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MSK > Radiology Review > Flashcards

Radiology Review Flashcards

1
Q

What are the 4 joints of the shoulder girdle?

A

Acromioclavicular joint
Glenohumeral joint (shoulder joint)
Sternoclavicular joint
Scapulothoracic joint

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2
Q

What are the 2 necks of the humerus?

A

Anatomical neck
Surgical neck

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3
Q

Where is the surgical neck of the humerus?

A

The neck of the humerus just below the head of the humerus

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4
Q

Where is the anatomical neck neck of the humerus?

A

Opposite the greater tuberosity as a diagonal line
Its a groove separating the head of the humerus from the rest

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5
Q

What forms the intertubercular groove/sulcus on the humerus?

A

Greater tuberosity and lesser tuberosity

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6
Q

What supports the Glenohumeral joint?

A

Glenohumeral ligaments
They form the joint capsule

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7
Q

What needs to be checked in a humerus fracture?

A

The neurovascular status

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8
Q

How to remember which side Ulnar is in the upper limb?

A

Ulnar = close to U

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9
Q

What is the most common type of shoulder dislocation?

A

Anterior dislocation

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10
Q

What sign signifies a posterior shoulder dislocation?

A

Light bulb sign

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11
Q

How do you refer to the direction of a dislocation?

A

Always describe the position of the distal part to the proximal part

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12
Q

What is a Hill-sachs deformity/lesion?

A

Dent/fracture in the posterolateral humeral head due to anterior dislocations

Infraspinatus and teres minor jams the humeral head against the glenoid fossa

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13
Q

What is a Bankart lesion?

A

When the force of the humeral head in the dislocation tears off part of the glenoid labrum

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14
Q

How does a hill-sachs lesion appear on an x-ray?

A

Dent in humeral head (posterolateral)

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15
Q

What are the ligaments that support the acromioclavicular joint?

A

Coracoclavicular ligament
Coracoacromial ligament
Acromioclavicular ligament

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16
Q

What are the 2 types of fracture that can occur at the elbow?

A

Supracondylar fracture
Intra articular fracture

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17
Q

What is a supracondylar fracture at the elbow?

A

Fracture that occurs above the condyles of the humerus

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18
Q

What is a fracture at the elbow above the condyles of the humerus called?

A

Supracondylar fracture

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19
Q

What is the dark areas surrounding joints?

A

Fat pads

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20
Q

If no fracture line is clearly visible, what may indicate that a fracture is present?
Why?

A

Increased size of the fat pads (Larger dark area)

Due to fluid like blood and/or fat in the joint from the broken bone

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21
Q

What type of dislocation is most common with the elbow?

A

Posterior dislocation

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22
Q

What is the method of injury which causes a Colles fracture/Dinner fork fracture?

A

FOOSH

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23
Q

How does a Colles fracture present?

A

Dinner fork deformity
Dorsal angulation

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24
Q

Why do scaphoid fractures often result in Avascular necrosis?

A

Retrograde blood supply
So if a fracture occurs damaging the blood supply, the proximal part has no blood supply

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25
Q

What artery supplies blood to the scaphoid?

A

Radial artery

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26
Q

Why can buckle fractures occur in children?

A

There bones are soft so Can be squashed since the bones start as a cartilaginous matrix

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27
Q

What is a Greenstick fracture?

What age group does this happen in?

A

Where theres a fracture on one side of the cortex with the other side being fine

Kids

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28
Q

What are the 3 bones that make up the pelvis?

A

Ilium (part of ilium you can palpate at top)
Ischium (bit you sit on)
Pubis

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29
Q

What bone does the femur articulate with at the knee joint?

A

Femur with Tibia

30
Q

What bone articulates at the distal articulation of the Talus?

A

Talus and navicular

31
Q

What does the navicular articulate with distally?

A

Navicular with 3 cuneiforms

32
Q

Which bones do the cuneiforms articulate with?

A

Medial cuneiform = 1st metatarsal
Middle cuneiform = 2nd
Lateral cuneiform = 3rd metatarsal

33
Q

What does the Cuboid bone articulate with at the distal end?

A

4th and 5th metatarsal

34
Q

When assessing the Hip what is the first line of investigation?

What are the potential second line investigations?

A

Radiographs (X-ray)

Ultrasound/CT/MRI

35
Q

Why are radiographs a good first line imaging technique?

A

Cheap
Quick
Low radiation dose

36
Q

On examination, how does a patients lower limb with a Neck of Femur Fracture present?

A

Leg shortened
ABducted
Externally rotated

37
Q

What classifies as a Neck of Femur (NOF) fracture?

A

Any fracture of the proximal femur up to 5cm below the lesser trochanter

38
Q

What are the 2 types of Neck of Femur Fractures?

A

Intracapsular
Extracapsular

39
Q

What is an Intracapsular Neck of Femur Fracture?

A

Fracture of the proximal femur above the intertrochanteric line

40
Q

Why is an intracapsular Neck of Femur fracture worrying?

A

Neck of Femur at risk of Avascular necrosis due to medial femoral circumflex artery being damaged (ligamentum Teres artery not sufficient to supply head in adulthood)

41
Q

What is the intertrochanteric line?

