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Part 4 Boards X-ray > AP Lumbopelvic > Flashcards

AP Lumbopelvic Flashcards

(63 cards)

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1
Q

Check the lower 1/3 of the SI joints

A

AS
Osteitis condensans ilia
DJD

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2
Q

AS

A

Bilateral fusion of the SI joints
Bilateral sacroilitis
Enteropathic arthritis
Gost joints (SI joint fused) and star sign (calcif sup SI joint)

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3
Q

Osteitis Condensans Ilia aka

A

Hyperostosis triangularis

Osteitis Triangularis

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4
Q

Osteitis condensans ilia

A

Multiparous females

20-40

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5
Q

Bilateral symmetrical trianglular sclerotic areas on the lower half of the ilium

A

Osteitis condensans ilia

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6
Q

Osteitis condensans ilia

A

Joint space is spared
Self-resolving
No labs

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7
Q

Case management osteitis condensans ilia

A

Trochanteric belt for stability

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8
Q

DJD lower SI joint

A

Sclerosis ilium side
>40
Bilateral whitening on ilia and sacral sides of SI joint

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9
Q

3 other possiblities aside from DJD

A

Early AS
PA
Reactive arthritis

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10
Q

Compare one ilium to the other for alterations in color or shape

A

Color - whiter = blastic mets, pagets
Darker - lytic mets, mm, benign bone tumors
Shape - PFF - paget’s, fractures, fibrous dysplasia

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11
Q

Find L4 and T12 - check for

A

Lumbarization or sacralization

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12
Q

L5 TPs may fuse or form joints with the sacrum

A

Sacralization

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13
Q

6 lumbars (1st sacral segment appears like a lumbar segment)

A

Lumbarization

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14
Q

Check the sacrum for alterations of color, shape, spina bifida, and knife clasp deformity

A

Color whiter - blastic mets or pagets
Color darker - lytic mets, mm, benign bone tumors (GCT)
Shape - PFCF - paget’s fractures congenital anomalies, fibrous dysplasia
Spina bifida - vertical radiolucency
Knife clasp - elongated L5 SP going into spina bifida of sacrum

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15
Q

Check the square block head system from bottom up

A 
Pedicles = eyes
SP = nose
TP = ears
Body = head
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16
Q

Check L5/S1 facets for

A

Tropism/asymmetrical facets

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17
Q

Check the body (head)

A

Hemivertebrae

Butterfly vertebra

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18
Q

Hemivertebrae

A

Half a VB
Failure of development of a lateral ossification center
Isolated wedged vertebra causes a congenital or structural scoliosis
Associated with scrambled spine appearance - multiple curvatures

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19
Q

Butterfly vertebra

A

Failure of the center of teh VB to ossify properly

NEVER creates a scoliosis

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20
Q

Butterfly vertebra aka

A

Receded cortical margins
Indented cortical endplates
Sagittal cleft defect
Increased intrapedicular distance

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21
Q

A crushed/smooshed head

A

Malignancy - mm/fx

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22
Q

A darker head

A

Mm or lytic mets

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23
Q

A brighter head

A

Pagets or blastic mets

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24
Q

Check the pedicles (eyes)

A

Pedicle agenesis - contralateral pedicle hypertrophy and sclerosis (superpedicle) - other pedicle obviously whiter
Lytic mets of pedicle

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25
Lytic mets of pedicle
Missing pedicle with contralateral side of no color change | Associated with winking owl sign
26
Check the spinouses (nose)
Spina bifida Fractures Missing
27
Spina bifida
Vertical radiolucency with smooth cortical margins around un-united pieces
28
Fractures
Double spinous sign
29
Missing
Agenesis Malignancy Surgery
30
Check the TP (ears)
Fracture Non-union Scoliosis
31
Fracture TP
``` Bone displaced from itself Fulcrum fracture Psoas and quad lumborum attachment Jagged radiolucency No cortical margins Displacement ```
32
Non-union TP
``` In place No symptoms Smooth Cortical margins present No displacement ```
33
Scoliosis named for
Largest or major curve | Named on side of convexity
34
Rotatory scoliosis
Spinouses deviate away from convexity
35
Simple scoliosis
Spinouses deviate towards convexity
36
M/c scoliosis
Adolescent idiopathic simple scoliosis - adams ortho test
37
X-ray lines scoliosis
Cobb’s | Risser ferguson’s
38
Case management 25 and younger scoliosis
<20 - adjust and monitor. With fisser’s sign and wrist films 21-40 refer to orthopedist - don’t adjust - milwaukee brace >40 surgical consultation
39
Scoliosis can lead to
DJD Cardiopulmonary compromise Postural fatigue
40
Check the ribs - m/c benign tumor
Fibrous dysplasia
41
Check the ribs
Fractures | Lytic mets
42
Fractures ribs
Most common condition | Bone displaced from itself
43
Check the ribs lytic mets
Most common malignancy | Look for teeth marks in the bone
44
Check the soft tissue from the ribs down to the iliac crest
``` AAA Renal artery Gallstones Kidney stones Staghorn calculi Pancreatic calcification Calcified spleen Splenic artery calcification Congenital anomaly ```
45
AAA on AP view appears like a
Half moon shape from the sides of L2-4 | Curvilinear
46
Radiographic signs AAA
Aortic dilation Curvilinear calcification Fusiform appearance
47
Special test AAA
Doppler ultrasound Diagnostic US Ultrasonography CT
48
AAA refer to
Cardiovascular specialist
49
Renal artery
Calcification - smaller cheerio | Aneurysm - larger cheerio
50
Gallstones
``` 90% can’t be seen (cholesterol) Bag of marbles right upper side R upper quadrant pain Steatorrhea Inc after fatty meal Long hx poor diet ```
51
Location at L1-2 Start at iliac crest and work your way up the film Black center outlined in white Affiliated with 9 F’s
Gallstones
52
Gallstones referral pain
To inferior border of the right scapula (viscerosomatic)
53
Murphy’s inspiratory arrest
Gallstones
54
Case management gallstones
Gastroenterologist Small - let pass or lithotripsy Large or blocking biled duct = surgery (take out Gb)
55
Special test
Ultrasound and cholecystogram
56
Kidney stones
``` 90% show up Laying down pisses it off Tx same as gallstones Refer nephrologist Pyelogram ureters ```
57
Location L1-2, start at the SI joint and work your way up the film Solid white in color
Kidney stones
58
M/c caslicum oxalate Murphy’s punch Bloo in urine, change in urinary frequency
Kidney stones
59
``` Calcification of the renal calyces Solid white in color Larger than stone Does not affect ureters Surgery ```
Staghorn calculi
60
Spotty white calcification that crosses the midline at L1-2 area
Pancreatic calcification
61
Upper left quadrant T12-L2 area | Does not cross the midline
Calcified spleen
62
Splenic artery calcification
Worm
63
Congenital anomaly order affection L5/S1 from most significant to least
``` Knife clasp Lumbosacral transitional segment Facet tropism Spina bifida L5/S1 Enlarged TP of L5 ```

Part 4 Boards X-ray (22 decks)

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