Diagnostic Imaging (Irene Gold) Part II and III Flashcards Preview

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Flashcards in Diagnostic Imaging (Irene Gold) Part II and III Deck (456):
1

Who are all Benign Bone Tumors (BBT) referred to?

Orthopedist

2

What are the four characteristics of all Benign Bone Tumors (BBT)?

Short zone of transition
Incidental finding
Geographic lesion
Encapsulated

3

What is the name of the most common Benign Bone Tumor (BBT) of the appendicular skeleton?

Osteochondroma

4

What are two types of Osteochondromas?

Pedunculated (Coat Hanger Exostosis/Cauliflower like)
Sessile

5

What is the name for multiple Osteochondromas?

Hereditary Multiple Exostosis (HME)

6

What percentage of Hereditary Multiple Exostosis (HME) undergo malignancy?

20%

7

What is another name for a Unicameral Bone Cyst (UBC)?

Simple Bone Cyst (SBC)

8

What is the location of a Simple Bone Cyst (SBC)?

Diaphyseal/Metaphyseal
Centrally Located

9

What age is a Simple Bone Cyst (SBC) usually seen in?

Under the age of 20 years old

10

What are the common locations of a Simple Bone Cyst (SBC) to appear?

Proximal:
Tibia
Fibula
Humerus

11

What Radiographic sign is associated with a Simple Bone Cyst (SBC)?

Fallen Fragment Sign

12

What is the location of a Aneurysmal Bone Cyst (ABC)?

Diaphyseal/Metaphyseal
Eccentrically Located

13

What age and gender is an Aneurysmal Bone Cyst (ABC) usually seen in?

Females under the age of 20

14

What is the location of a Giant Cell Tumor (GCT)?

Epiphyseal/Metaphyseal

15

What age range usually has a Giant Cell Tumor (GCT)?

20-40 year olds

16

What "classification" do 20% of Giant Cell Tumors become?

Quasi-Malignant

17

What are five "characteristics" of a Quasi-Malignant tumor?

Non-Expansible
Pain and Swelling present
Pathological fracture
Reduce after surgery
Can come back

18

What kind of appearance is seen on x-ray of a Giant Cell Tumor (GCT)?

Soap Bubble (Saponaceous)

19

What is the location of a Chondroblastoma?

Epiphyseal/Metaphyseal

20

What age would you commonly see a Chondroblastoma?

Younger than the age of 20

21

What two Benign Bone Tumors (BBT) have night pain relieved by aspirin?

Osteoid Osteoma
Brodie's Abscess (Chronic Osteomyelitis)

22

What is another name for a Brodie's Abscess?

Chronic Osteomyelitis

23

What is the x-ray appearance for a Osteoid Osteoma and Brodie's Abscess?

Radiolucent central "nidus" with severe reactive sclerosis

24

What is the most common Benign Bone Tumor (BBT) of the hand?

Enchondroma

25

What kind of appearance with an Enchondroma have?

Stippled
Cortical thinning

26

What is the name of the condition that is multiple Enchondromas?

Ollier's Disease

27

What percentage of people with Ollier's Disease may have malignant degeneration?

10%-50%

28

What two things will patients with Ollier's Disease have?

Predisposed to fracture
Permanent Deformities

29

If a patient has soft tissue calcification and Enchondromas what is the condition called?

Maffucci's Syndrome

30

What is the most common Benign Bone Tumor (BBT) of the spine?

Hemangioma

31

What is another name for a Hemangioma?

Vascular Neoplasm

32

What is the appearance of a Hemangioma on x-ray?

Vertical Striations
Corduroy Cloth Appearance

33

What is the name of the Benign Bone Tumor (BBT) that appears as a round/oblong radiopaque lesion; Bone Island?

Enostoma

34

What is it called when there are multiple Enostomas?

Osteopoikilosis

35

What is the name of the Benign Bone Tumor (BBT) that most commonly affects the neural arch?

Osteoblastoma

36

What vertebral level is most commonly effected by a Osteoblastoma?

Atlas, C1

37

What is the most common Benign Bone Tumor (BBT) to affect the skull?

Osteoma

38

In what part of the skull is an Osteoma most commonly found?

Frontal Sinuses

39

What x-ray view is best to see an Osteoma?

Caldwell Projection

40

What Benign Bone Tumor (BBT) has a monostotic form, is dark on x-ray and must have deformed bone?

Fibrous Dysplasia

41

What x-ray sign is associated with Fibrous Dysplasia; Monostotic form (70%)?

Rind Sign

42

In the condition of Fibrous Dysplasia what physiologically replaces normal bone?

Fibrous Tissue

43

What are four Characteristics and/or Appearances of Fibrous Dysplasia?

Saber Shin Tibia
Sheppard's Crook (Hip)
"Ground Glass" appearance
Jagged "Café Au Lait" spots ("Coast of Maine")

44

What Benign Bone Tumor (BBT) has a familial history?

Neurofibromatosis

45

What are eight Characteristics and/or Appearances of Neurofibromatosis?

-Patient may present with:
-Scoliosis
-Cervical Kyphosis
-Posterior Vertebral Scalloping, with Intervertebral Foramen (IVF) enlargement
-Straight "Café Au Lait" spots ("Coast of California")
-Genetic Malformation
-Rib Deformity
-Lisch nodules; Growth on the iris of the eye, looks like a freckle

46

What is another name for Multiple Myeloma?

Plasma Cell Sarcoma

47

What age is Multiple Myeloma often seen in?

50 years old

48

What are three characteristics are seen in Multiple Myeloma?

-Cachexia (Weakness or wasting of the body, from chronic disease)
-Weight Loss
Anemia

49

What is the most common primary malignancy of bone?

Multiple Myeloma

50

What part of the bone is effected in the condition of Multiple Myeloma?

Plasma Cells of Bone Marrow

51

What two "Terms/Names" are associated with Multiple Myeloma?

"Punched Out Lesions" (Multiple Dark Densities)
"Rain Drop Skull"

52

What additional condition is can be seen in Multiple Myeloma?

Pathological collapse of a vertebra (Vertebral Plana)

53

What are four lab findings in Multiple Myeloma?

M Spike on the Immunoelctrophoresis
Reversal of the Albumin/Globulin (A/G) Ratio
Bence-Jones Proteinuria
Elevated Erythrocyte Sedimentation Rate (ESR)

54

What Special Test is ordered for Multiple Myeloma and what is the outcome of the Special test?

Special Test: Bone Scan
Outcome/Result: Cold

55

What is the most common malignant tumor of bone?

Metastatic Disease (Lytic and Blastic)

56

What is the age that is associated with Lytic Metastatic Disease?

Older than 40

57

What two symptoms are often seen in a patient with Lytic Metastatic Disease?

Recent Unexplained weigh loss
Skeletal Pain worse at night

58

What are the x-ray appearance of Lytic Metastatic Disease?

Moth eaten
Permeative pattern
"Eats" away pedicle
"Swiss Cheese" Skull

59

What lab will be ordered for both Lytic/Blastic Metastatic Disease?

