracture?
Obliques
An ankylosis of a vertebra is called ________
Spondylosis
A physeal fracture due to compressive deformity of the growth plate.
Salter-Harris V
An inverted Napoleon’s Hat signifiies
Anterior displacement of L5 over the sacrum
MC Lumbar transverse process fractures occur at which levels?
L2 & L3
Transverse fracture of the base of the 5th metatarsal is called a _____ fracture
Jones fracture
(aka = Dancer’s fracture)
A fracture that penetrates or breaks the skin is called
An open fracture
Types of Spondylolisthesis:
Due to biomechanical stress of the pars
Isthmic Spondylolisthesis
An x-ray sign that suggests a slipped capital femoral epiphysis is the ___________ sign.
Klein’s Line fails to intersect femoral epiphysis
MC type of fracture in the T/L spine
Compression fracture
An inflammation of one or more vertebra is called ___.
Spondylitis
The grading method of a spondylolisthesis is called ___
Meyerding’s
The widening or frank separation of a fibrous or cartilaginous joint is called ____
a diastasis.
What 2 identifying marks are noted in recent vertebral compression fractures?
Zone of Impaction
and/or
anterior step defect
A metaphyseal fragment of a physeal fracture is termed ___
Thurston-Holland fragment
A “Rider’s Bone” is sometimes used to describe ___
an Ishial tuberosity apophysis
Calcification of muscle due to trauma is called _______
Myositis Ossificans
The type of avulsion fracture where a small piece of bone from the corner of a phalanx or other tubular bone is pulled away.
Corner Fracture
(aka = chip fracture)
This is an example of ______.
What are we looking for in the above picture?
Skinner’s Line
- Horizontal line is drawn perpendicular to mid shaft of femur at top of greater tuberosity.
- Horizontal line is at or below the fovea = normal. If above fovea = suggests fracture of femur.
The term “perched facet” is used to describe _____
Facet Dislocation or subluxation
A fracture that does not break the skin is called a ____ fracture.
A closed fracture
A fracture through the displaced growth plate which carries with it a corner of the bone metaphysis
Salter Harris II
An avulsion fracture of the ITB (iliotibial band) at the margin of the lateral tibial condyle, often seen as a flake of bone, is called a ____ fracture.
Segond’s fracture
Looser lines, Milkman’s syndrome, and Umba zonen are associated with this type of fracture.
Pseudo fractures
Types of Spondylolisthesis
One that occurs due to long standing degeneration of the disc (DDD), lumbar Z-joints, and degenerative arthrosis (DJD)
Degerative Spondylolisthesis
An unstable fracture that involves all 4 pubic rami of the pelvis is termed a _____ fracture
Straddle
The tearing away of a portion of a bone at a muscular or ligamentous attachment. What is the name of this type of fracture?
Avulsion
The red line is called ______ line.
George’s Line
The mechanism of injury (MOI) of a lumbar pars fracture occur due to _____
Violent hyperextension
a) A direct blow to the toe such as when striking an object with a bare foot may produce a fracture of any phalynx. This is called a ____ fracture.
b) Which phalanges are most common in this fracture?
Bedroom fracture
(phalanges 1 & 5 are MC)
a) High incidence of metatarsal fractures of military recruits is called a ____ fracture.
b) Which digits are MC in these types of fractures?
March fracture
(MC are metatarsals of digits 2 & 3)
A double fracture to the same side of the pelvis is termed a ______ fracture.
Is this a stable or unstable fracture?
Malgaigne
(unstable)
The term used to describe a slipping of a vertebra.
Spondylolisthesis
What is the definition of apophysis?
Bone outgrowth (a bony bump)
The “empty vertebra” sign is an indication of which vertebral fracture?
Chance fracture
(aka = lap belt fracture)
What is the name of the fracture in which bone appears bent and tension on the convex side produces a cortical interruption while the concave side stays intact?
Hickory Stick
(aka = green stick)
A fracture in which linear radiolucencies are visible and are oriented 90 degrees to the long axis of the involved bone. These are associated with bone softening diseases such as Paget’s and osteomalacia.
Pseudo fracture
The 5 Lumbar “Scotty Dog” components are:
- Pedicle = eye
- TVP = nose
- SAP = ear
- IAP = foreleg
- Pars = neck
Lumbar Ossification Bridging Syndrome (LOBS) is a term used to describe what part of the lumbar spine?
Ossified bridges between injured TVPs
The name of the disease diagnosed when a radiograph shows there are 3 or more anterior vertebral wedges in a row is _______.