A

Line between the greater trochanter and the lesser trochanter of the femur

42
Q

Who are more likely to get intracapsular neck of femur fractures?

A

Older osteoporotic patients following low energy falls

43
Q

What is an extracapsular Neck Of Femur Fracture?

A

Fracture of proximal femur below the intertrochanteric line

44
Q

Who more commonly gets extracapsular fractures of the neck of femur?

A

Younger/middle aged patients with high energy injuries like RTCs

45
Q

What is a dislocation of the hip?

A

Complete dissociation of femoral head from acetabulum

46
Q

What is subluxation?

A

A partial dislocation where there is abnormal articulation between parts that shouldn’t be articulating

47
Q

In a Neck of Femur Fracture why is the lower leg shortened, abducted and externally rotated?

A

Shortened = thigh muscles pull distal fragment up

Abducted = gluteus medius and minimus abduct the distal fragment

Externally rotated = gluteus medius + minimus and the Short lateral rotators:
-piriformis
-superior Gemellus
-Obturator internus
-inferior Gemellus
-Quadratus femoris

48
Q

What are the 2 causes of dislocation of the hip?

A

Traumatic dislocation (high energy… RTC)
Congential = developmental dysplasia of hip

49
Q

What is the most commonly seen type of traumatic hip dislocation?

A

Posterior dislocation

50
Q

On examination, how does the lower limb present with a posterior hip dislocation?

A

Shortened
Adducted (Opposite to NOF fracture)
Medially rotated (Opposite to NOF fracture)
Flexed

51
Q

What nerve is at risk of damage as a result of a posterior hip dislocation?

What condition can be caused?

Why can this happen?

A

Sciatic nerve

Sciatic nerve palsy

Sciatic nerve sits posterior to the femur

52
Q

On examination, how does an anterior hip dislocation present?

A

Lower limb is:
-externally rotated
-abducted
-slightly flexed

Similar to the Neck Of femur fracture (just not shortened)

53
Q

What nerve is at risk of damage as a result of a anterior hip dislocation?

What condition can be caused?

Why can this happen?

A

Femoral nerve

Femoral nerve palsy

Femoral nerve runs anterior to femur

54
Q

What is a central hip dislocation?

A

When he femoral head is driven through the acetabulum causing a fracture

55
Q

Why is a central hip dislocation so dangerous?

A

Risk of intrapelvic haemorrhage from pelvic venous plexuses

56
Q

What happens in Osteoarthritis of the hip?

What are the common presentations of osteoarthritis on an x-ray?

A

Breakdown of hyaline cartilage in a synovial joint leading to rubbing and injury to bone

LOSS
Loss of joint space
Osteophytes
Subchondral sclerosis
Subchondral cysts

57
Q

What are the 2 types of osteoarthritis?

A

Primary (idiopathic)
Secondary (precipitating cause:
-trauma
-infection
-obesity
-endocrine abnormalities)

58
Q

What are some primary risk factors of osteoarthritis?

A

-age
-female
-non Caucasian
-genetics
-nutrition

59
Q

How is osteoarthritis of the hip treated?

A

Weight reduction
Activity mod
Analgesia + NSAIDs
Steroid of Hylaruronic acidic injections

Total hip replacement

60
Q

What does a straight line that is not a fracture line indicate on an x-ray?
(See page 28 of radiology review lecture if confused)

A

Fluid build up
Suggests a potential fracture
LIPOHAEMARTHROSIS (blood + fat in fracture)

61
Q

What usually causes femoral shaft fractures?

A

High velocity trauma
RTCs
Fall from height

62
Q

How does a femoral shaft fracture present?

A

Proximal fragment = abducted due to glut medius and minimus, flexed because of iliopsoas

Distal fragment = Adducted due to adductors

63
Q

What may be potentially compromised as a result of a distal femoral shaft fracture?

A

Popliteal artery

64
Q

What type of knee injury usually occurs as a result of a high energy injury with axial loading of the knee?

A

Tibial plateau fracture

65
Q

What is affected in a tibial plateau fracture?

Why condyle is most commonly affected?

A

The articulating surface of the tibia within the knee joint

Either uni-condylar or bi-condylar

Lateral tibial condyle most commonly affected

66
Q

What are some complications of Tibial Plateau fractures?

A

Articular cartilage damaged
Post traumatic osteoarthritis
Meniscal tears or ACL injury

67
Q

What can cause a patellar fracture?

A

Direct impact
Eccentric contraction of quadriceps

68
Q

What can be mistaken for a fracture patellar?

What causes this?

Which area of the patella does this happen at?

A

Bi-partite patella (not pathological)

Failure of union of a secondary ossification centre

Superolateral portion of patella

69
Q

What is the Unhappy triad?

A

Large fore to the lateral aspect of knee joint causing injury to:

-Medial collateral ligament (MCL)
-Medial meniscus
-Anterior Cruciate Ligament (ACL)

70
Q

What are the ligaments which at least 3 of the 4 need to be ruptured for the knee to dislocate?

A

ACL (Anterior Cruciate Ligament)
PCL (Posterior Cruciate Ligament)
MCL (Medial Collateral Ligament)
LCL (Lateral Collateral Ligament)

71
Q

What vessel is at risk in a knee dislocation?

A

Popliteal artery

MSK (36 decks)

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