Alkaline Phosphatase

60

What Special Test and result/outcome are ordered for a patient with both Lytic/Blastic Metastatic Disease?

Special Test: Bone Scan
Result/Outcome: Hot

61

What are the three conditions that have an Ivory White Vertebrae (IWV) on x-ray?

MPH

Metastatic Disease (Blastic)
Paget's
Hodgkin's Disease

62

What is the most common age and gender for the condition of Hodgkin's Disease?

Males
20-40 years old

63

Along with an Ivory White Vertebrae (IWV) what other x-ray finding is seen in a Hodgkin's Disease patient?

Anterior Scalloping of the vertebral body

64

What will be seen on the P-A chest film of a patient with Hodgkin's Disease?

Unilateral hilar lymphadenopathy

65

How is Hodgkin's Disease confirmed?

Biopsy

66

What does the presence of Reed-Sternberg Cells indicate?

Hodgkin's Lymphoma

67

What age is Blastic Metastatic Disease seen in?

Over the age of 40

68

Where does Blastic Metastatic Disease metastases to and from?

Starts in the Prostate and goes to the Lumbar Spine (Through the Valves of Batson)

69

What is another name for Paget's Disease?

Osteitis Deformans

70

What age and gender is the condition Osteitis Deformans often seen in?

Males over the age of 50

71

What are the four stages of Paget's Disease?

Lytic or Destructive
Combined
Sclerotic
Malignant (Osteosarcoma)

72

What six thing are caused on x-ray with a patient with Paget's Disease?

Cortical Thickening
Picture Frame Vertebrae
Bone Expansion
Increased Bone Density
Coarsened Trabeculae
Bowing Deformities

73

What Lab and Result/Outcome is ordered for a patient with Paget's Disease or Osteosarcoma?

Lab: Alkaline Phosphatase
Result/Outcome: Increased

74

What Special Test and Result/Outcome is ordered for a patient with Paget's Disease or Osteosarcoma?

Special Test: Bone Scan
Result/Outcome: Hot

75

What is the most common malignancy found in children?

Osteosarcoma

76

In what area of the bone is Osteosarcoma seen?

Diaphyseal

77

What age group is Osteosarcoma seen in most commonly?

10-30

78

What kind of reaction is seen in Osteosarcoma?

Periosteal Reaction

Speculated
Radiating
Sunburst

79

What two conditions are seen in patients over the age of 40, that have a periosteal reaction (Speculated/Radiating/Sunburst) reaction of bone?

Chondrosarchoma
Fibrosarcoma

80

What condition of bone is often seen in patients aged 10-25 years old?

Ewing's Sarcoma

81

In what area of the bone is Ewing's Sarcoma often found in?

Diaphysis of Long Bones

82

What type of Periosteal Reaction is seen in Ewing's Sarcoma?

Multi-Paralleled Onion Skin (Laminated)

83

What are three other x-ray findings associated with Ewing's Sarcoma?

Bone expansion
Codman's Triangle
Saucerization

84

What is the name of the condition see in patients over 40 years old, that is described as "Aberrant notochordal Cell tumor"?

Chordoma

85

What are the two most common locations for a Chordoma?

Most Common- Sacrum
2nd Most Common- Skull

86

What age and gender range are most effected by scoliosis?

Females
13-19

87

How is scoliosis named?

For the side of major Convexity

88

What is the most common type of Scoliosis?

Right Thoracic Convex Idiopathic Scoliosis

89

In Rotatory Scoliosis to which side do the Spinous Processes deviate?

Concavity

90

In Simple Scoliosis what way do the Spinous Processes deviate?

Convexity

91

What two lines are used to measure Scoliosis?

Cobb's
Resser Ferguson's

92

What is the treatment of a patient that has a scoliosis that measures under 20 degrees?

Adjust and Monitor

93

Scoliosis: What range (in degrees) would you send a patient to an orthopedist for a Milwaukee Brace?

21-40 degrees

94

Over how many degrees is a patient with scoliosis referred to a surgical consultant?

Over 40 degrees

95

If a patient has a scoliosis of over 50 degrees what are to complications to be worried about?

Cardio-Pulmonary Compromise
Degenerative Joint Disease (DJD)

96

What are three way to monitor scoliosis?

Risser's Sign
Left wrist films (Best)
Tanner's Staging

97

What is Rheumatoid Arthritis called in Children?

Still's Disease

98

What are seven x-ray finding in a patient with Rheumatoid Arthritis (RA)?

-Symmetrical Distribution
-Bilateral uniform loss of joint space
-Rat bite erosions
-Pannus formation
-Periarticular Osteoporosis (Localized)
-Distal Interphalangeal (DIP) joint spared
-Atlanto-Axial Instability

99

What four signs seen in the hands of a patient with Rheumatoid Arthritis (RA)?

Haygarth's nodes (Metacarpal Phalangeal (MCP) Joints)
Swan Neck deformity
Boutonniere Deformity
Ulnar or Fibular deviation (Lanois Deformity)

100

With a patient with Rheumatoid Arthritis (RA), what is the associated condition described as "Benign swelling of the semimembranosus bursa"?

Baker's Cyst (Popliteal Fossa)

101

What four Labs with be positive in a patient with Rheumatoid Arthritis (RA)?

RA Latex
FANA
Erythrocyte Sedimentation Rate (ESR)
C Reactive Protein (CPR)

102

What type of anemia is seen in a Patient with Rheumatoid Arthritis (RA)?

Normocytic Normochromic Anemia

103

What is the name of the condition that is seen in a patient with Rheumatoid Arthritis (RA) and also has dry eyes and mouth?

Sjogren's

104

What is another name for Ankylosing Spondylitis (AS)?

Marie Stumpell

105

Who would you co-manage patients with Rheumatoid Arthritis (RA), Systemic Lupus Erythematosus (SLE) and Ankylosing Spondylitis (AS)?

Rheumatologist

106

What age and gender does the condition of Ankylosing Spondylitis (AS) affect?

Male
15-35 years of age

107

Where does Ankylosing Spondylitis (AS) start?

Sacroiliac (SI) joint

108

What is an early sign of Ankylosing Spondylitis (AS)?

Low Back Pain (LBP) with morning stiffness

109

What condition is Ankylosing Spondylitis (AS) associated with?

Anterior Uveitis (Iritis)

110

What three orthopedic test are performed on a patient with Ankylosing Spondylitis (AS)?

Chest expansion
Forester's Bowstring
Lewin Supine

111

What is the radiographic finding of the Sacroiliac (SI) joint in Ankylosing Spondylitis (AS)?

Bilateral Sacroiliac (SI) joint fusion (Ghost Joints)

112

What are the seven radiographic findings in Ankylosing Spondylitis (AS)?

Shiny Corner Sign (Early)
Bilateral marginal syndesmophytes
Squaring of the vertebral bodies
Bamboo spine
Dagger Sign
Trolley Track Sign
Poker Sign

113

What two labs will be positive/increased in Ankylosing Spondylitis (AS)?

