Imaging Of The Lower Limb

Front 1

What is the normal degree for the Axis of the Neck of the Femur with the Axis of the Shaft of the Femur?

Back 1

120-130 degrees

Front 2

What is the name for the nice smooth curve over the Oburator Foramen?

Back 2

Shentons Line

Front 3

What are the 2 routine hip radiographs?

Back 3

AP
AP Frog Leg

Front 4

What is an Intracapsular Femoral Fracture?

Back 4

Femoral Neck and Head fractures

Front 5

What is an Extracapsular Femoral Fracture?

Back 5

Intertrochanteric Fracture
Subtrochanteric Fracture

Front 6

When do femoral neck fracture most commonly occur?

Back 6

AFTER a fall

Front 7

Femoral neck fractures can also be related to __________ instead of a single traumatic event.

Back 7

Chronic Stress

Front 8

Stress fractures of the neck of the femur can be subdivided into what?

Back 8

Fatique fractures and Insufficiency Fractures

Front 9

What is a Femoral neck fracture that results from an increased or abnormal stress placed on normal bone?

Back 9

Fatigue Fractures (stress fractures)

Front 10

What is Femoral neck fracture that results from normal stress placed on a diseased bone, such as osteoporotic bone?

Back 10

Insufficiency Fractures (pathologic fractures)

Front 11

What is the main concern with a femoral neck fracture?

Back 11

Osteonecrosis of Femoral Head

Front 12

What percent of people die from a femoral neck fracture?

Back 12

15-34% (age dependent)

Front 13

What percent of Femoral Neck fractures result in osteonecrosis of the femoral head?

Back 13

5-18%

Front 14

What type of femoral fracture occurs as a result of a fall- from direct or indirect forces?

Back 14

Intertrochanteric Fractures

Front 15

Where on the femur do Intertrochanteric Fx occur?

Back 15

occurs along lines between theGreater and Lesser Trochanter

Front 16

Which heals better, Intracapsular or Extracapsular femoral fractures?

Back 16

Extracapsular because has an excellent blood supply

Front 17

What is the MAIN underlying bone disease that would prequel a Pathologic fracture of the Hip?

Back 17

Osteoporosis

Front 18

What is the most common bone tumor that could lead to pathologic fractures of the hip?

Back 18

Metastatic disease

Front 19

What are the 4 most common types of Metastatic Carcinoma?

Back 19

Breast
Prostate
Lung
Renal

Front 20

Lytic cancer tends to have _______density and Blastic cancer tends to have ________ density.

Back 20

Lytic- low density
Blastic- high density

Front 21

When would a hip joint replacement be performed?

Back 21

with Advanced Degenerative Disease

Front 22

What is replaced with a hip joint replacement?

Back 22

Acetabulum and head

Front 23

What accounts for 90% of all hip dislocations?

Back 23

Posterior dislocations

Front 24

What occurs when the knee and hip are flexed and a force is applied at the knee?

Back 24

Posterior dislocation

Front 25

What occurs when a direct blow to the posterior aspect of the hip, or from a force applied to an abducted leg that levers the hip anteriorly out of the acetabulum?

Back 25

Anterior Dislocation

Front 26

What occurs when a direct impact to the lateral aspect of the hip forces the hip centrally through the acetabulum into the pelvis?

Back 26

Central Dislocation- actually a fracture-dislocation

Front 27

What type of dislocation is seen on the xray with the femoral head in the obturator foramen?

Back 27

Anterior Hip Dislocation- leg is stuck in abduction

Front 28

What type of hip dislocation is the leg stuck in abduction?

Back 28

Anterior Dislocation

Front 29

What is the test for Development Dysplasia of the hip?

Back 29

Ortoloni Maneuver

Front 30

What is a positive result of the Ortoloni maneuver? What is this indicative of?

Back 30

"clunk" is heard when the hip reduces into the acetabulum during abduction. Clunk indicates Development Dysplasia of the hip

Front 31

What percent of newborns are born with Development Dysplasia of the hip?

Back 31

0.1-0.2% of all newborns

Front 32

What are 3 predisposing factors to Development Dysplasia of the hip?

Back 32

Female 80%
Family History
Breech or other abnormal pos.

Front 33

What are 3 things to look for with a possible Development Dysplasia of the hip?

Back 33

1. Shentons Line
2. Small Epiphysis
3. Increased Acetabular Index

Front 34

What is the normal acetabular index for a newborn?

Back 34

less than 30 degrees

Front 35

What is the normal acetabular index for a 2 year old?

Back 35

less than 20 degrees

Front 36

What is another name for Development Dysplasia of the Hip?

Back 36

Congenital Hip Dislocation

Front 37

What are 2 routine femur views?

Back 37

AP
Lateral

Front 38

Femur fractures are usually _______ and are treated with intermedullary rods.

Back 38

Transverse fx

Front 39

What are 2 possible complications with a femur fx?

Back 39

Severe Hemorrhage
Pulmonary Embolism-fat embolism

Front 40

What are the 4 routine knee views?

