Imaging Notes

Question 1

What are the basic projection for the Acromioclavicular joint?

Answer 1

AP, bilateral without weights

AP, bilateral with weights

Question 2

What are the basic projections for the shoulder?

Answer 2

AP external rotation

AP internal rotation

Question 3

What is the normal distance between the clavicle and the coracoid process?

Answer 3

1.0- 1.3cm

Question 4

what is the normal distance between the clavicle and the acromion?

Answer 4

0.3- 0.8cm

Question 5

What are the routine radiologic evaluation of the scapula?

Answer 5

AP

Lateral

Question 6

What are the common radiograph views for a shoulder dislocation?

Answer 6

Axillary view and the scapular Y lateral view

Question 7

What are the fundamental tenets of musculoskeletal MRI for any joint?

Answer 7

Define anatomy

Detect abnormal fluid

Question 8

What are the ABCDS of MRI

Answer 8

Alignment
Bone signal
Cartilage
Edema
Soft tissue and synovial fluid

Question 9

Fractures of the body of the scapula are usually the result of ?

Answer 9

a direct blow or violent trauma and are relatively rare

Question 10

What are the basic projections of the elbow?

Answer 10

AP
Lateral
Obliques

Question 11

What are the basic projections of the hand?

Answer 11

PA
Lateral
Obliques

Question 12

What are the basic projections of the wrist?

Answer 12

PA
Lateral
Oblique

Question 13

The degree of severity of degeneration will affect the ability of the spine to withstand what ?

Answer 13

• trauma
• to assume postural changes
• make functional gains in mobility and movement patterns

Question 14

What is an example of a direct trauma to the spine?

Answer 14

Hit directly on the spine like getting hit with a bat

Question 15

What is an example of indirect trauma to the spine?

Answer 15

Severe fall or car accident

Question 16

What should physical evaluations of the spine include besides a diagnostic study?

Answer 16

Ligamentous stability test are very important to include after a trauma

Question 17

What are the basic projections of the cervical spine?

Answer 17

AP open mouth
AP lower C- spine
Lateral
Right and left oblique

Question 18

Why is the AP open mouth view important?

Answer 18

This view demonstrates the articulation of C1 and C2

Question 19

What would indicate ligamentous laxity or tear, fracture, or dislocation of the atlantoaxial joint?

Answer 19

Any alterations of landmarks in the AP openmouthed view

Question 20

What is important about the C2-C3 articulation and T1?

Answer 20

C2-C3 possesses the first intervertebral disk

T1 possesses the first rib articulation

Question 21

What is the lateral view of the cervical spine good for?

Answer 21

evaluating the intervertebral disks space

Question 22

Right and left obliques of the cervical spine are good for showing what?

Answer 22

intervertebral foramina

Question 23

What is the lateral; flexion and extension stress view used for?

Answer 23

to examine the joints at the end ranges of voluntary flexion nd extension

Question 24

What are the ABCDS of MRI for the spine?

Answer 24

Alignment
Bone signal
Canal space/ Central nervous system
Disk integrity
Soft tissues

Question 25

What is the main projection for TMJ?

Answer 25

Transcranial view

Question 26

Why would imaging of the cervical spine be included in the assessment of TMJ disorders?

Answer 26

- Pain associated with TMJ is usually in the sensory distribution of C2, C3, and C4 dermatomes - Postion of sub cranial joints can influence the biomechanics of the TMJ

Question 27

Chain of events that occur with the loss of cervical lordosis:

Answer 27

Mid cervical lordosis is flattened of reversed with forward head position - leads to a shift of load from lower cervical to midcervical and sub cranial spine - premature osteoarthritic changes of the facet joint - increased incidence of headaches

Question 28

What are the basic projections for the thoracic spine?

Answer 28

AP thoracic spine | Lateral thoracic spine

Question 29

What are the basic projection of the sternum?

Answer 29

Posterior oblique | Lateral

Question 30

What are the basic projections of the ribs?

Answer 30

AP or PA | Anterior oblique or Posterior oblique

Question 31

What does the AP and PA view of the ribs show?

Answer 31

AP shows the posterior ribs | PA shows the anterior ribs

Question 32

What does the oblique rib projection show?

Answer 32

Axillary ribs

Question 33

What imaging is generally used now for the thoracic and lumbar spines after a blunt trauma?

Answer 33

CT scan

Question 34

What is the primary modality to evaluate neural compromise, cord edema, cord contusion, epidural hematoma or ligamentous disruption?

Answer 34

MRI

Question 35

What is Risser's sign of skeletal maturity?

Answer 35

- 1+ indicates an excursion of the apophysis over 25% of the crest - 2+ means 50% of the crest is "capped" - 3+ is 75% is capped - 4+ is 100% capped - 5+ indicates osseous fusion is complete

Question 36

What is the Cobb method of measurement?

Answer 36

The Cobb method is a widely accepted radiographic measurement of scoliotic curves

Question 37

What is the general treatment guidelines for idiopathic scoliosis?

Answer 37

- Patients with curves of minimal magnitude: no active treatment; just observation - Patients with curves between 20 and 40 degrees: spinal bracing and exercise for several months - Patients with curves over 50 degrees: surgical fixation

Question 38

What are the basic projection of the chest?

Answer 38

PA | Left Lateral

Question 39

What does a PA view of the chest show?

Answer 39

Lung fields from the apices down to the costophrenic angles, air filled trachea, the heart, the great vessels, and the bony thorax

Question 40

What structures are best seen from the left lateral view of the chest

Answer 40

- Heart - Aorta - Posterier tracheal wall - Posterior esophageal wall - Left lung

Question 41

What information can echocardiography provide?

Answer 41

information on abnormalities in the pattern of blood flow, cardiac output and ejection fractions, function of the valves, thickness and motion of the heart wall etc.

Question 42

What are the basic projections of the lumbar spine?

Answer 42

AP Lateral Right and left obliques Lateral L5-S1

Question 43

What is spondylolysis?

Answer 43

only a fracture on one side "dog with collar"

Question 44

What is spondylolisthesis?

Answer 44

both sides have fractured and separated "dead dog"

Question 45

What is the basic projection of the Pelvis?

Answer 45

AP

Question 46

What is the basic projection of the hip and proximal femur?

Answer 46

AP | Lateral Frog leg

Question 47

What are the basic projections of the knee?

Answer 47

AP Lateral PA axial "tunnel" Tangential view "sunrise"

Question 48

What does the PA axial "tunnel" view of the knee show?

Answer 48

detects loose bodies in the joint, and possible osteochondral defects

Question 49

What is considered to be the most commonly injured, major weight bearing joint in the body?

Answer 49

The ankle

Question 50

why can subtle ankle and foot fractures be missed in initial examinations?

Answer 50

because the subtle fractures can be very similar to ankle sprains

Question 51

What are the basic projections of the ankle?

Answer 51

AP AP oblique Lateral

Question 52

What are the basic projections of the foot?

Answer 52

AP Lateral Oblique

Question 53

What are accessory bones?

Answer 53

an anomalous bone that usually form because of a failure of one or more ossification centers to unite with the main mass of bone

Question 54

What are the most commonly occurring accessory bones of the foot?

Answer 54

os trigonum os intermetatarseum os tibiale