HLA B27
Erythrocyte Sedimentation Rate

114

What condition looks identical to Ankylosing Spondylitis (AS), in the pelvis but Gastrointestinal dysfunction?

Enteropathic Arthropathy

115

What are two other names for Enteropathic Arthropathy?

Crohn's Disease
Ulcerative Colitis

116

What is the age and gender that the condition of Psoriatic Arthritis is seen?

Males
20-50 years of age

117

What three signs will be present in a patient that has Psoriatic Arthritis?

Silver Scale lesion on extensors
Pitted nails
Cocktail sausage digits

118

What are six radiographic findings in a patient with Psoriatic Arthritis?

Non-marginal syndesmophytes of the spine
Increased joint space
Mouse ear deformities
Pencil in Cup deformity
Ray Sign
Atlanto-Axial instability

119

What lab will be positive in a patient with Psoriatic Arthritis?

HLA B27

120

What is another name for Reiter's Disease?

Reactive Arthritis

121

What gender and age does the condition of Reactive Arthritis commonly affect?

Males
20-30 (+/-)

122

What are three symptoms are seen in patients with Reiter's Disease?

Can't see, Can't pee, Can't Dance with me

Conjunctivitis
Urethritis
Arthritis (Heel Spur)

123

What Venereal disease is usually the cause of Reactive Arthritis?

Chlamydia

124

What are three radiographic findings seen in Reiter's Disease?

Non-Marginal Syndesmophytes of the spine
Calcaneal Spur (Heel Spur)
Fluffy Periostitis

125

What lab will be positive in the condition of Reactive Arthritis?

HLA B27

126

What gender is Systemic Lupus Erythematosus (SLE) most commonly seen in?

Females

127

What are the five signs/symptoms of Systemic Lupus Erythematosus (SLE)?

Malar/Butterfly rash (Sunlight precipitates a skin rash)
Oral ulcers
Discoid lesions
Alopecia
Raynaud's phenomenon

128

In what condition will Ulnar Deviation straighten out?

Systemic Lupus Erythematosus (SLE)

129

What Labs will be increased/positive in the condition of Systemic Lupus Erythematosus (SLE)?

LE Prep
FANA
Erythrocyte Sedimentation Rate (ESR)
Anti-DNA

130

What two things will be decreased in Systemic Lupus Erythematosus (SLE)?

Leukopenia (Decrease in White Blood Cells (WBC))
Thrombocytopenia (Decrease Thrombocyte)

131

What Is another name for Scleroderma?

Progressive Systemic Sclerosis

132

What gender and age is the condition of Progressive Systemic Sclerosis most commonly effect?

Females
30-50 years old

133

What symptom is associated with Scleroderma?

Erosion of the distal tufts of the phalanges

134

What condition has CREST syndrome?

Progressive Systemic Sclerosis

135

What is CREST Syndrome?

C- Calcinosis (Calcium deposits in the skin)
R- Raynaud's Phenomenon
E- Esophageal Dysmotility (Difficulty Swallowing)
S- Sclerodactyly (Tightening of skin of fingers or toes)
T- Telangiectasia (Dilation of capillaries)

Seen in the condition of Progressive Systemic Sclerosis

136

What Labs will be increased/positive in Scleroderma?

FANA
RA Latex (30%)

137

What is another name to Osteitis Condensans Ilia?

Osteitis Triangularis

138

What population is Osteitis Condensans Ilia seen in?

Multiparous Female
20-40 years of age

139

What condition has no labs and is self resolving?

Osteitis Condensans Ilia

140

What is the case management Osteitis Triangularis?

Trochanteric Belt for stability

141

What is the joint space on the x-ray in Osteitis Condensans Ilia?

Normal

142

What is the radiographic finding in Osteitis Triangularis?

Bilateral/Symmetrical triangular sclerosis areas on the lower half of the ilium

143

What is the most common joint affecting the knee?

Synoviochondrometaplsia

144

What condition is seen with "multiple loose bodies within the joint that are round or oval in shape"?

Synoviochondrometaplsia

145

What is another name for Neurogenic Arthropathy?

Charcot's Joint

146

What four conditions do you often see Charcot's Joints?

Diabetes
Tabes Dorsalis
Syphilis
Syringomyelia

147

What are the 6 D's in weight bearing joints?

Distension
Density of Subchondral sclerosis
Debris within the joint
Dislocation
Disorganization
Destruction of the bone

148

What are two other names for the condition of Diffuse Idiopathic Skeletal Hyperostosis (DISH)?

Forestier's Disease
Ankylosing Hyperostosis

149

What is the gender and age often seen is Diffuse Idiopathic Skeletal Hyperostosis (DISH)?

Male
Over the age of 40 years old

150

What symptom is seen in Ankylosing Hyperostosis?

Neck stiffness or pain on swelling

151

What other condition is commonly seen/associated Diffuse Idiopathic Skeletal Hyperostosis?

Diabetes Mellitus

Hemoglobin, A1c, Fasting Blood Sugar (FBS)

152

What ligament is ossified in Forestier's Disease?

Ossification Posterior Longitudinal Ligament (OPLL)

153

What are the radiographic finding of Diffuse Idiopathic Skeletal Hyperostosis (DISH)?

Four (4) contiguous segments involved
Flowing hyperostosis (Anterior Bridging)
Candle wax dripping
Disc space is preserved

154

What is the treatment for Forestier's Disease?

Adjust; as long as no facet involvement, no inflammation

155

The HLA B27 lab will be positive in what percentage of patient's with Ankylosing Hyperostosis?

30%

156

What is another name for Degenerative Joint Disease (DJD)?

Osteoarthritis

157

Is Degenerative Joint Disease (DJD) inflammatory or non-inflammatory disease?

Non-inflammatory

158

What are the most commonly involved joints in Degenerative Joint Disease (DJD)?

Weight Bearing Joints (Hip or Knee)

159

What is a common associated finding with Degenerative Joint Disease (DJD)?

Subchondral cyst

160

What condition usually become more stiff with rest and improves movement with activity?

Degenerative Joint Disease (DJD)

161

What are two complications of Degenerative Joint Disease (DJD)?

Spinal Canal Stenosis
Intervertebral Foramen (IVF) Encroachment

162

What is the most common area of the spine effected by Degenerative Joint Disease (DJD)?

C5/C6

163

What three findings will you see in a patient's spine with Degenerative Joint Disease (DJD)?

Intervertebral Disc (IVD) narrowing
Osteophytes
Endplate Sclerosis

164

What are four finding of the hand seen in patients with Degenerative Joint Disease (DJD)?

-Non-uniform loss of Joint space
-Heberden's Nodes seen at the Distal Interphalangeal (DIP) Joint
-Decreased joint space with sclerosis
-Asymmetrical Distribution

165

What is the x-ray finding of the hip in Degenerative Joint Disease (DJD)?

Decreased superolateral joint space with sclerosis

166

What is the radiographic finding of the knee in Degenerative Joint Disease (DJD)?

