Terms Flashcards
Direct Search - A, B, C, S
A - Alignment
B - Bone
C - Cartilage (joint space)
S - Soft Tissue
Imaging that allows detailed examination of anatomy & abnormalities that are covered by shadows & are inaccessible by conventional radiography
Conventional tomography
Imaging is important in assessment of trauma to skull, face, spine, pelvis, hips, & shoulders
Computed tomography
Imaging hinges on the selective uptake of certain compounds by different organs of the body. Utilizes the isotope techntium-99m-methylene disphosphate
Bone Scintigraphy AKA Radionuclide bone scan
Contrast opacification of joint cavities to evaluate joint disease
Arthrography
Introduction of a water-soluble contrast agent into an artery or vein
Angiography
Contrast examination of the spine and spinal cord by injection into subarachnoid space
Myelography
Placement of water-soluble contrast media into the intervertebral disc under fluoroscopic control
Discography
Based on the re-emission of an absorbed radiofrequency while the patient is in a strong magnetic field. Signal is emitted by hydrogen nuclei
MRI
This imaging technique produces a fat image in which structures containing fat (bone marrow, subcutaneous fat) appear bright
T1 Weighted image
Produces a water image in which substances that contain predominantly free or loosely bound water molecules (neoplasms, edema, inflammation, healthy nucleus pulposus) appear bright whereas substances w/ tightly bound water (ligs, menisici, tendons) appear dark
T2 weighted image
Disruption in the continuity of bone
Fracture
Complete loss of continuity b/w opposing bones at a joint
Dislocation
Partial loss of continuity b/w opposing bones at a joint
Subluxation
Displacement of a bone in relation to opposing bones in a slightly or synarthrodial joint
Diastasis
Most caused by forces acting at a point remote from a site of fracture
Indirect Force
Type of fracture determined by magnitude of the force
Direct force
Discontinuity between 2 or more fragments
Complete fracture
Skin overlying fracture is intact
Closed fracture
Skin overlying fracture is disrupted
Open fracture
Results in partial discontinuity; portion of cortex remains intact
Incomplete Fracture
Owing to compression forces the cortex bulges outward
Torus (Buckling) Fracture
Occurs primarily in infants & children under 10yr; bone bends, applying tension to the convex side, producing a transverse fracture w/ the concave side remaining intact
Greenstick (Hickory stick) Fracture
Fracture that has more than 2 fragments
Comminuted Fracture
Fracture that exhibit the tearing away of a portion of the bone by a forceful muscular or ligamentous pulling. Frequent sites are the tuberosities of tubular bones & the lower cervical spinous process
Avulsion Fracture
Fracture occurs when a portion of bone is driven into its adjacent segment because of the compressive forces
Impaction Fracture
Type of fracture that is caused by repetitive stress, causing gradual formation of microfractures & eventually an interruption in the bone structure at a greater rate than ca be offset by the reparative process
Stress Fracture
A type of stress fracture that is caused by abnormal stress involving normal bone
Fatigue fracture
A type of stress fracture caused by normal stress involving abnormal bone
Insufficiency fracture
Fracture often associated w/ bone-softening disease such as Paget’s rickets, osteomalacia
Pseudofracture
Type of fracture that gives clinical signs of its presence w/o any radiological evidence
Occult Fracture
Two most common locations for occult fractures
Scaphoid & ribs
This type of Fx orientation runs at a right angle to the long axis of a bone
Transverse Fx
This type of fracture orientation runs approx. 45deg to the long axis of the bone; common in the shaft of a long tubular bone
Oblique Fx
Torsion, coupled w/ axial compression & angulation creates this type of Fx orientation
Spiral Fx
Medial angulation of a bone is AKA?
a Valgus configuration
Lateral angulation of a bone is AKA?
A Varus configuration
This is concerned w/ closeness of the bony fragments in a fx
Apposition
This type of Salter-Harris Fx is a fx through the growth plate; pure epiphyseal separation caused primarily by shearing forces
Type I
Salter Harris Type I Fx occurs most commonly at what age?
