Stenosis, Hip, Shoulder Lines of Mensuration (Exam 1)

Question 1

Which line assessment is used to screen for canal stenosis?

Answer 1

Eisenstein’s method for sagittal canal measurement

Question 2

What is the procedure for Eisenstein’s lumbar method for sagittal canal measurement?

Answer 2

-for all lumbars except L5
-articular process line= line connecting superior and inferior tips of articular processes
-posterior body margin (George’s line)
-at L5, use spinolaminar line to posterior body line

Question 3

What is the normal measurement for Eisenstein’s lumbar method for sagittal canal measurement?

Test 1 q

Answer 3

15mm

Question 4

What does it mean if someone has <15mm on Eisenstein’s lumbar method for sagittal canal measurement?

Answer 4

lumbar spinal canal stenosis

Question 5

What is the most reliable measurement for canal stenosis?

Answer 5

Eisenstein’s method for sagittal canal measurement

Question 6

What is a major contributor to canal stenosis?

Answer 6

posterior osteophytes

Question 7

What is the procedure for Eisenstein’s cervical method for sagittal canal measurement?

Answer 7

-a line is placed at the posterior vertebral body and at the spinolaminar region
-line is placed from the most anterior aspect of spinolaminar line straight forward to the posterior body line
-if posterior osteophyte is present, measure to the back of the osteophyte

Question 8

What is the normal measurement for C1 on Eisenstein’s method for sagittal canal measurement?

Test 1 q

Answer 8

16mm+

Question 9

What is the normal measurement for C2 on Eisenstein’s method for sagittal canal measurement?

Answer 9

14mm+

Question 10

What is the normal measurement for C3 on Eisenstein’s method for sagittal canal measurement?

Answer 10

13mm+

Question 11

What is the normal measurement for C4-C7 on Eisenstein’s method for sagittal canal measurement?

Answer 11

12mm+

Question 12

Which line assessment uses A->P hip view?

Answer 12

hip joint space width

Question 13

What is the procedure for hip joint space width?

Answer 13

-superior joint space- space between the most superior point of the femur and the adjacent acetabulum
-medial joint space (tear drop distance)- space between the most medial surface of the femur head and the opposing acetabulum

Question 14

What is the normal measurement range for superior joint space of hip?

Answer 14

3-6mm

Question 15

What is the normal measurement range for medial joint space of hip?

Answer 15

4-13mm

Question 16

What is the rule of thumb for hip joint space width?

Answer 16

medial joint space should double the superior joint space width

Question 17

What does it mean if theres a loss of superior joint space in the hip?

Midterm q

Answer 17

OA (degenerative arthritis)

Question 18

What does it mean if theres a loss of medial joint space in the hip?

Midterm q

Answer 18

RA (inflammatory arthritis) until proven otherwise

Question 19

What line analysis assessments are only for children?

Answer 19

1) acetabular angle
2) misc. measurements of growing hips
3) Klein’s line
4)

Question 20

What line analysis assessments use AP pelvis view?

Answer 20

1) acetabular angle
2) misc. measurements of growing hips
3)

Question 21

What line analysis assessments use AP pelvic and hip view?

Answer 21

1) measurements of protrusio acetabuli/ kohler’s line
2) Shenton’s/Makka’s/Menard’s line
3) iliofemoral line
4) femoral angle/ femoral angle of incidence/ femoral neck angle/ Mikulicz’s angle
5) Skinner’s line
6)

Question 22

What is the procedure for acetabular angle?

Answer 22

-transverse line is drawn through the right and left triradiate cartilage’s (most inferior and medial points of acetabulum) at the pelvic rim (Y-Y line)
-another line drawn connecting the inferior medial points with the superior lateral points
-the acute angle is measured

Question 23

What is this line called?
-transverse line is drawn through the right and left triradiate cartilage’s (most inferior and medial points of acetabulum) at the pelvic rim

boards q

Answer 23

Y-Y line

Question 24

What does it mean if the acetabular angle is more than 29 degrees?

test q

Answer 24

acetabular dysplasia or congenital hip dysplasia

Question 25

What does it mean if the acetabular angle is less than 12 degrees? test q

Answer 25

down's syndrome

Question 26

What is the procedure for misc. measurements of growing hips?

Answer 26

-construct the Y-Y line (transverse line is drawn through the right and left triradiate cartilage's (most inferior and medial points of acetabulum) at the pelvic rim) -vertical line is drawn perpendicular to the Y-Y line at the superolateral margin of the acetabulum = omberdanne's line -SBRB= perkin's line -hip is divided into 4 quadrants

Question 27

What is this line called? -vertical line is drawn perpendicular to the Y-Y line at the superolateral margin of the acetabulum

Answer 27

omberdanne's line

Question 28

What is the normal measurement for misc. measurements of growing hips?

Answer 28

femoral epiphysis should be in the 3rd quadrant (inferior-medial quadrant)

Question 29

What does it mean if the femoral epiphysis is in the 4th quadrant (inferior-lateral) for misc. measurements of growing hips?

Answer 29

congenital hip dislocation

Question 30

What is the most common location for dislocation in misc. measurements of growing hips?

Answer 30

4th quadrant

Question 31

What is the other name for protrusio acetabuli?

