Diagnostic Imaging - Shoulder

Question 1

At any given point in time only about ___ of the humeral head makes contact with the glenoid fossa

Answer 1

30%

Question 2

The scapulothoracic bursa is located between the

Answer 2

SA and the ribs

Question 3

Clavicle is considered what type of bone

Answer 3

long bone - even though it does not have a medullary canal

Question 4

Ossification of the shoulder skeletal components begins with the

Answer 4

two primary ossification centers of the clavicle at the 5th week of gestation

Question 5

When does the secondary center of the clavicle fuse

Answer 5

(the sternal side of the bone fuses with the shaft) between 18 and 25 years

Question 6

Which bone is typically the last of the long bones to fuse

Answer 6

clavicle

Question 7

When is the humeral head evident

Answer 7

6 months

Question 8

When is the greater tuberosity evident

Answer 8

1 to 3 years

Question 9

When is the lesser tuberosity evident

Answer 9

4 to 5 years

Question 10

The tuberosities fuse to the humeral head around what age

Answer 10

7

Question 11

The proximal epiphyseal plate is fused when

Answer 11

at about 19 years

Somewhat earlier for females than males

Question 12

The scapula ossifies primarily via

Answer 12

intramembranous ossification

Question 13

Coracoid
Appears:
Fuses to scap:

Answer 13

3-18 months

18-25 years

Question 14

Base of coracoid and upper glenoid fossa
Appears:
Fuses to scap:

Answer 14

7 years

15-18 years

Question 15

Acromion
Appears:
Fuses to scap:

Answer 15

14-20 years

22-25 years

Question 16

Inferior angle
Appears:
Fuses to scap:

Answer 16

15 years

20 years

Question 17

Vertebral borders
Appear:
Fuses to scap:

Answer 17

16 years

25 years

Question 18

Glenoid fossa
Appear:
Fuses to scap:

Answer 18

10 years

20 years

Question 19

Acromion has how many ossification centers And when are they normally fused by

Answer 19

It has two to three

Normally fused by 25 years

Question 20

If one or more acromion ossification centers don’t fuse it is called

Answer 20

os acromiale

Question 21

Os acromiale - sx

Answer 21

Often is asymptomatic but is risk factor for AC OA and impingement syndrome
Can also be mistaken for a fracture

Question 22

Standard projection shoulder

Answer 22

AP External Rotation

AP Internal Rotation

Question 23

AP External Rotation - Patient Position

Answer 23

Patient is placed in anatomic position
Humeral epicondyles are parallel to the film
Patient can be supine or upright

Question 24

AP Internal Rotation - patient position

Answer 24

Patient asked to place hand on abdomen

Question 25

Anatomical landmarks in AP internal rotation projection

Answer 25

1. Greater tuberosity on lateral humeral head 2. Lesser tuberosity on medial side of humeral head 3. Medial humeral head on glenoid fossa 4. Acromion and AC joint 5. Spine of scap 6. Coracoid process

Question 26

Hill Sach Lesion is often seen with what type of projection

Answer 26

AP internal projection | Groove like indentation on post-lat aspect of humeral head

Question 27

How does a Hill Sach lesion occur

Answer 27

Result of an anterior humeral dislocation

Question 28

Sprengel's deformity

Answer 28

Hypoplastic condition that develops in utero Most common congenital condition of shoulder Trauma has to occur for there to be a fracture of the scapula though

Question 29

Transcapular projections are used when

Answer 29

In traumatic situations when the shoulder is unable to move into various positions

Question 30

Transcapular projection is often used to assist in the evaluation of what type of condition

Answer 30

one that involves the humerus and the scapula

Question 31

What is visualized with a transcapular projection

Answer 31

Scapular spine Coracoid Acromion Proximal humerus with the humeral head over the glenoid

Question 32

Transcapular projection - patient position

Answer 32

30 degree oblique position (on side) | Patients arm remains at the side in neutral

Question 33

Transcapular projection - central ray moves in what direction

Answer 33

posterior to anterior

Question 34

What can you see with a transcapular view

Answer 34

``` Acromion Humeral head Coracoid Scap body Clavicle Prox shaft of humerus Ribs ```

Question 35

AC joint pathology can be from

Answer 35

traumatic and non traumatic conditions

Question 36

Most common reason for radiographic examination of the shoulder

Answer 36

Shoulder stability or lack thereof

Question 37

Most common procedures in traumatic events (AC Joint)

Answer 37

Zanca | AP bilateral

Question 38

Zanca AC joint - view

Answer 38

AP projection with central ray tilted upward 10-15 degrees - used if can't see what need with AP bilateral

Question 39

AP Bilateral

Answer 39

Allows for comparison of both joints

Question 40

AC joint radiographs - WB vs. NWB

Answer 40

WB - stress radiograph Attach 10-15 pound weight to patients hand or wrist Help to determine stability of AC joint

Question 41

When examining the stability of the AC joint what is measured

Answer 41

The clavicle position in relationship to the acromion and coracoid

Question 42

The distance between the articulating ends of the clavicle and the acromion should be

Answer 42

0.3 - 0.8 cm

Question 43

The coracoclavicular distance should be

Answer 43

1 - 1.3 cm

Question 44

If a fracture or dislocation of the SC joint is suspected what view is used

Answer 44

Serendipity view

Question 45

What is visible with a Zanca projection

Answer 45

Acromion Humerus Clavicle Glenoid