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Semester 4 PM Exam 4 > Wrist and Hand Imaging > Flashcards

Wrist and Hand Imaging Flashcards

1
Q

Primary ossification center of MC and phalangeal shafts begins at

A

8 wks gestation

Shafts are fully formed at birth

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2
Q

No ossification in carpals seen when

A

Newborn - 5 or 6 months

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3
Q

Ossification centers of capitate and hamate appear at

A

6 months

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4
Q

MCs and radius have secondary ossification centers by

A

1 year

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5
Q

Triquetrum center ossification is visible by when

A

2 years

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6
Q

Secondary ossificiation centers of ulna appear when

A

by 5 years

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7
Q

All carpal bones except pisiforma are visible on xray when

A

by 6 years

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8
Q

9-13 years - the secondary ossification centers of the phalanges are

A

Wider than the shafts

Capral bones are in their adult shapes

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9
Q

All seondary ossification centers should be present at

A

14 years F

16 years M

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10
Q

Routine projections

A

PA
Lateral
Oblique - often added to complete the series

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11
Q

PA projection - position

A

hand as flat as possible with palmar aspect closest to the film
Thumb in oblique position

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12
Q

PA projection - what is the longest

A

Proximal phalanges

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13
Q

What is in line with the long axis of the radius

A

Long axis of the 2nd MC

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14
Q

Where should you be able to draw a ling

A

Along distal articulating surfaces of the 3-5 MCs

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15
Q

MC fx - common where

A

3rd and 4th - known as a boxers or brawlers fracture

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16
Q

Thumb - sesamoid bones

A

2 of them at the MC head

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17
Q

What inserts onto the sesamoid bones

A

Adductor pollicis - the ulnar one

Flexor pollicis brevis - radial one

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18
Q

Sesamoid bones lie within the

A

palmar plate

close to origin of the tunnel for FPB

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19
Q

What can cause fx to sesamoid bones

A

Severe hyperextension trauma - is probably more likely to rupture palmar plate and associated ligaments
Can develop hematoma through FPB

20
Q

Most commonly fractured carpal bone

A

Scaphoid

21
Q

Scaphoid is usually fractured where

A

at midpoint

22
Q

Kienbocks disease

A

Avascular necrosis of lunate - often without history of trauma

23
Q

Sesamoid within the flexor carpi ulnaris

A

Pisiform

overlaps triquetrum on PA

24
Q

Trapezium is superimposed with

A

Trapezoid

25
Q

Injury to trapezium

A

Rare - almost always collateral to injury of other wrist structures

26
Q

Capitate isolated injury

A

Rare

27
Q

Hamate fracture

A

Uncommon but should be considered if pt is involved in activities with clubs or bats

28
Q

Fracture of distal radius ___% of all skeletal fx

A

16%

29
Q

Alignment - carpal arches

A

Gilulas lines

30
Q

1st line - carpal arches - formed by

A

Proximal convex surfaces of scaphoid, lunate, and triquetrum

31
Q

2nd line - carpal arches - formed by

A

Distal concave surfaces of the same bones

32
Q

3rd line - carpal arches - formed by

A

proximal convex curves of capitate and hamate

33
Q

Ulnar variance

A

Difference between the length of ulna and radius

Should be less than or equal to 1.0 mm

34
Q

Positive ulnar variance - defined as ulna being

A

more than 1 mm distal to the radius

35
Q

Positive ulnar variance occurs with

A

age, secondary to degenerative changes in fibrocartilaginous disc

36
Q

Positive ulnar variance is associated with

A

ulnar impact fracture and lunotriquetral ligament disruption

37
Q

Positive ulnar variance is commonly seen in

A

gymnasts secondary to stress on radial growth plates

38
Q

Negative ulnar variance - define

A

ulna is shortened compared to the radius

39
Q

Negative ulnar variance - commonly seen in

A

Kienbocks disease

40
Q

Kienbocks disease

A

Osteonecrosis of the lunate

41
Q

Lateral view - best for determining what

A

displacements of long bones in hand and carpals

42
Q

Lateral view - what is resting on the receptor

A

Ulnar border of hand

43
Q

Lateral view - central ray moves from

A

Radial to ulnar

44
Q

Lateral view - what is magnified and why

A

Thumb - because of distance from the receptor

45
Q

Lateral view shows what view of thumb and what view of other fingers

A

Posterolateral of thumb

Lateral of rest of hand and wrist

46
Q

Lateral view - most bones are

A

superimposed

but can still identify displacement

47
Q

Volar tilt - angle formed between

A

A line connecting distal points of the volar and dorsal rim of the radius
A second line perpendicular to the long axis of the radius

Semester 4 PM Exam 4 (10 decks)

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