Decreased medial joint space with the lateral space preserved

167

What are three possible etiologies of Degenerative Joint Disease (DJD)?

Sports Injury
Unrelated Microtrauma
Genetic

168

What are the eight conditions classified as Inflammatory Arthritdes?

Rheumatoid Arthritis (RA)
Systemic Lupus Erythematosus (SLE)
Scleroderma
Osteitis Condensans Ilia

Psoriatic Arthritis
Enteropathic Arthropathy
Ankylosing Spondylitis
Reactive Arthritis (Reiter's)

169

What are the four conditions classified as Degenerative Arthritdes?

Degenerative Joint Disease (DJD) (Osteoarthritis)
Diffuse Idiopathic Skeletal Hyperostosis (DISH)
Neurogenic Arthropathy
Synoviochondrometaplsia

170

What are the four conditions classified as Metabolic Arthritdes?

-Gout
-Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD)
-Hydroxyapatite Deposition Disease (HADD)
-Septic Arthritis

171

What age and gender is Gout often seen in?

Males
Older the 40 years of age

172

What causes the condition of Gout?

Overproduction of uric acid

173

What are the signs/symptoms of Gout?

Extremely painful, red, hot and swollen joint(s)

174

What is the most common joint for the condition of Gout to effect?

Metatarsal Phalangeal (MTP) joint of the big toe

Gout is mono-articular

175

What is the term for a "swollen first metatarsal phalangeal (MTP) joint"?

Podagra

176

In the condition that has tophi crystals often the ear?

Gout

177

What are the two radiographic findings in Gout?

Overhanging Margin
Juxta-articular erosion

178

What labs will be positive/increased in the condition in Gout?

Increased Uric Acid
Positive Erythrocyte Sedimentation Rate (ESR)

179

What Special Test will be done in the condition of Gout?

Joint Aspiration

180

What is the pharmacologic approach to help patients with Gout?

Acute Gout: Colchicine
Chronic Gout: Allopurinol

181

Who is a patient with Gout referred to?

Rheumatologist

182

What is something a patient with Gout can do to decrease the symptoms?

Dietary Changes
(Don't consume Red Wine and Cheese, purines are bad)

183

What is another name for Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD)?

Pseudogout

184

What condition has "Thin linear calcification parallel to the articular cortex within the joint space"?

Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD)

185

What joint is Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD) most commonly seen in?

Knee

186

What is the condition when the cartilage is affected with Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD)?

Chondrocalcinosis

187

What is the best way to diagnosis and confirm Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD)?

MRI

188

What condition most commonly effects the shoulder?

Hydroxyapatite Deposition Disease (HADD)

189

What are the radiographic findings of Hydroxyapatite Deposition Disease (HADD)?

Round or oval calcifications near the insertion of the bursa or tendon

190

What condition destroys the disc and has a lab of an increased White Blood Cell (WBC) counts?

Septic Arthritis

191

How will an patient with Septic Arthritis present to the office?

Fever
Chills
Possible history of trauma/surgery

Joint will be:
Warm
Tender
Swollen

192

What are two other terms of Avascular Necrosis (AVN)?

Osteonecrosis
Osteochondrosis

193

What is the major cause of Avascular Necrosis (AVN)?

Trauma

194

How long does it take Avascular Necrosis (AVN) to heal?

8 months to 2 years

(All Avascular Necrosis (AVN) are Self-Resolving)

195

What condition can Avascular Necrosis (AVN) lead to?

Degenerative Joint Disease (DJD)

196

What two test are Special Test for Avascular Necrosis (AVN)?

Bone Scan
MRI

197

What is the most common Avascular Necrosis (AVN) of the hand?

Scaphoid (Carpal Bone)

198

What is the name of the Avascular Necrosis (AVN) of the Scaphoid?

Preiser's

199

What is the name of the Vertebral End Plate Epiphysis Avascular Necrosis (AVN)?

Scheuermann's

200

What is the location effected by Legg Calve Perthes?

Femoral (Head) Epiphysis

Avascular Necrosis (AVN)

201

What bone is effected in Kohler's Avascular Necrosis (AVN)?

Navicular (Tarsal)
(Kold Feet)

202

What is the most common dislocation of the hand?

Lunate (Carpal)

203

What is the name for the Avascular Necrosis (AVN) of the Lunate?

Keinboch's
(Kein Hands)

204

What bone is effected in Sever's Avascular Necrosis (AVN)?

Calcaneus

205

What is the location of Blount's Avascular Necrosis (AVN)?

Medial Tibial Condyle

206

Where does Freiberg's Avascular Necrosis (AVN) occur?

Head of the 2nd or 3rd Metatarsal

(Freiberg's Foot)
(Morton's Neuroma)

207

Where is the Osteochondritis Dessicans Avascular Necrosis (AVN) located?

Articular surface of the Lateral aspect of the Medial Femoral Condyle

208

When there is a Avascular Necrosis (AVN) of the Capitellum what is the name associated with it?

Panner's

209

What is the best radiographic view to see Osteochondritis Dessicans?

Tunnel View

210

What population do you often see Osteochondritis Dessicans in?

Athletes
+/- 16-25 years old

211

What condition has "knee locks out on extension" and associated with Wilson's Sign?

Osteochondritis Dessicans

212

What condition is most commonly seen +/- 10-16 year olds?

Scheuermann's Disease

213

What are the signs of Scheuermann's Disease?

Round of the shoulders
Increased Kyphosis
Young patients with back pain

214

What are two radiographic signs of Scheuermann's Disease?

-Slight loss of the anterior body height; of one or more vertebrae (10-15%)

-Multiple endplate irregularities of three or more continuous vertebrae

215

What are four Case Management ideas for a patient with Scheuermann's Disease?

Thoracolumbar Brace
Strengthen Erector musculature
Stretch the Pectoralis muscle
Stop Physical Activates

216

What two things can Scheuermann's Disease lead to?

Permanent Postural Deformities
Early Degenerative Joint Disease (DJD)

217

What is the name of the condition that has an Avascular Necrosis (AVN) of the femoral head?

Legg Calve Perthe's

218

What population is Legg Calve Perthe's most commonly seen in?

+/- 4-9 Obese Males

219

What are four radiographic findings will you see in Legg Calve Perthe's?

-Fragmentation of the femoral head (Crescent Sign)
-Flattening of the femoral head
-Increased white density of the femoral head (Snow Capped Appearance)
-Increased joint space

220

What is the appearance of a healed Legg Calve Perthe's?

Mushroom Capped Appearance

221

Who would you refer a patient with Legg Calve Perthe's?

Orthopedist for an "A" Brace

222

What Type of Salter Harris is the condition Slipped Capital Femoral Epiphysis?

Type 1 Salter Harris

223

What gender and age is effected in the condition of Slipped Capital Femoral Epiphysis?

Males (Boy)
+/- 10-16 years of age

224

What direction does the femoral Head slide in Slipped Capital Femoral Epiphysis?

Inferior and Medial

225

What direction does the femoral Neck side in Slipped Capital Femoral Epiphysis?

