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Image Interp II > Pelvis Hip & Femur > Flashcards

Pelvis Hip & Femur Flashcards

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1
Q

What findings & type of joint disease is demonstrated here?

A
  • Non-uniform loss of joint space on left (at superior femoral-acetabular joint space)
  • Subchondral sclerosis & subchondral cysts
  • Osteophyte at the acetabular margin

Degenerative arthritis (OA or DJD)

(Recommend for possible ortho referral)

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2
Q

Degenerative joint disease of the hip is termed ____

A

Malum coxa senilis

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3
Q

T/F: There is a good correlation between radiographic features of DJD in the hip & clinical picture

A

F

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4
Q

Non-uniform joint loss is common in the hip, specfically MC where

A

Superior femoral-acetabular joint space

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5
Q

Collar type ____ around femoral head/neck junction is a common radiographic feature in DJD of hip

A

Osteophytes

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6
Q

______ aka cortical thickening along medial femoral neck is a common radiographic feature in DJD of hip

A

Buttressing

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7
Q

A common radiographic feature in DJD of hip is ____ which demonstrates one medial joint space >2mm vs. the opposite side

A nonspecific sign

A

Waldenstrom’s sign

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8
Q

What findings are demonstrated here in this case of DJD of the hip?

A

Subchondral sclerosis & collar osteophyte around femoral neck

Also buttressing

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9
Q

What findings are demonstrated here?

A
  • Bilateral & symmetric distribution
  • Decreased joint space at axial portion of femoral-acetabular joint. decreases medial & superior → uniform loss of joint space
  • Periarticular osteopenia (yellow)

Infammatory disease process (Rhuematoid Arthritis)

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10
Q

Protrusio acetabuli in the hip is MC caused bilaterally by what disease process

A

RA

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11
Q

Bilateral, symmetric narrowing of axial joint space in the hip is associated with what disease process?

A

RA

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12
Q

What disease process is likely the cause of the findings here?

A

RA

DDX = bone softening diseases such as osteomalacia, padgets

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13
Q

What findings are demonstrated here?

A
  • Normal subchondral bone, normal joint spacing at the hip
  • Ill-defined, irregular margins at pubic symphysis
  • Monoarticular inflammatory arthritis → septic arthritis (until proven otherwise) or osteitis pubis
  • Recommend medical referral, CBC w/ blood culture to r/o septic arthritis

(Osteitis pubis common in young athletes, women post-childbirth)

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14
Q

15 y.o male

What type of disease process is demonstrated here & what is the likely cause?

A

Inflammatory arthritis in kids → juvenile idiopathic arthritis or hemophilia

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15
Q

_____ (malunion/nonunion) of pelvic fractures is uncommon; _____ (malunion/nonunion) is common

A

Nonunion; Malunion

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16
Q

Stable or unstable fracture

A

Stable

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17
Q

Stable or unstable fracture

A

Unstable

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18
Q

What kind of stable fracture

A

Duyerney fraction

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19
Q

What kind of unstable fracture

A

Straddle fx

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20
Q

What kind of unstable fracture

A

Malgaigne fx

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21
Q

What kind of unstable fracture

A

Sprung pelvis

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22
Q

What kind of unstable fracture

A

Bucket handle fx

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23
Q

What hip pathology is demonstrated here?

A

AIIS avulsion fx on the left (normal growth plate on right)

