Upper Limb 2

Question 1

Mensuration of Elbow

Answer 1

Anterior Humeral line
Radiocapitellar line

Question 2

Effusion of elbow, what will shown in fat pads

Answer 2

Anterior fat pad will displaced and show sail sign

Posterior fat pad will become elevated and visible

Question 3

What will be shown in Abnormal Wrist Fat Pad

Answer 3

Abnormal pronator quadratus fat pad will be displaced and bowed
Normal will show a straight line

Question 4

Principal Radiographic features for Osteo arthritis (OA)

Answer 4

• Asymmetrical joint-space narrowing
• Subchondral sclerosis of bone
• Marginal osteophytes
• Subchondral cysts

Question 5

Erosive Osteoarthorosis common sites and radiographic sign

Answer 5

• Common at distal interphalangeal joint (DIP) and occasionally in 1st metacarpophalangeal joint (MCP)
• Common among postmenopausal women
• Bilateral symmetric distribution

Imaging sign: Gull wing

Question 6

Typical hand deformities in rheumatoid arthritis

Answer 6

• Ulnar drift
• Knuckle subluxation (partial dislocation)
• Wrist subluxation
• Finger swan neck
• Finger boutonniere
• Z-shaped thumb

Question 7

RA in Elbow what radiographic signs show?

Answer 7

• Prominent distal humerus, radial head and coronoid process erosions
• Positive fat pad sign (posteriorly)

Question 8

RA in Hand and Wrist what clinical finding show

Answer 8

• Proximal distribution with wrist finding usually appearing first
• Fusiform swelling
• Periarticular osteopenia
• Ulnar deviation of phalanges (Late)
• Swan neck, Boutonniere, hitchhiker deformity due to tendon rupture (late)

Question 9

Clinical features of Psoriatic Arthritis

Answer 9

• 20 to 50 years old
• nail changes (pitting,ridging, discoloration, loss of nail, thickening of skin

Question 10

General radiologic features for Psoriatic arthritis

Answer 10

• Asymmetric distribution
• Soft tissue swelling
• Normal bone mineralization
• Erosions
• Fluffy periostitis
• Narrowed (late) or widened joint space (early)

Question 11

Deformity in Psoriatic arthritis

Answer 11

• Pencil-in-cup deformity
• Opera glass hand
• Arthritis mutilans

Question 12

Common Site for Gout

Answer 12

1st metatarsophalangeal joint (MTP)

Question 13

Radiographic sign for gout in Elbow

Answer 13

• Erosions of olecranon and adjacent ulna
• Trophaceous involve of olecranon bursa leads to prominent mass on lateral view (Rising Sun)

Question 14

Radiographic sign for gout in Wrist and hand

Answer 14

• Erosions, soft tissue swelling and misalignment
• Overhanging sign
• Erosion of the carpal (sporty carpal sign)

Question 15

Most common fracture in elbow for children

Answer 15

Distal humerus, Supracondylar (60%)
distal fragment usually displaces posteriorly

Question 16

What will show Proximal Radius Fracture in xray

Answer 16

Chisel fracture - Incomplete fracture of radial head that extends to center of articular surface

Question 17

What is Monteggia’s Fracture

Answer 17

Fracture of Proximal ulna with dislocation of radius at proximal shaft

Question 18

What is Galeazzi’s Fracture (reverse monteggia’s fracture)

Answer 18

Fracture of distal radial shaft with dislocation of distal radioulnar joint

Question 19

What clinical finding for Nursemaid’s Elbow (pulled elbow)

Answer 19

• immediate pain; stuck in mid-pronation due to pain
• maintain supination to reduce the dislocation and ends pain