Superior and Lateral

226

What three lines are used to assess Slipped Capital Femoral Epiphysis?

Klein's
Shenton's
Skinner's

227

In a patient that has Slipped Capital Femoral Epiphysis, who should they be referred to?

Orthopedist

228

What are the components of Putti's Triad, seen in Congenital Hip Dysplasia?

Hypolastic Femoral head
Shallow Acetabular Shelf
Femoral head outside of the Acetabulum

229

What are four orthopedic exams performed in patients with Congenital Hip Dysplasia?

Hip Telescoping
Ortolani's
Barlow's
Allis'

230

What is the name of the condition that has "Axial migration of the femoral head with uniform loss of joint space"?

Protrusio Acetabuli

231

What condition is often seen with Bilateral Protrusio Acetabuli?

Rheumatoid Arthritis (RA)

232

What other five conditions are often seen with Protrusio Acetabuli?

Osteoporosis
Osteomalacia
Paget's
Trauma
Idiopathic

233

What line is used to measure Protrusio Acetabuli?

Kohler's Line

234

On an x-ray what will be completely obliterated in the condition of Protrusio Acetabuli?

Kohler's Teardrop

235

What type of fracture is described as "Portion of the bone torn away by muscle or ligament by traction force"?

Avulsion Fracture

236

What is a Comminuted Fracture?

Fracture with more than two fragments

237

What is the term used for "Displacement or separation of a slightly moveable joint"?

Diastasis

238

What is a Compound (Open) Fracture?

Skin Ruptured and bone Exposed

239

In what population will you see a Greenstick/Hickory Stick Fracture?

Children, an incomplete fracture

240

How is an Impaction Fracture described?

Bone fragments driven into one another

241

What is the name of the fracture that has "one side of the cortex affected/ incomplete fracture?

Torus/Buckling Fracture

242

What kind of fracture is caused by insufficiency or repetitive motion?

Stress/Fatigue Fracture

243

What kind of fracture is not always seen on x-ray and my become more evident a week to ten days after the initial injury?

Occult Fracture

244

What is the name of the fracture that is seen in the first metacarpal?

Bennett's Fracture

245

What is the name of the fracture seen in the second and third metacarpals?

Boxer's Fracture

246

Where is a Bar Room Fracture most commonly seen?

Fracture of the forth and fifth metacarpal

247

What carpal bone is the most commonly fractured?

Scaphoid

248

What is the name given to the fracture of the proximal Ulna?

Nightstick Fracture

249

What is the name of the fracture that has a fractured ulna with radial head displacement?

Monteggia Fracture
M(OOO)UUUU
M= Monteggia
U=Ulna Fractured

250

How is a Galeazzi Fracture described?

Fracture of the distal 1/3 of the radius with dislocation of the distal radio-ulnar joint
GRRRRRRR
G=Galeazzi
R=Radial Fractured

251

What fracture type is a "Fracture of the distal radius with Posterior displacement of the distal fragment"?

Colles Fracture

252

What is a Smith's Fracture?

Fracture of the distal radius with Anterior displacement of the distal fragment

253

What is the common are of a March/Stress fracture to occur?

Second, Third, Forth metatarsals

254

What fracture usually occurs as a transverse fracture at the Base of the fifth metatarsal?

Jones Fracture

255

What is the name of an avulsion fracture of a Spinous process?

Clay Shoveler's Fracture

256

What is the most common area for a Clay Shoveler's Fracture to happen?

C6-T1

257

What is the cause of a Clay Shoveler's Fracture?

Hyper-flexion injury

258

What is the name of the fracture that is Unstable and effects the pedicels bilaterally of C2?

Hangman's Fracture

259

What is the most common cause of a Hangman's Fracture?

Hyper-extension injury

260

What fracture type is a "Fracture through the anterior and posterior arches of the atlas due to axial compression"?

Jefferson Bursting Fracture

261

What is often seen on x-ray in a patient that has a Jefferson Bursting Fracture?

Large Periodentoid Space

262

What type of Odontoid fracture is an "Avulsion of the tip of the dens"?

Type I

263

How is a Type II Odontoid Fracture described?

Fracture through the base of the dens

264

What Type of Odontoid Fracture is through the Body of C2?

Type III

265

What is the name of the fracture that is described as "Avulsion fracture of the anterior inferior aspect of the vertebral body from a hyperextension trauma"?

Teardrop Fracture

266

Where is the most common place for a Teardrop Fracture to happen?

C2

267

What other issues is seen in patient's with a Teardrop Fracture?

Acute Anterior Cervical Cord Syndrome

268

Is a Teardrop Fracture stable or unstable?

Highly Unstable Fracture

269

What condition effects the Tibial Apophysis in patients of +/- 10-16 years of age?

Osgood Schlatter's

270

What kind of brace is used in Osgood Schlatter's Disease?

Cho-Pat Brace

271

What are two symptoms of Osgood Schlatter's Disease?

Pinpoint Pain
Swelling

272

What is the name of the avulsion fracture of the ischial tuberosity?

Rider's Bone Fracture

273

What fracture is described as a "Horizontal fracture through a single body and posterior arch"?

Chance Fracture

274

What is another name for the Chance Fracture?

Seatbelt Fracture

275

What is the most common levels for a Seatbelt/Chance Fracture to occur at?

L1-L3

276

What condition is a "Fracture through the pars interarticularis without slippage?

Spondylolysis

277

How is the condition of Spondylolisthesis described?

Slippage of the vertebral body with or without fracture

278

What type of Spondylolisthesis is a Congenital defect?

Type I/ Dysplastic

279

What is the definition of a Type II/Isthmic Spondylolisthesis?

Fracture through the Pars

280

What is the most common level of a Type II/Isthmic Spondylolisthesis?

L5

281

What is a common population to see a Type II/Isthmic Spondylolisthesis?

Gymnast

282

What is the Type of Spondylolisthesis that is Degenerative Joint Disease (DJD) of the facet joint?

Type III/Degenerative

283

What is the most common level to have a Type III/Degenerative Spondylolisthesis?

L4

284

Where is the fracture located in a Type IV/Traumatic Spondylolisthesis?

Fracture through the pedicle (Fracture anywhere but the Pars)

285

What Type of Spondylolisthesis is considered Pathological?

Type V

Seen in Bone Diseases (i.e Paget's)

286

What two grades of Spondylolisthesis can be Adjusted?

Grade 1
Grade 2

287

What is the preferred Grading Scale of Spondylolisthesis?

Meyerding's

288

What are the grades and percentages of Spondylolisthesis?

Grade 1- Up to 25%
Grade 2- 26-50%
Grade 3- 51-75%
Grade 4- 76-100%

289

What Grade of Spondylolisthesis has the Radiographic finding of "Inverted Napoleon Hat Sign"?

Grade 3
Grade 4

290

What is the purpose of flexion and extension films?

Stability

291

What Special Test should be order in a patient that has a Spondylolisthesis?