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24
Q

What findings are outlined here in an adolescent patient

A
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25
What findings are seen here?
- Extra bone on femur = post-traumatic heterotopic ossification - Disruption of arcuate line of sacrum on left side (pink) - Disruption of cortex in superior & inferior pubic ramus (yellow) - Unstable pelvic fx → Malgaigne fx (fx thru sup & inf pubic rami w/ fx or dislocation posteriorly around SI jt) - Refer for CT for further eval
26
What type of pelvic fx is demonstrated here?
27
What type of pelvic fx is demonstrated here?
28
What findings are demostrated here?
Abnormal Klein's line on the left Slipped Femoral Capital Epiphysis AKA Salter Harris Type 1 fx (Red = growth plates)
29
What are 3 major pediatric hip disorders?
Slipped Femoral Capital Epiphysis Legg-Calves Perthes Disease aka AVN Developmental Dysplasia
30
\_\_\_\_\_ (intracapsular/extracapsular) femoral neck fx has a worse prognosis due to AVN
Intracapsular
31
MC type of intracapsular fx; usually impacted, easily missed =
Subcapital fx
32
What type of intracapsular femoral neck fx is shown here?
Subcapital fx
33
Transverse fx through mid-neck = what type of intracapsular femoral neck fx
Midcervical fx
34
Transverse fx @ base of neck; pathologic fx's occur here = what type of intracapsular femoral neck fx
Basicervical fx
35
What type of femoral neck fx is demonstrated here?
Subcapital fx
36
What type of femoral neck fx is demonstrated here?
Midcervical fx
37
What type of femoral neck fx is demonstrated here?
Basicervical fx
38
What type of femoral neck fx's raises alarm bells for thinking there may be an underlying pathology for this fx?
Basicervical (intracapsular) & Subtrochanteric (extracapsular)
39
What are the 2 types of extracapsular femoral neck fxs?
Intertrochanteric Subtrochanteric
40
What type of extracapsular femoral neck fx is demonstrated here?
41
What type of extracapsular femoral neck fx is demonstrated here?
Subtrochanteric
42
What pathology is demonstrated here
Posterior hip dislocation (refer out for CT)
43
What are the 3 ddx based on the age & aggressive appearence of the lesion in this case?
- Ewing's Sarcoma - Osteosarcoma - Osteomyelitis
44
MC cause & location of osteomyelitis/septic arthritis?
Staph Aureus Femur
45
This case demonstrates a chronic case of \_\_\_\_
46
Phemister's triad consists of: And is associated with what condition
- Gradual loss of joint space (key for diff. from other inflamm processes) - Juxta-articular osteoporosis - Articular erosions Tuberculous Arthritis
47
What condition is demonstrated here?
48
An oval lucency (greater than 1cm) surrounded by sclerosis
(due to ankylosing of the joint, think infection therefore brodies vs. osteoid osteoma or osteoblastoma)
49
What are the most likely differentials of this aggressive process in the left ilium of this 65 y.o pt?
- Metastasis - Myeloma - Lymphoma
50
\_\_\_\_\_ seen below can be a ddx for blastic metastasis
Enostoma ("bone island")
51
What condition is associated with the findings seen here?
- Increased density, accentuated & enlarged trabeculae patterns on right - Filled in Kohler's teardrop → likely Paget's disease
52
What condition is likely the cause of the findings seen here?
red = blade of glass or flame sign (well demarcated border between normal & affected bone)
53
What condition is likely the cause of the findings seen here?
Fibrous Dysplasia Usually leave me alone lesion, may want ortho referral
54
What condition is likely the cause of the findings seen here?
Polyostotic fibrous dysplasia
55
What are the possible differentials associated with these findings?
- Small lucency (aka lucent nidus) surrounded by area of sclerosis - Osteoid Osteoma (usually smaller lucency therefore most likely) - Brodie's Abcess - Osteoblastoma
56
These findings are likely caused by what condition
Osteoid Osteoma
57
What condition is likely the cause of the findings seen here?
DDX: Osteosarcoma, Ewing's Sarcoma & Osteomyelitis
58
What condition is likely the cause of these findings?
AVN of femoral head bilaterally
59
What is the gold standard for dx of AVN?
MRI
60
Features of ____ include: - Sclerosis with cystic areas w/ generalized osteopenia of all surrounding osseus features - Linear subchondral lucency of femoral head known as crescent sign - Femoral head deformity
AVN
61
What condition is likely the cause of these findings?
Crescent sign outlined
62
What condition is likely the cause of these findings?
- Smaller, flattened, fragmented, sclerotic femoral head Legg-Calve-Perthes disease
63
What condition is likely the cause of these findings?
Widening of SI joints = hyperparathyroidism
64
What condition is likely the cause of these findings?
Putti's Triad: - Small femoral head - Laterally displaced femoral head - Increased acetabular angle DX: Developmental dysplasia of the hip
65
What condition is likely the cause of these findings?
Developmental dysplasia of the hip
66
What condition is likely the cause of these findings?
Tri-radiate pelvis → osteogenesis imperfecta

Image Interp II (10 decks)

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