Answer 31

kohler's line

Question 32

What is the procedure for measurements of protrusio acetabuli/ kohler's line?

Answer 32

-line is constructed tangentially from the cortical margin of the pelvis to the outer border of the obturator foramen -assess the acetabular floor relative to this line

Question 33

What is the normal measurement for measurements of protrusio acetabuli/ kohler's line?

Answer 33

acetabular floor should be lateral to the line and NOT cross line

Question 34

What does it mean if acetabular floor cross the measurements of protrusio acetabuli/ kohler's line?

Answer 34

acetabuli protrusio

Question 35

Acetabuli protrusio is usually due to?

Answer 35

bone softening conditions

Question 36

What are the other names for shenton's line?

Answer 36

makka's line or menard's line

Question 37

What is the procedure for shenton's line/ makka's line/ menard's line?

Answer 37

curvilinear line is constructed along the undersurface of the femoral neck and continues across the joint to the inferior margin of this superior pubic ramus

Question 38

What is the normal measurement for shenton's line/ makka's line/ menard's line?

Answer 38

line should be smooth and unbroken, especially at transition zone between femoral neck and superior pubic ramus

Question 39

What does it mean if shenton's line/ makka's line/ menard's line doesn't look like an umbrella?

Answer 39

-hip dislocation -femoral neck fracture -slipped femoral epiphysis

Question 40

What is the procedure for iliofemoral line?

Answer 40

curvilinear line is constructed along the outer surface of the ilium, across the joint, and onto the femoral neck

Question 41

What is the normal measurement for iliofemoral line?

Answer 41

line should be smooth and unbroken

Question 42

What may cause a discrepancy in symmetry in the iliofemoral line?

Answer 42

-congenital dysplasia -clipped femoral capital epiphysis -femoral dislocation or fracture

Question 43

What are the other names for femoral angle?

Answer 43

-femoral angle of incidence -femoral neck angle -Mikulicz angle****

Question 44

What is the procedure for femoral angle?

Answer 44

-line is drawn down the long axis of the femoral shaft -another line is drawn down the long axis of the femoral neck -the obtuse angle is measured

Question 45

What is the normal measurement range for femoral angle?

Answer 45

120-130 degrees

Question 46

What does it mean if femoral angle is <120 degrees? test 1 q

Answer 46

coxa vara (hip out), genu valgum (knees in)

Question 47

What does it mean if femoral angle is >130 degrees?

Answer 47

coxa valga (hips in), genu varum (knees in)

Question 48

What are the 3 conditions that cause coxa vara in adults?

Answer 48

1) paget's disease 2) osteomalacia 3) fibrous dysplasia- polyostotic type

Question 49

What is the procedure for Skinner's line?

Answer 49

-line is drawn through and parallel to the axis of the femoral shaft -another line is placed at a right angle to the femoral shaft line and tangential to the tip of the greater trochanter

Question 50

What is normal measurement for skinner's line?

Answer 50

the fovea capitis should be at or above skinner's line

Question 51

If the fovea capitis lies below skinner's line then this is due to....

Answer 51

superior displacement of the femur relative to the femoral head caused by -fracture -slipped femoral capital epiphysis -paget's disease -osteomalacia -fibrous dysplasia- polyostotic type

Question 52

Which line assessment uses AP hip, pelvis, and frog leg hip view?

Answer 52

Klein's line

Question 53

What is the procedure for Klein's line?

Answer 53

-line is constructed tangential to the outer margin of the femoral angle -assess the overlap of the femoral head relative to this line

Question 54

What is the normal measurement for Klein's line?

Answer 54

-there should be some degree of overlap -the outer margin of the femoral head will be lateral to the line

Question 55

What does it mean if theres a lack of overlap across Klein's line by the femoral head? test 1 q

Answer 55

slipped capital epiphysis

Question 56

Which line assessment uses lateral foot or calcaneus view?

Answer 56

1) Boehler's line

Question 57

What is the normal measurement for Boehler's line? test 1 q

Answer 57

28-40 degrees

Question 58

What does it it mean if Boehler's line is <28 degrees?

Answer 58

calcaneal fracture

Question 59

Which line assessment uses AP shoulder view?

Answer 59

1) acromiohumeral joint space 2)

Question 60

What is the procedure for acromiohumeral joint space?

Answer 60

the distance between the inferior surface of the acromion and the articular cortex of the humeral head is measured

Question 61

What is the normal measurement range for acromiohumeral joint space?

Answer 61

7-11mm

Question 62

What does it mean if the acromiohumeral joint space is <7mm?

Answer 62

rotator cuff tear or degenerative tendinitis

Question 63

What does it mean if the acromiohumeral joint space is >11mm?

Answer 63

dislocation and joint effusion

Question 64

What line assessment uses AP or PA shoulder view?

Answer 64

1) acromioclavicular joint space 2)

Question 65

What is the procedure for acromioclavicular joint space?

Answer 65

-joint space is measured at the superior and inferior borders -the values obtained are averaged

Question 66

What is the normal average measurement for acromioclavicular joint space?

Answer 66

3mm

Question 67

What does it mean if the acromioclavicular joint space is <3mm?

Answer 67

DJD

Question 68

What does it mean if the acromioclavicular joint space is >3mm?

Answer 68

traumatic separation or resorption due to RA, hyperparathyroidism, or trauma