Mid semester exam

Question 1

1 - Describe the major radiographic findings.

2 - What is the name of this condition and what is its aetiology?

Answer 1

1 -
Loss of height of the anterior portions of the vertebrae over multiple levels.

Trapezoidal shaped vertebrae. Irregular end plates.

2 -

Scheuermann’s

Avascular necrosis of the secondary ring of the vertebral body. Could be hereditary, endocrine or osteoporosis

Question 2

What is the site and age of Legg-calve-perthes?

Answer 2

Femoral capital epiphysis

3-12 (peak 5-7)

Question 3

What is the site and age of Friebergs?

Answer 3

Metatarsals heads of 2nd and 3rd digits of the feet

13-18 year old girls

Question 4

What is the site and age of Kienbocks?

Answer 4

Lunate

20-40 year olds, predominately males

Question 5

What is the site and age of Kohlers?

Answer 5

Navicular

5 year olds, predominantley males

Question 6

What is the site of osgood schlatters?

Answer 6

Tibial tuberosity (tibial tubercle apophysis)

Question 7

What is the aetiology of osgoods?

Answer 7

Traction apophysitis/ tendonitis caused by trauma or repetitive microtrauma.

Question 8

What are the radiological features of Osgood schlatters?

Answer 8

Soft tissue swelling

Patella tendon thickening

Bones appear with irregular isolated ossicles towards anterior margin of tuberosity.

Possible chondro osseous avulsion

Question 9

What is the best image to view radiographic findings?

Answer 9

T2 or Fat sat sagittal

Question 10

1 - Describe the radiographic findings?

2 - Give 3 different differentials.

3 - Choose one and outline your reasoning behind your diagnosis and radiographic findings.

Answer 10

1 -

Osteopaenia (widespread) enlargement of bones and epiphysis regions.

Eggshell thin cortices

Reactive sclerosis

Increased soft tissue density

Pseudocysts

Erosive changes - anteroinferior and posterosuperior calcaneus = interruption to cortices

2 -

Charcots joint

JRA

Osteogenesis imperfecta

Haemophilia

3 -

Juvenile RA - Causes enlargement of the epiphyseal regions. Also results in osteopaenia due to disuse or medications. Cortical thinning

Haemophilia - Juxtaarticular osteopaenia, haemarthrosis could cause the osteopaenia, joint disorganisation, cortical thinning, osteophytes.

Question 11

What are the films in a complete ankle series?

Answer 11

Dorsoplantar, lateral, medial oblique

Question 12

How would you go cobbs on this diagram?

Answer 12

:)

Question 13

What are the 3 areas of the body used to determine skeletal maturity?

Answer 13

Non-dominant hand - distal radial epiphysis

Vertebral ring epiphysis

Iliac epiphysis (risser sign)

Question 14

Provide some complications that may arise from the image seen above right

Answer 14

Degeneration (levels just above and below hardware), # around hardware, sensitivity to weather, infections from surgery, DJD, pain, Supp OM

Question 15

What age bracket and sex do we need to be concerned about with scoliosis?

Answer 15

Females, 12-16, convex left

Question 16

Outline the method to interpret chest films.

Answer 16

1 - Request details

2 - Technical

3 - Trachea

4 - Heart and mediastinum

5 - Diaphragm

6 - Pleura

7 - Lung fields

8- Hidden areas

9 - Hila

10 - Below diaphragm

11 - Soft tissue density

12 - Bone

Question 17

What are the major radiographical findings?

What is the diagnosis

Answer 17

Pancake/vertical heart

Hyperlucent lung fields

Barrel chest

Depressed diaphragm

Blebs

Hyperinflated

Diagnosis = emphysema

Question 18

1 - What are the black arrow heads pointing at?

2 - What are 2 possible reasons for the radiographic findings?

Answer 18

1 - Apophysis of the calcaneus

2 - Avulsion

Normal finding

Severs

Question 19

1 - What is the diagnosis?

2 - How might the patient present in the clinic?

Answer 19

1 - Hiatal hernia

2 - heart burn, chest pain, dysphagia, loss of weight, anorexia, reflux

Question 20

1. What is the diagnosis
2. What is the arrow pointing at?
3. What is the common age bracket for this patients condition?
4. Any other radiographic findings?

Answer 20

1. Perthes or Dwarfism
2. Sagging rope sign - intertrochanteric line
3. 3-12
4. Buttressing of femoral head, mushroom cap deformity, coxa magna, coxa vara

Question 21

1. What is this congenital malformation called?
2. Is it clinically significant?
   3.

Answer 21

1. Pectus carinatum
2. Yes, the restriction of the ribs could alter lung capacity - low tidal volume predisposes to pneumonia

Question 22

1. Describe 4 radiographic findings
2. What is the condition?

Answer 22

1. Flattened pelvis (champagne glass pelvis), mushroom cap femoral head, coxa magna, enlargement of lesser trochanter, diverticuli
2. Dwarfism

Question 23

1. What type of study is this?
2. Outline 8 muscles attaching to the scapula

Answer 23

CT bone window axial and coronal

Rotator cuff

Teres major

Levator scapulae

Latissimus dorsi

Trapezius

Deltoid

Pec minor

Omohyoid

Question 24

This is the L4/5 disc space

1. Which nerve root is displaced?
2. What reflexes would be affected
3. What muscles are affected by this nerve root?
4. What is A, B, C and D

Answer 24

1. L5
2. Achilles
3. • gluteus maximus muscle mainly S1.
   • gluteus medius muscle.
   • gluteus minimus muscle.
   • tensor fasciae latae.
   • tibialis anterior.
   • tibialis posterior.
   • extensor digitorum brevis.
   • extensor hallucis longus.
4. A = left L4 nerve root, B = right common iliac artery, C = Colon, D = facet

Question 25

1. What is the arrow pointing at? 2. Is this clinically significant? 3. Provide 1 other radiographic finding? 4. What is the type of study?

Answer 25

1. Bakers cyst 2. Can be painful and cause decreased ROM, and can also burst and cause a lot of pain. Can also cause pain with movement. 3. Increased fluid in the lateral femoral condyle 4. MRI Axial Fat sat

Question 26

1. What is the major radiographic finding? 2. How does it happen 3. What is the diagnosis? 4. Which ethnicity is this condition common in?

Answer 26

1. 'hair on end' 2. Due to marrow hyperplasia and widening of the diploe. 3. Sickle cell anaemia or thalassemia 4. Thalassemia = mediterranean, sickle cell anaemia = african american

Question 27

1. What is the radiographic finding? 2. What are 3 conditions that can cause this?

Answer 27

1. Splenomegaly 2. Sickle cell anaemia, rheumatoid arthritis, AIDs, osteoporosis, thalassaemia, haemophilia (blood transfusions)

Question 28

1. What is the arrow pointing to?

Answer 28

1. Renal calculi, calcified lymph node, malignant mass

Question 29

1. What is the type of image? 2. Which structure can be seen? 3. What are the contraindications to this study?

Answer 29

1. Intravenous pyelogram 2. Renal pelvis and part of the ureter 3. Allergy to contrast media

Question 30

What type of image is this?

Answer 30

T1 MRI

Question 31

What type of image is this

Answer 31

MRI T2

Question 32

What type of image is this?

Answer 32

Proton density

Question 33

What is the type of image? What lines of alignment would be most appropriate?

Answer 33

CT soft tissue window Cervical curve angle, cervical line of gravity, ALL, PLL

Question 34

What type of image is this? What lines of alignment would be most appropriate?

Answer 34

CT bone window Cervical curve angle, cervical line of gravity, ALL, PLL