Scheuermann’s disease (not a fracture)
2nd MC fracture of the Lumbar Vertebrae
TVP fracture
A fracture of normal bone due to abnormal or unusual biomechanical stresses are placed.
A Fatigue stress fracture
A common impact fracture of the elderly with osteoporosis involving the lateral tibial plateau is called a ____ fracture.
Bumper fracture
(aka = fender fracture)
A fracture of the spine is said to be ____ if only the anterior or posterior column is fractured.
stable
A comminuted fracture of the distal tibia and fibula where the patient was known to wear a skier’s boot.
Boot Top fracture
(aka = skier’s boot fracture)
A fracture through a diseased bone due to normal biomechanical stresses.
Insufficiency stress fracture
An impact fracture of the spine is called __(a)__
When an impaction fraction occurs on the skull or axial skeleton it is called a __(b)__ fracture.
a) compression fracture
b) depression fracture
Multiple fractures of the same bone is called a ___ fracture
Comminuted
Type of Spondylolisthesis:
Involves Congenital Under-Development of the Upper Sacrum.
Can be associated with Spina Bifida Occulta
Dysplastic Spondyloslisthesis
A partial fracture that spares the cortex on one side of the involved bone, and usually due to immature bone elasticity. What is the name of this fracture?
Incomplete
A degeneration or defect, particularly of the pars.
Spondylolysis
In a multiple fracture of the same bone, sometimes a small triangular fragment of cortical bone is found. What is the name of this fragment?
A butterfly fragment
A fracture of the spine is said to be ____ if the middle or multiple columns are fractured.
unstable
MC pars fractures of the lumbar spine occur at which levels?
L4 & L5
A radiograph in which the femoral head is inferiorly dispaced relative to the acetabulum suggests what?
Anterior Hip dislocaton
Can be either a completely separated chip of a piece of cartilage or a piece of cartilage that has not completely separated from the “mother” cartilage is called _____.
Osteochondritis Dissecans (OCD)
(aka = joint mice)
Are most vertebral burst fractures stable or unstable?
Unstable
True or False:
Articular cartilage is avascular
True
A physeal fracture that involves the growth plate and epiphysis resulting in an intra-articular fracture.
Salter-Harris III
A banana fracture is associated with which disease?
Paget’s
MC locations for fractures in the C-spine
C1-C2 and C5-C7
Which part of the spine do most fractures occur?
a) C-Spine
b) T-Spine
c) L-Spine
C Spine
A Burst Fracture of C1 is called a _____ fracture.
Jefferson fracture
MC location for an atlas fracture
Posterior Arch
Displaced lateral masses of C1 laterally creating an increase of paraodontoid space of greater than ____ mm indicates possible _________ ligament rupture.
7 mm
transverse ligament rupture
Best x-ray view for suspected posterior arch fracture of the atlas
Lateral Cervical
MOI for posterior arch fracture of C1
Axial compression
&
Hyper extension
Anterior arch fracture of the atlas usually involves _____ ligament and _____ muscle. These fractures are typically called _____fractures.
Anterior Longitudinal Ligament (ALL)
Longus Colli Muscle
Avulsion Fractures
Normal ADI for an adult
no greater than 3 mm
Normal ADI for a child
No greater than 5 mm
Bilateral Disruption through the pedicles of the Axis is called a _____ fracture.
Hangman’s Fracture
An avulsion fracture of a triangular shaped fragment from the anterior-inferior corner of the axis body is called a ____ fracture.
Teardrop fracture
Which type of Odontoid fracture is unstable? And, what is the issue with the Dens?
Type 2 Odontoid fracture
The issue is the base of the Dens is the fracture location. MC yields a tilt in the dens of > 5-degrees.
What types of Dens fractures are considered stable? Where are the locations of the fractures?
Type 1 Dens Fracutre is Stable: Location of fracture is the tip of the Dens. This is an avulsion of the tip of the dens and involves the apical or alar ligaments.
Type 3 Dens fracture is stable: Location of fracture is below and around the base of the Dens, deep within the vertebral body.
A congenital failure of development of the dens is known as ________-
Os Odontoidium
MOI of Whiplash Syndrome
Forced hyperflexion & Hyperextension
An Avulsion fracture of the spinous processes resulting from abrupt flexion of the head or from repeated stress caused by the pulling of the rhomboids and trapezius muscles.
Clay Shoveler’s fracture
Name the Carpal Bones
a) Scaphoid (navicular), b) Lunate, c) Capitate, d) Hamate, e) Trapezoid, f) Trapezium, g) Triquetrum, h) Pisiform.