SPECT

292

What is the most common dislocated carpal bone?

Lunate

293

What is associated with a Lunate Dislocation?

Pie Sign

294

What two signs are associated with a Scaphoid Dislocation?

Terry Thomas Sign
Signet Ring Sign

295

What joint is effective in a chronic anterior shoulder dislocation?

Glenohumeral Joint

296

What two deformities are seen in Glenohumeral Joint Dislocation?

Bankhart
Hill-Sacks/Hatchet

297

What is a SLAP Lesion?

Superior Labrum Anterior to Posterior

298

What is torn is a SLAP Lesion?

Glenoid Labral Tear

299

What condition is associated with a SLAP Lesion?

Shoulder Instability

300

What is the Congenital Anomaly that the "Arcuate foramen form when the Atlanto-occipital ligament calcifies"?

Posterior Ponticus

301

What is another name for the Posterior Ponticus?

Posticus Ponticus

302

What two structures are transmitted through the Posticus Ponticus?

Sub-occipital nerve
Vertebral Artery

303

What condition is there a 20% missing of the Transverse Ligament?

Down's Syndrome

304

What area will be increased on radiographic films in a Patient with Down's Syndrome?

Atlanto Dens Interspace (ADI)

Must do flexion and extension films before adjusting

305

What is the name of the condition when the "cephalic part of the dens is not fused with the body of C2?

Os Odontoideum

306

What finding are seen on the x-ray of a patient that has an Os Odontoideum?

Smooth, Wide, Lucent defect between the body of C2 and the dens

307

What condition has two adjacent vertebrae ossified at birth?

Congenital Block

308

What are two radiographic findings in Congenital Block?

Wasp Waist Appearance
Hypoplastic (Rudimentary) Disc

309

What condition has the following three symptoms:
Short Webbed Neck
Low Hair Line
Decreased Range of Motion (ROM)?

Klippel-Feil Syndrome

310

What two other conditions is Klippel-Feil syndrome associated with?

Sprengle's Deformity
Onovertebral Bone

311

What is the definition of Klippel-Feil Syndrome?

Multiple Congenital Blocks

312

What two associated conditions are seen in Pedicle Agenesis?

Contra lateral pedicle hypertrophy
Sclerosis

313

What is the name of the Congenital Anomaly that is "Failure of the anterior center of the vertebral body to ossify properly"?

Butterfly Vertebra

314

What is the Congenital Anomaly that has "Failure of development of a lateral ossification center"?

Hemivertebra

315

What condition can an isolated wedged vertebra (Hemivertebra) cause?

Scoliosis

316

What type of deformity is often seen with a Hemivertebra?

Gibbus Deformity

317

What Congenital Anomaly is "Failure for the lamina to fuse"?

Spina Bifida

318

In the condition of Spina Bifida, what lab will be Increased and what macronutrient with be Deficient?

Increased: Fetoprotein
Deficient: Folic Acid

319

What is Sacralization (Transitional Vertebrae)?

L5 Transverse Processes (TP) may fuse or form joints with the sacrum

320

What is it called if a patient has six lumbar vertebrae or the first sacral segment appears like a lumbar segment?

Lumbarization (Transitional Vertebrae)

321

What is it called when two articular plans/facets are asymmetrical?

Facet Tropism

322

What is the most common level for Facet Tropism to occur?

L5/S1

323

What is Knife-Clasp Syndrome?

Spina Bifida of S1 with L5 Spinous enlargement

324

In what movement is pain caused in Knife-Clasp Syndrome?

Extension

325

What is the angle for Coxa Vara and Coxa Valga?

Cox Vara: Less than 120 degrees

Cox Valga: Greater than 130 degrees

326

What line is used to measure both Coxa Vara and Coxa Valga?

Mikulicz's

327

What is the name of the abnormality of the upper extremity that has a shortened distal radius?

Madelung's Deformity

328

What two things can cause Madelung's Deformity?

-Asymmetrical prominence of the ulnar styloid (Radial Deviation)
-Posterior subluxation of the distal ulna

329

What is the upper extremity abnormality that is described as "Ulna is usually shorter than the radius"?

Negative Ulnar Variance

330

When is a Negative Ulnar Variance often seen?

With a Scapho-Lunate dislocation

331

What is the name of the condition that has "Calcification of the medical collateral ligament"?

Pelligrini Steida

332

What is the name of the condition that has "calcification of a muscle belly"?

Myositis Ossificans

333

What two muscles will you often see the condition of Myositis Ossificans?

Biceps
Quadriceps

334

What is the name of the condition that has "calcification within veins"?

Pheboliths

335

Is Pheboliths symptomatic or asymptomatic?

Asymptomatic

336

On what x-ray view will you see the Fat Pads of the elbow?

Lateral

337

What is often seen when the Fat Pats of the Elbow are disrupted?

Fracture of the radial head

338

What age and gender do you often see a Calcified Prostate?

Males
Over the age of 50

339

Where is the prostate located/ where will the patient feel pain?

On top of the symphisis pubis

340

What two labs are increased if a patient has Prostate issues?

Prostate Specific Antigen (PSA)
Acid Phosphatase

341

Where does Prostate issues most commonly metastasize to?

Lumbar Spine

342

What lab will be increased in metastasized prostate issues?

Alkaline Phosphatase

343

What is the most common benign tumor in females?

Uterine Fibroid

344

What are two other names for a Uterine Fibroid; tumor of smooth muscle?

Fibroid Cyst
Leiomyoma

345

What is the referral pain for a patient with Cholelithiasis?

Inferior border of the right scapula (Viscerosomatic)

346

What organ does the term Cholelithiasis refer to?

Gallbladder

347

What two Special Test are used for the condition of Cholelithiasis?

Ultrasound
Cholecystogram

348

What is the most common location of a Abdominal Aortic Aneurysm (AAA)?

Distal to the Renal Arteries

349

At what diameter is it classified as an Abdominal Aortic Aneurysm (AAA)?

Larger than 3.8 cm

(Normal Abdominal Aortic can measure up to 3.8 cm)

350

What are three radiographic findings of Abdominal Aortic Aneurysm (AAA)?

Aortic Dilation
Curvilinear Calcification
Fusiform Appearance

351

What four Special test would you do for a patient who has an Abdominal Aortic Aneurysm (AAA)?

Doppler Ultrasound
Diagnostic Ultrasound
Ultrasonography
CT

352

Who do you refer a patient with an Abdominal Aortic Aneurysm (AAA) to?

Vascular Specialist

353

What are the two classic radiographic findings in the condition of Sickle Cell Anemia?

"Hair on End" in the skull
"H" shaped vertebrae

354

What are two other names for Thalassemia?

Cooley's Anemia
Mediterranean Anemia

355

What condition is seen with a "Hereditary disorder of hemoglobin synthesis"

Thalassemia

356

What kind of Anemia is seen in patients with Thalassemia?

Microcytic Hypochromic Anemia

357

What are the two x-ray finding is patients with Thalassemia?