Under 5
This type of Salter-Harris Fx is a fx through the growth plate & metaphysis; caused by shearing or avulsive + compressive forces
Type II (Most common)
Most common age & location for a Salter-Harris Type II Fx?
10-16; distal radius
Name of sign associated with a SH II fx?
Thurston-Holland sign AKA Corner sign (metaphyseal fragment)
What type of Salter Harris fx is through the growth plate & epiphysis?
Type III
What type of Salter Harris fx goes through the growth plate, metaphysis, & epiphysis?
Type IV
What type of Salter-Harris fx is a compression fx through the growth plate
Type V
Most common age for a Salter-Harries Type III fx?
10-15
Most common site of Type III Salter-Harris?
Distal tibia
Type of force that cause Type III Salter-Harris?
Intra-articular shearing forces
Type of force that causes Type IV Salter-Harris?
Vertical splitting forces
Most common site of Salter-Harris Type IV?
Lateral humeral condyle before age 10; distal tibia after age 10
Type of force that causes a Salter Harris Type V?
Crushing or compression force
Most common sites for a Salter-Harris Type V
distal femur, prox. & distal tibia
This is the plastic exudate & tissue that develops around the ends of, & ultimately unites, the fx fragments
Callus
Refers to a fracture that doesn’t unite w/i a reasonable amount of time
Delayed Union (16-18 wks)
Fracture that fails to unite
Nonunion
This is usually involves open fractures or fractures treated by surgical reduction; typically caused by Staph. aureus
Osteomyelitis
Severe & painful regional osteoporosis after rather trivial trauma
Reflex Sympathetic Dystrophy Syndrome
This is due to ischemia of the muscles followed by fibrosis; most common following supracondylar fx of humerus
Volkmans Ischemic Contracture
Occasionally following trauma to soft tissues, an enlarging painful mass develops
Myositis Ossificans
Most common type of skull fracture
Linear fx
Type of skull fx that typically results from impact by a small object; commonly found in frontal & parietal bones & most common in children
Depressed/Linear Fx
Represents a variation of the depressed fracture & is seen most often in young children
Ping Pong Fx
This fx is indicated by air/fluid levels in sphenoid sinus & pts complain of constantly swallowing something salty
Basilar fx
Type of fx that represents a traumatic sutural separation, which is usually unilateral & seen most commonly in children
Diastatic Fx
This is caused by a tear in the dura causing CSF to accumulate
Leptomeningeal Cyst
Fx that results from a blow by a fist or a ball directly over the globe of the eye; assoc. w/ the Drop Sign
Orbital blowout Fx
A fracture through the zygomatic arch, maxillary process, & the frontal process
Tripod fx
Nasal fxs typically have what type of orientation?
Transverse
What do all types of LeFort fxs ultimately transect?
pterygoid process
Type I LeFort fx is AKA?
