imaging of trauma in lower limb

Question 1

what are the 3 types of hip fractures

Answer 1

• intracapsular
• extra capsular
• subtrochanteric

Question 2

what type of hip fracture is likely to cause avascular necrosis

Answer 2

• intracapsular hip fracture

Question 3

what are the 4 imaging steps for a hip fracture

Answer 3

1. xray examination
2. xray diagnosis
3. fluoroscopy in theatre
4. post operative follow up

Question 4

what type of surgical option is chosen for a hip fracture with the femoral head in tact

Answer 4

DHS, dynamic hip screw

Question 5

what type of imaging modality is used for occult fractures

Answer 5

CT
MRI

Question 6

define occult

Answer 6

not accompanied by readily discernible signs or symptoms.

Question 7

imaging can aid in pre-operative planning

Question 8

MRI can detect bone bruising or chondral defects on the medial aspect of the patella

Question 9

what is a patellar chondral defect

Answer 9

occurs when the articular cartilage that lines the patella become damaged.

Question 10

what is a CT angiography with subtraction

Answer 10

Subtraction is a post-processing technique to eliminate high-density structures, such as bone, from CT images.

Question 11

what type of procedure can be done to stop traumatic femoral bleed due to fracture

Answer 11

interventional embolisation

• Embolization procedures allow blockage of blood vessels without invasive surgery. Embolization can be used to stop arterial bleeding, and can also be used to block blood vessels for other reasons, such as to treat tumors, shrink vascular malformations, or re-direct flow.
• interventional radiologist accesses the femoral artery at the groin. Small catheters and wires are used to navigate into the chosen artery, confirmed with angiography. An occluding substance can then be injected, or small coils can be placed into the artery to block the vessel.

Question 12

what is jumpers knee

Answer 12

Jumper’s knee is an overuse injury that happens when frequent jumping, running, and changing direction damages the patellar tendon.

Question 13

what is runners knee

Answer 13

Runner’s knee occurs when the kneecap rubs against the femur as it moves.

• pain in and around the kneecap (patella).

Question 14

what is hurdlers fracture

Answer 14

Avulsion of hamstrings caused by rapid contraction extending the hip and flexing the knee

Question 15

what does ORIF stand for and what is this

Answer 15

open reduction internal fixation

• surgical implementation of implants for the purpose of repairing a bone

(flat bar with loads of screws)

Question 16

what is interlocking intermedullary nail fixation

Answer 16

metallic implants used for the repair of traumatic long bone fractures. They consist of a large diameter rod, inserted into a bone medullary cavity and secured to it with locking bolts going from one cortex to another and capturing the nail inside the medullary cavity.

Question 17

what is an ankle sprain

Answer 17

due to rolling ankle etc, theres a stretch or tear in the ligaments that help hold your ankle bones together

Question 18

what are the 3 ligaments that can be affected in an ankle sprain

Answer 18

• posterior talofibular ligament
• anterior talofibula ligament
• calconeofibular ligament

Question 19

what are the 3 levels of ankle sprain

Answer 19

• grade 1 (stretching, small tears)
• grade 2 (larger but incomplete tear)
• grade 3 (complete tear)

Question 20

what imaging modality is used to assess extent of ligament damage

Answer 20

US
MRI

Question 21

what is the difference between a stable and unstable ankle fracture

Answer 21

If this ‘ring’ is broken at one site only, it remains stable, but if it is broken at two or more sites, it becomes unstable.

• if bone and ligament or several bony fractures = unstable

Question 22

what is a stress fracture

Answer 22

tiny cracks in a bone. They’re caused by repetitive force, often from overuse

(not apparent on initial radiography)

Question 23

what is a march fracture

Answer 23

• metatarsal stress fractures, are most commonly second and third metatarsal fractures caused by overuse injuries.
• result from a sudden increase in the intensity, duration, and frequency of activity without sufficient rest

Question 24

what is a hurdlers avulsion fracture

Answer 24

hamstring origin avulsion. In extreme cases, an avulsion fracture will occur where the hamstring muscle tears the bone where it attaches off your pelvis. This happens after a sudden and forceful eccentric contraction of your hamstrings with your hip flexed e.g. hurdling or performing the splits.