"Erlenmeyer Flask deformity"-- Widened Epiphysis
"Hair on End" in the skull

358

What gender and age is Hyperparathyroidism often seen in?

Females
30-50 years old

359

What two things does an overactive Parathyroid gland cause?

Increase: Blood Calcium
Decrease: Phosphorus

360

In what condition will you see "Brown Tumors" (Central Geographic osteopenia in bones)?

Hyperparathyroidism

361

What are the two classic radiographic findings in Hyperparathyroidism?

"Salt and Pepper" Skull
"Rugger-Jersey Spine"

362

What lab will be increased in Hyperparathyroidism?

Alkaline Phosphatase

363

What is another name for Osteopetrosis?

Marble Bone

364

What condition is hereditary and an absents of bone marrow?

Osteopetrosis

365

What are two associated conditions with Osteopetrosis?

Anemia
Hepatosplenomegaly

366

What are the early and late radiographic findings of Osteopetrosis?

Early: "Bone within a Bone"
Late: "Sandwich Vertebrae"

367

A deficiency in one of the three following macronutrients can cause Rickets?

Vitamin D
Vitamin C
Phosphorus

368

Where is Rickets most commonly seen?

At the growth plates, usually of long bones

369

What are common muscle finding in a patient with Rickets?

Weakness
Tetany

370

What will be three things seen on x-ray in a patient with Rickets?

-"Paintbrush Metaphysis" (Absent zone of Provisional Calcification)
-Bone Deformity
-Lucency

371

What special imaging uses a contrast and has a 10X better image quality than plan film?

CT

372

What kind of units is a CT measured in?

Hounsfield

373

What are seven major conditions that can a CT help with?

1. Anything in the LUNG
2. Aneurysms
3. Brodie's Abscess
4. Spina Bifida
5. Spondylitis
6. Spinal Canal Stenosis
7. Lateral Recess Stenosis

Minor Things:
Discitis
Osteomyelitis
Occult fractures
Bone fragment locations
Intra-articular fractures
Calcification of soft tissue
Traumatic Lesions
Pathologies
Abnormalities

374

What Special Imaging measures bone Density for Osteoporosis?

Dual Energy X-Ray Absorptiometry (DEXA Scan)

375

What is the usual radioactive injection substance in a Bone Scan?

Technetium 99

376

What is another name for a Bone Scan?

Scintigraphy

377

What does a Bone Scan measure?

"Attempt" to lay down new bone

378

What condition does a Cold Bone Scan indicate?

Multiple Myeloma (MM)

379

What five conditions does a Hot Bone Scan indicate?

Avascular Necrosis (AVN) (ALL)
Metastatic Disease (Blastic and Lytic)
Paget's
Hodgkin's
Fractures

380

What Special Imaging shows Soft Tissue 100x better than CT?

MRI

381

MRI does not use radiation, what is used instead?

Gadolinium

382

What three conditions is MRI best for?

Multiple Sclerosis (MS);plaqueing in brain and spinal cord
Avascular Necrosis

383

T1 weighted MRI are used for what conditions?

Fatty Pathologies (i.e. Muscular Dystrophy)

384

T2 weighted MRI are used for what conditions?

Water Density (i.e. Cerebrospinal Fluid (CSF))

385

What color is bone on MRI?

Black (Signal Void)

386

In an MRI what color is the weighted component?

White

387

What Special Imaging utilizes signal intensities and surface coils?

MRI

388

What Special Imaging is used for Soft Tissue?

MRI

389

What six components are seen using the Special Imaging; MRI?

Intervertebral Disc (IVD)
Spinal Cord
Meninges
Meniscus
Ligaments
Bone

390

Where is the Basilar Angle Line drawn from?

Drawn from the nasion to the center of the Sella Turcica
A line is drawn from the basion (Anterior Foramen Magnum) to the center of the Sella Turcica.

391

What is the Significance of (Martin's) Basilar Angle?

If the angle is greater than 152 degrees it indicates Platybasia which is associated with Basilar Impression

392

What are the landmarks that McGregor's Line is drawn from?

From the hard palate to the base of the occiput

393

What is the significance of McGregor's Line?

**Most accurate line to evaluate Basilar Impression**

If the odontoid is greater than 8mm above this line in males, or greater than 10mm in females, it indicates Basilar Impression

394

What are the landmarks of Chamberlain's Line?

Hard palate to the Opishtion (Posterior foramen Magnum)

395

What is the significance of Chamberlain's Line?

If the odontoid is more than 7mm above this line, it indicates Basilar Impression

396

What Landmarks are McRae's Line drawn from?

Anterior foramen magnum (Basion) to the posterior foramen magnum (Opishtion)

397

What is the Significance of McRae's Line?

If the odontoid is above this line, it indicates Basilar Impression

398

What are the Landmarks used to measure the Atlantodental Interspace (ADI)?

C1 (Atlas) anterior tubercle to the odontoid

399

What is the Significance of the Atlantodental Interspace (ADI)?

Space larger than 3mm in Adults, 5 mm in Children

Indicates: Transverse ligament rupture or instability due to trauma

Down's Syndrome or Inflammatory Arthritis

400

What Landmark's are used to drawn George's Line?

Posterior body margins are checked for alignment with what should be a smooth, continuous line

401

What is the Significance of George's Line?

Discontinuous, line may indicate A-P vertebral malposition such as:
Anterolisthesis
Retrolisthesis

402

What Landmarks are used to draw the Posterior Cervical Line?

Lines drawn at each spinolaminar junction should form a smooth arc-like curve

403

What is the Significance of the Posterior Cervical Line?

Discontinuous, line may indicate A-P vertebral malposition such as:
Anterolisthesis
Retrolisthesis

404

What are the Landmarks for the Stress Lines of the Cervical Spine?

Lines are drawn at the posterior bodies of C2 and C7

405

What is the Significance of the Stress Lines of the Cervical Spine?

Flexion should intersect at C5/C6
Extension should intersect at C4/C5

May be altered by muscle spasm, joint fixation, or disc degeneration

406

What is the Landmarks for Prevertebral Soft Tissue?

Anterior vertebral bodies to posterior margins of air shadow of:
Pharynx
Larynx
Trachea

407

What is the significance of the Prevertebral Soft Tissues?

Indicates a soft tissue mass, tumor (No accident), infection, Hematoma (Injury)

**Spaces**
Retropharyngeal (C2-C4): Greater than 7 mm
Retrolaryngeal (C5): Greater than 14 mm
Retrotracheal (C6-C7): Greater than 22 mm

408

What Landmarks are used for Cobb's Method?

Locate the superior and inferior extremes of the scoliosis

Draw a parallel line through the superior end plate of extreme superior vertebra and though the inferior end plate of the extreme inferior vertebra

Intersecting perpendicular lines are drawn and the angle is measured

409

What is the Significance of Cobb's Method?

Best Method to evaluate Scoliosis

410

What Landmarks are used for Risser-Ferguson Method?