The Cervical Bowtie sign is associated with ________.
Facet dislocation
The prevertebral soft tissue space dimensions that indicate normal, uninjured C-spine
C2 < 7mm
C6<21 mm
Note: how to remember these dimension
2/7 = 6/21
numerator is vertebral level & denominator is the distance in mm.
Body of C2 should not exceed 7 mm in children or adults and C6 at 21 mm in adults - doesn’t say what should be for children
MC fractured ribs
R4 - R9
A golfer whose club strikes the ground instead of the ball may end up fracturing which areas of his ribs (golfer’s fracture)
a) anterior
b) posterior
c) lateral
Lateral ribs = Golfer’s fracture
2 fractures to the same rib may result in the isolated section of rib to move paradoxically - opposite direction to that of the rest of the ribs during ventilation. This is called a ______.
Flail Chest
MC site of the clavicle for fracture is ________.
mid clavicle
A fracture of the greater tuberosity of the humerus is called a ___ fracture.
Flap fracture
Most shoulder dislocations occur in which direction?
Anterior
A compression fracture of the humeral head next to the greater tuberosity is called a ___________.
Hill-Sachs (aka = hatchet) lesion
An avulsion of the inferior glenoid labrum is called a _______.
Bankart lesion.
A tear of the superior glenoid labrum is called a _____.
SLAP lesion
AC separation grade:
A-C joint space is increased & coraco-clavicular level is WNL or widened < 5mm
Grade II
AC separation grade:
Both joint spaces are increased & coracoclavicular space is widened to > 5mm
Grade III AC separation
MC location for elbow fracture during childhood
supracondylar humerus
MC location for elbow fracture for an adult?
Radial head and neck of the radius
What do these yellow lines represent?
Anterior Humeral line
normal = line goes through middle 1/3 of capitellum in lateral view
What does the arrow on the right mean?
What does the arrow on the left mean?
Fat Pad Sign for Radial Head/Neck Fractures
- Arrow on left (anterior) is normal fat pad
- Arrow on right (posterior) is abnormal indicating fx (not visible)
What do the arrows indicate?
Shows an hour glass or
symmetrical figure 8.
Indicates a true lateral elbow radiograph
What does the yellow line represent?
What does the red line represent?
Are these normal or abnormal findings?
Yellow Line = anterior humeral line
Red Line = Radio-Capitellar line
Both should intersect at mid Capitellum, which indicates a normal finding.
The Mnemonic for forearm fractures is:
MUGR
Monteggia Fracture = Ulnar head fx & radial head luxation
Galeazzi Fracture = Radial head fx & ulnar head luxation
A forearm fracture due to the patient’s arm acting defensively against an attack from another person or object is called a ______ fracture.
Nightstick fracture
A transverse or comminuted fracture of the distal radius with posterior displacement/angulation of the wrist.
Colles’ Fracture
A Transverse or comminuted fracture of the distal radius with anterior angulation/displacement of the wrist.
Smith’s fracture
(aka = reverse Colles’ fracture)
A fracture of the posterior rim of the distal radius is called a ________ fracture.
Barton’s fracture
A fracture of the anterior rim of the distal radius is called a ________ fracture.
Reverse Barton’s fracture
A fracture of the radial styloid of the wrist is called a ____ fracture.
Chauffeur’s fracture
MC carpal bone fractured is the ______.
Scaphoid
A lateral radiograph of the wrist showing a posterior displacement of the capitate is called a __________.
Perilunar dislocation
What does this radiograph show?
Lunate Dislocation
What is the name of the sign on this xray and what does it indicate?
“Pie” sign indicates a lunate dislocation
What is the name of this sign and what does it indicate on this xray?
Terry Thomas sign
(aka = David Letterman sign)
Indicates Navicular (scaphoid) luxation
What is the name of this fracture?
Bar Room Fx
= 4th or 5th metacarpal neck fracture
Boxer’s Fx = 2nd or 3rd metacarpal fx
An intra-articular fx of 1st metacarpal base with dislocation
Bennett Fracture
Comminuted intra-articular fracture of the 1st metacarpal base with dislocation
Rolando Fracture
In the distal phalanges of the hand, a chip or small avulsion fracture at the base of an interphalageal joint.
Baseball fracture
(aka = Mallet fracture)
A chronic ulnar collateral ligament tear at the first metacarpal joint with instability
Gamekeeper’s Thumb
(aka = Skier’s Thumb)