Floating Palate
This type of LeFort Fx is AKA Craniofacial Disassociation; it’s a separation of the facial bones from the skull
Type III
This type of LeFort fx is in the shape of a pyramid
Type II
Type of fracture that is caused by repetitive stress, causing gradual formation of microfractures & eventually an interruption in the bone structure at a greater rate than ca be offset by the reparative process
Stress Fracture
A type of stress fracture that is caused by abnormal stress involving normal bone
Fatigue fracture
A type of stress fracture caused by normal stress involving abnormal bone
Insufficiency fracture
Two most common locations for occult fractures
Scaphoid & ribs
This type of Fx orientation runs at a right angle to the long axis of a bone
Transverse Fx
This type of fracture orientation runs approx. 45deg to the long axis of the bone; common in the shaft of a long tubular bone
Oblique Fx
Torsion, coupled w/ axial compression & angulation creates this type of Fx orientation
Spiral Fx
This is concerned w/ closeness of the bony fragments in a fx
Apposition
This is due to ischemia of the muscles followed by fibrosis; most common following supracondylar fx of humerus
Volkmans Ischemic Contracture
Occasionally following trauma to soft tissues, an enlarging painful mass develops
Myositis Ossificans
Type of skull fx that typically results from impact by a small object; commonly found in frontal & parietal bones & most common in children
Depressed/Linear Fx
Represents a variation of the depressed fracture & is seen most often in young children
Ping Pong Fx
This fx is indicated by air/fluid levels in sphenoid sinus & pts complain of constantly swallowing something salty
Basilar fx
Type of fx that represents a traumatic sutural separation, which is usually unilateral & seen most commonly in children
Diastatic Fx
This is caused by a tear in the dura causing CSF to accumulate
Leptomeningeal Cyst
Fx that results from a blow by a fist or a ball directly over the globe of the eye; assoc. w/ the Drop Sign
Orbital blowout Fx
Nasal fxs typically have what type of orientation?
Transverse
Most common fx of the atlas; usually a bilateral vertical fracture through the neural arch; occurs as a result of the posterior arch of the atlas being compressed b/w the occiput & the large posterior arch of the axis during severe hypertension; Stable
Poster arch fx of atlas
This fx is usually the result of MVA; bilateral fractures located just anterior the inferior facets of C2; Unstable
Hangman’s Fx AKA Traumatic spondylolisthesis
Avulsion of a triangular-shaped fragment from the anterior inferior vertebral body margin caused by acute hyperextension; stable
Extension teardrop fx
Commonly missed fx; M/C occurs at C4-C7; caused mainly by compression forces; Horizontal Facet Sign; Unstable
Articular Pillar/Facet Fx
Comminuted fx involving both the posterior & anterior arches caused by a blow on the vertex transmitting forces through the occipital condyles; Overlap sign; stable
Jefferson Fx AKA Bursting Fx of the atlas
Nucleus pulposus implodes through the superior endplate of the vertebra causing a comminuted fx; usually unstable
Burst fx
Specific form of the burst fx caused by combination of flexion & compressive forces; avulsed teardrop fragment; Unstable
Flexion Teardrop Fx
Fx that occurs as a result of mechanical compression of the involved vertebra b/w the adjacent vertebral bodies from forced hyperflexion; Stable
Simple Wedge Fx AKA Compression Fx
Avulsion injury of the spinous process by sudden force (abrupt flexion) placed on the ; ligamentum nuchae; Stable; Double spinous process sign
Clay-Shoveler’s Fx
Combination of distraction & flexion forces which causes a disruption of capsular & posterior ligaments; unstable
Hyperflexion Strain/Sprain AKA traumatic anterior subluxation
Severe hyperflexion & distraction injury that is M/C at C4-C7 primarily involving soft tissue; unstable
Bilateral Facet Dislocation
Impingement on the spinal cord occurs in isolated rupture of the transverse ligament with an intact odontoid process
Guillotine Effect
An avulsion fx of the tip of the odontoid process as a result of apical or alar ligament stress; usually forms an oblique fx line; stable
Type I Odontoid Process Fx (Anderson & d”Alonzo)
A fx at the junction of the odontoid process & the body of the axis. Often complicated by nonunion; unstable
Type II Odontoid Process fx
Oblique fx at the base of the odontoid process that extends into the body; disruption of the ring of the axis;stable
Type III Odontoid Process fx
Injury caused by a flexion-rotation force. Gives bow-tie or butterfly appearance on lateral view
Unilateral Facet dislocation
Theses fxs occur in the mid & lower C-spine, readily depicted on CT, usually secondary to hyperextension
Lamina Fx
Uncommon fx of C-spine, commonly caused by lateral flexion, common at C7, usually located at its junction with the pedicle
Transverse Process Fx
Unique condition of the upper cervical complex that is frequently undiagnosed & poorly understood; patient exhibits torticollis, head in “cock robin position”
Rotary Atlantoaxial Fixation
A deformity that represents the anteriorly displaced corner of the superior vertebral cortex; fragment of bone
Step Defect
Anterior depression of the vertebral body occurs in compression fx creating this deformity
Wedge deformity
A band of radiopacity may be seen just below the vertebral endplate that has been fx
Zone of impaction
Excessive amounts of small or large bowel gas in a slightly distended lumen indicates what?