Back 40

AP
Lateral
Oblique
Patella View

Front 41

Should you be concerned is you have a flabella behind the knee?

Back 41

no, it's normal

Front 42

What is a sesmoid bone that serves as a fulcrum between the tendons?

Back 42

Patella

Front 43

What is an area of high density that is seen with bursitis, trauma or bleeding?

Back 43

Effusion

Front 44

What does fat in the knee joint indicate?

Back 44

Has to be a fracture

Front 45

In a lateral view, describe the fat-fluid level.

Back 45

Fat rises above the fluid

Front 46

Where do you find Bipartite Patella?

Back 46

ALWAYS in upper outer quadrant- it's an ossification center that is pretty common

Front 47

What are cortical avulsions of the proximal lateral tibia plateau?

Back 47

Segond Fx

Front 48

What is usually seen in ski patients and is a little, flat lateral fx at the proximal tibia?

Back 48

Segond fx

Front 49

What is another name for Segond Fractures?

Back 49

Flake fx

Front 50

Segond fractures ALWAYS indictate injury to _____________.

Back 50

ACL

Front 51

Why does the ACL look bright on a MRI, aren't ligaments usually black?

Back 51

bright because it has fat thru out

Front 52

What is responsible for connecting one meniscus to another?

Back 52

Transverse Ligament

Front 53

Which meniscus is largest, medial or lateral?

Back 53

medial

Front 54

What ligament of the knee has a hook shape and should have continuity?

Back 54

Posterior Cruciate Lig- very strong and hard to tear

Front 55

When looking at a Sagittal MRI of the knee joint, what ligament runs towards the front of the knee and appears to fan out?

Back 55

ACL

Front 56

What image is best to view the PCL?

Back 56

Sagittal Middle Images

Front 57

How do you know that the sagittal image is a medial cut?

Back 57

can see the "bowtie"

Front 58

Which meniscus is larger, anterior or posterior?

Back 58

Posterior meniscus LARGER

Front 59

What is the only image you can use to diagnose an injury to the meniscus?

Back 59

Sagittal Image- bc only one you can see entire ligament

Front 60

What are 2 routine views for the Lower Leg?

Back 60

AP
Lat

Front 61

With a fractured distal tibia, what else should be observed?

Back 61

always look at proximal fibula because it will likely be fx too

Front 62

What is a Medial Tibial Stress Syndrome?

Back 62

shin splints

Front 63

What are 3 routine Ankle views?

Back 63

AP
Lateral
Oblique

Front 64

With lateral inversion, twisted ankle, what should be observed?

Back 64

base of 5th metacarpal for fx

Front 65

What is the name of the joint between the Talus and the Navicular bones?

Back 65

Transverse Tarsal joint

Front 66

With an AP ankle view what is a curvey line between the tibia and foot?

Back 66

Ankle Mortus

Front 67

What is an ellipticial lesion whose long axis runs parallel with the long axis of the tibia?

Back 67

Bone Island

Front 68

How big are bone island bening lesions?

Back 68

always less than 1 cm

Front 69

What is a fracture of the medial and lateral malleolus?

Back 69

Bimalleolar Fracture

Front 70

What is a medial, lateral and posterior malleolar fracture?

Back 70

Trimalleolar Fx

Front 71

Widening of the ankle joint is indicative of what?

Back 71

Unstable ankle- test the ligament by inverting the ankle

Front 72

What is a way to classify tibial fractures?

Back 72

Salter Harris Classification

Front 73

Wat does a partial archilles tear look like on an MRI?

Back 73

Really fat or edema in the tendon

Front 74

What is discontinuity of the archilles tendon and the calcaneuous?

Back 74

Complete Tear

Front 75

What are the Routine Foot Views?

Back 75

AP
Lateral
Oblique (foot is hard to see, thats why we do oblique even though its a bone)

Front 76

What is a normal Boehler's Angle?

Back 76

should be 30-40 degrees

Front 77

What does a Boehler's angle less than 30 degrees indicative of?

Back 77

Fracture- even if you don't see it

Front 78

What is used to find Boehler's angle?

Back 78

Anterior and Superior aspects of the Calcaneus bone

Front 79

What type of fracture is the base of the 5th metatarsal pulled off by the ligament?

Back 79

Inversion Fx (avulsion fx)- usually TRANSVERSE

Front 80

What is a fracture to the proximal 5th metatarsal?

Back 80

Jones Fx

Front 81

When looking at the foot, apophysis run _______, and fractures run ___________.

Back 81

Apophysis- run up and down
Fractures- transverse

Front 82

What type of fracture is seen at the 2nd and 3rd metatarsals?

Back 82

Stress Fractures- take a long time to see

Front 83

What should you do to see a stress fracture since they take so long to see on an Xray?

Back 83

Bone scan

Front 84

What is a fracture of the Cuneiform and Cuboid bones?

Back 84

Lisfranc Fracture Dislocation

Front 85

What on an image seems to have the toes shift laterally and there is a big space between big toe and 2nd toe?

Back 85

Lisfranc Fracture Dislocation