Locate the superior and inferior extremes of scoliosis and the apical segment

Diagonal lines are drawn to locate the center of the vertebral bodies

Two lines are drawn connecting the center of the apical segment with each end vertebra and resulting angle is measured

411

What is the Significance of Risser-Ferguson Method?

Scoliosis Evaluation

Values are 25% below Cobb Method of evaluation

412

What Landmarks are used to draw Sacral Inclination?

Tangential line is drawn parallel and through the posterior margin of S1 and a vertical line is drawn intersecting the sacral line

413

What is the Significance of Sacral Inclination?

Hypo/Hyperlordosis

Normal angle: 30-72 degrees
Average angle: 46 degrees

414

What Landmarks are used to draw the Lumbosacral Angle?

Oblique lines are drawn through and parallel to the sacral base

Horizontal line parallel to the bottom or the edge of the film

415

What are two other names for the Lumbosacral Angle?

Sacral Base Angle
Ferguson's Angle

416

What is the Significance of the Sacral Base Angle?

Hypo/Hyperlordosis

Normal angle: 26-57 degrees
Average angle: 41 degrees

417

What Landmarks are used to draw Meyerding's Grading Method of Spondylolisthesis?

The sacral base is divided into quadrants and the relative position of the posterior inferior aspect of L5

418

What is the Significance of Meyerding's Grading Method?

Determines the degree of Anterolisthesis

419

What Landmarks are used to draw Ullman's Line?

Line drawn parallel and through the sacral base
Perpendicular line drawn from the sacral promontory

420

What is another name for Ullman's Line?

Garland Thomas Line?

421

What is the Significance of Ullman's Line?

L5 beyond the perpendicular line: Spondylolisthesis

422

What are the Landmarks used to draw Eisenstein's Method?

Line drawn to connect the tips of the superior and inferior articular processes
The distance to the posterior body margin an the midpoint is measured

423

What is the Significance of Eisenstein's Method?

A measurement less than 15 mm: Spinal Canal Stenosis

424

What are the Landmarks used for Canal/Body Ratio?

A: Interpedicular Distance
B: Sagittal Canal Dimension (Eisenstein's Method)
C: Transverse Body Dimension
D: Sagittal Body Dimension

425

What is the Significance of Canal/Body Ratio?

Ratio: 1x2/3x4

Higher the ratio, the smaller the canal

If greater than 1.6 at L3, L4 of if the ratio is 1:6.5 at L5=
Canal Stenosis

426

What Landmarks are used to drawn the Lumbosacral Disc Angle?

Lines are drawn parallel and through the inferior end plate of L5 and the Superior end plate of S1

427

What is the Significance of the Lumbosacral Disc Angle?

Hypo/Hyperlordosis

Normal angle: 10-15 degrees

428

What is another name for Ferguson's Line?

Lumbar Gravity Line

429

What Landmarks are used to draw Ferguson's Line?

Vertical line is drawn though the center of the L3 vertebral body

430

What is the Significance of the Lumbar Gravity Line?

The line should intersect the sacral base

Line Anterior to the Sacrum: Hyperlordosis
Line Posterior to the Sacrum: Hypolordosis

431

What Landmarks are used to draw Macnab's Line?

A line is drawn parallel and through the inferior end plate

432

What is the Significance of Macnab's Line?

If the line intersects the superior articular process of the vertebra below:
Facet Imbrication
Extension Malposition

433

What Landmark's are used to draw Hadley's "S" Curve?

A curvilinear line is drawn along the inferior aspect of the transverse process and the inferior articular process, and through the joint space to the superior articular process of the vertebrae below

434

What is the significance of Hadley's "S" Curve?

Should be a smooth "S" shaped curve

An interruption in the "S" curve indicates:
Subluxation
Facet Imbrication

435

What are the Landmarks used to draw Kohler's Line?

A line is drawn along the Pelvic inlet to the outer aspect of the Obturator Foramen

436

What is the Significance of Kohler's Line?

If the Acetabular floor crosses the line it indicates:
Unilaterally: Protrusio Acetabuli
Bilaterally: Rheumatoid Arthritis (RA)

437

What Landmarks are used to draw Shenton's Line?

A smooth curvilinear line is drawn along the inferior femoral neck to the superior aspect of the Obturator foramen

438

What is the Significance of Shenton's Line?

An interruption/discontinuous line indicates:
Dislocation
Femoral Neck Fracture
Slipped Capital Femoral Epiphysis (SCFE)

439

What Landmarks are used to draw the Iliofemoral Line?

A smooth curvilinear line is drawn along the outer ilium, across the joint and onto the femoral neck

440

What is the Significance of the Iliofemoral Line?

Bilateral asymmetry indicated:
Slipped Capital Femoral Epiphysis (SCFE)
Dislocation
Fracture
Dysplasia

441

What Landmarks are used to draw the Femoral Angle?

Two lines are drawn through and parallel to the mid-axis of the femoral shaft and the femoral neck

442

What is another name for the Femoral Angle?

Mikulicz's Angle

443

What is the Significance of the Femoral Angle?

Normal is 120-130 degrees

Less than 120 degrees: Coxa Vara
Greater than 130 degrees: Coxa Valga

444

What Landmarks are used to draw Skinner's Line?

Line drawn through and parallel to the femoral shaft
Perpendicular line is drawn tangential to the tip of the greater trochanter

445

What is the Significance of Skinner's Line?

Fovea Capitus should lie above or at the level of the trochanter line.
If the Fovea Capitus falls below the line, it indicates:
Fracture
Coxa Vara
Cox Valga

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What Landmarks are used to draw Klein's Line?

A line is drawn along the outer margin of the femoral neck

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What is the Significance of Klein's Line?

The femoral head should intersect this line
Failure to intersect this line indicates:
Slipped Capital Femoral Epiphysis (SCFE)

448

What are the Landmarks used for the Patellar Position?

A line is drawn between the superior and inferior patellar pole
A line is drawn between the inferior patellar pole and the Tibial tubercle

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What is the Significance of the Patellar Position?

Patellar length and patellar tendon should be approximately equal

If the tendon length is 20% greater than the patellar length indicates:
Patella Alta

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What are the Landmarks for Heel Pad Measurement?

The shortest distance is measured between the plantar surface of the calcaneus and the external skin

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What is the Significance of the Heel Pad measurement?

If the distance is
Greater than 25 mm in males
Greater than 23 mm in females

Indicates increased thickening often associated with Acromegaly

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What are the Landmarks used for Boehler's Angle?

The three highest points on the superior aspect of the Calcaneus are connected with two lines

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What is the Significance of Boehler's Angle?

If the angle is greater than 28 degrees it indicates:
Calcaneal Fracture (Less than 22 Degrees)
Dysplastic Calcaneus

Normal Angle: 28-40 degrees
Average Angle: 34 degrees

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What are three signs/symptoms a patient with Reye's Syndrome will have?

Deafness
Neurological Defects
Seizures

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What condition will have Anderssen Lesions?

Ankylosing Spondylitis (AS)

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What condition will you see a Subchondral Cyst?

Degenerative Joint Disease (DJD)