Abdominal Ileus
A mechanical ileus is caused by what?
Bowel obstruction by an object
An adynamic ileus is caused by what?
Decreased peristalsis b/c of an innervation problem
A specific form of compression fx of the vertebral body whereina a posterosuperior fragment is displaced into the spinal canal
Lumbar Burst Fx
Second most common fx of the lumbar spine; Occur from avulsion of the paraspinal muscles, usually secondary to a severe hyperextension & lateral flexion blow to the lumbar spine
Transverse Process Fx
Horizontal splitting of the spine & neural arch, ending in an upward curve that usually reaches the upper surface of the body just in front of the neural foramen
Seat Belt AKA Chance Fx AKA Lap Belt Fx AKA Fulcrum Fx
Separation of the posterior vertebral body ring apophysis; usually has a Schmorl’s Node assoc. w/ it
Posterior Apophyseal Ring Fx
An injury response peculiar to the clavicle is bone resorption of the distal segment, usually 1-3mm, & never more than 2-3cm
Post-traumatic Osteolysis
Compression fx from humerus being shoved into glenoid after ant. dislocation
Hill-Sachs deformity
Humeral head hits the pos. rim of glenoid during a pos. shoulder dislocation
Trough Sign
Similar to Hill-Sachs, just on inferior side of humeral head
Bankart’s lesion
Rounded cystic appearance to humeral head, caused by internal rotation
Racquet Sign
Type of AC sprain where the AC lig. is stretched but not disrupted, & the coracoclavicular lig. is intact
Type I (Mild sprain)
Type of AC sprain where the AC lig. is torn & the coracoclavicular ligs. are stretched but intact
Type II (moderate sprain)
Type of AC sprain where the AC lig. & cora coclavicular ligs are completely disrupted
Type III (Severe sprain)
Fx of the iliac wing caused by a direct force from a lateral direction. Best seen on an oblique view
Duverney’s Fx
An ipsilateral double vertical fx of the sup. pubic ramus & the ischiopubic ramus, w/ fx or dislocation of the SI joint
Malgaigne’s Fx
Fx through the sup. pubic ramus & ischiopubic junction on the side opposite the oblique for of impact to the pelvis
Bucket-Handle Fx
M/C type of unstable fx of the pelvis. Double vertical fx that involves both superior pubic rami & ischiopubic junctions bilaterally
Straddle Fx
Complete separation of the symphysis pubis & one or both of the SI joints
Sprung Pelvis AKA Open Book fx
Type of acetabular fx that ususally occurs after a blow to the knee while the leg is in flexion & adduction
Posterior Rim Fx (Dashboard Fx)
Type of acetabular fx that divides the innominate bone into sup. & inf. halves. M/C type of acetabular fx
Central Acetabular Fx ( Explosion Fx)
A curvilinear line is constructed along the under-surface of the femoral neck & is continued across the joint to the inf. margin of the sup. pubic ramus
Shenton’s Line
A line is drawn through & parallel to the axis of the femoral shaft. A second line is constructed at right angles to the shaft line & tangential to the tip of the greater trochanter. The relationship of the fovea capitis to this trochanteric line is assessed.
Skinner’s Line
Two lines are drawn through & parallel to the mid-axis of the femoral shaft & femoral neck. Determines coxa cera/coxa valgus
Femoral Angle Line
Results from the impact of the femoral condyles being forced into the weaker tibial plateau.
Tibial Plateau Fx AKA Fender or Bumper Fx
