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Fall Semester PM Exam 2 > Shoulder Diagnostic Imaging > Flashcards

Shoulder Diagnostic Imaging Flashcards

(67 cards)

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1
Q

The clavicle is a long bone without a what?

A

medullary canal

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2
Q

ossification of the shoulder complex begins with what bone and when?

A

clavicle at 5 weeks gestation

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3
Q

clavicle ossification

A

the secondary center of ossification at the sternal end fuses wit hthe shaft at age 18-25. the clavicle is the last long bone to fuse.

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4
Q

Scapulothoracic bursa location

A

Scapulothoracic bursa is between SA and the ribs. Repetitive mechanical trauma to this area is the cause of snapping scapula syndrome

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5
Q

primary factor for instability of GHJ

A

labrum

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6
Q

ossification center of humeral head is present at what age

A

6 months

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7
Q

GT ossifies when

A

age 1-3

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8
Q

LT ossifies when

A

age 4-5

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9
Q

at what age do the GT and LT fuse to the humeral head?

A

age 7

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10
Q

proximal epiphysial plates of humerus fuse at what age?

A

19

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11
Q

Scapula

A

7+ centers of ossification

intramembranous ossification, not endochondral

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12
Q

coracoid age appears and age fuses to scapula

A

appears at age 3-18 months

fuses age 18-25 yrs

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13
Q

base of coracoid and upper glenoid fossa age appears and age fuses to scapula

A

appears age 7

fuses age 15-18

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14
Q

acromion age appears and age fuses to scapula

A

appears age 14-20

fuses 22-25

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15
Q

inferior angle age appears and age fuses to scapula

A

appears 15

fuses 20

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16
Q

vertebral border age appears and age fuses to scapula

A

appears 16

fuses 25

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17
Q

lower 2/3 of glenoid fossa age appears and age fuses to scapula

A

appears 10

fuses 20

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18
Q

term that refers to the failure of the acromion to fuse

A

os acromiale

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19
Q

Os Acromiale

A

failure of the acromion to fuse
should be fused by age 25
often asyptomatic but a risk factor for AC OA
can be mistaken for an acromial fracture

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20
Q

minimum required projections of shoulder according to the ACR

A
  1. AP ER
  2. AP IR
  3. Lateral (Y) (transcapular)
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21
Q

AP ER position

A

supine or upright in true anatomical position

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22
Q

position of humeral epicondyles in AP ER

A

parallel to film

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23
Q

position of AP IR

A

supine or upright with hand on abdomen (purpose is so that shoulder is in IR position)

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24
Q

A hill Sach lesion is best seen on which projection?

A

AP IR

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25
Hill Sach lesion
anterior humeral dislocation | will see a groove-like indentation of the posterior lateral aspect of the humeral head
26
What is a Sprengel's deformity and what other abnormalities is it associated with?
hypoplasia of the scapula while in utero most common congential condition of the shoulder often accompanied by other congenital abnormalities and developmental delays
27
T/F scapular radiographs are not commonly ordered unless the patinet has a history of trauma
true
28
Transcapular projection also called
scapular y view (lateral view)
29
When is a Transcapular projection ordered?
post trauma when a patient cannot move their shoulder
30
what is imaged in a transcapular projection?
spine of scapula, coracoid, and acromion | proximal humeral head is seen positioned OVER the glenoid cavity
31
position of transcapular projection
30 degrees oblique arm at side in neutral central ray moves PA
32
which projection gives a clearer view of the ACJ?
Zanca ACJ projection
33
ACJ
often involved in traumatic and non-traumatic shoulder conditions implicated in development of impingement syndrome
34
most common reason for radiographic shoulder exam?
joint instability (ACJ)
35
when is a zanca ACJ projection ordered and what is it?
ordered if a bilateral AP projection of the ACJ is inadequate AP projection with central ray tilted up 10-15 degrees
36
purpose of zanca aCJ projection?
provides clear unobstructed view of ACJ
37
AP projection with central ray tilted up 10-15 degrees = which projection?
Zanca ACJ
38
Bilateral ACJ projection (plane)
AC joint is planar, meaning it offers limited stability
39
cause of ACJ pathology
overuse, leading to degenerative changes | examine aCJ via standard radiographic views
40
when is a bilateral AP projection of the ACJ done?
if instability is suspected
41
what type of radiograph helps us determine the level of ACJ instability?
stress radiograph: 10-15 lb weight attached to patients hand "WB" vs "NWB" WB and NWB help us determine level of instability!!!
42
what are we looked at/for in a stress radiograph of the ACJ?
the position of the clavicle in relationship to the acromion and the coracoid. this is used to determine ACJ stability
43
proper acromial-clavicular distance
0.3-0.8 cm
44
proper coracoclavicular distance
1.0-1.3cm
45
SCJ
more stable than ACJ susceptible to similar degenerative changes and inflammatory conditions as ACJ trauma is more likely to cause clavicular fracture than SCJ disruption
46
which view is used if fracture or dislocation of SCJ is suspected?
serendipity view: AP projection with central ray tilted up 40 degrees
47
AP IR projection: greater tuberosity is located where
GT is superimposed on lateral aspect of humeral head
48
AP IR projection: psoition of LT
LT is on medial side of humeral head
49
AP IR projection: medial humeral head position
medial humeral head can be superimposed on glenoid fossa. LT can also be superimposed on fossa.
50
AP IR projection: acromion and ACJ
acromion and ACJ are clearly visible above GHJ
51
AP IR projection: coracoid process
coracoid process below the clavicle
52
location of humeral head in transcapular projection
humeral head positioned over the glenoid
53
AP views (IR and ER) allow for excellent visualization of what 2 joints?
GHJ and ACJ as well as adjacent osseous structures including distal clavicle and scapula
54
AP views are good for?
acute trauma to evaluate fracture or dislocation | also helpful for bursitis or ACJ arthritis
55
Position of Glenohumeral "True" AP (grashey) view
patient is rotated posteriorly 35-45 deg so the plane of the scapula is parallel to the film
56
Glenohumeral "True" AP (grashey) view
allows for evaluation of GHJ space, shows superior or inferior movement of humeral head seen with instability, and detects joint space narrowing (arthritis)
57
Axillary lateral view patient position
supine | arm abducted to 90
58
Axillary lateral view
centered over mid GHJ and directed in a distal to proximal direction while tilted 15-30 degrees towards the spine
59
Axillary lateral view good for
anterior or posterior GH subluxation | bankart fractures
60
Scapular Y view position
pateint upright or prone with afftected side roated 30-45 degrees
61
scapular y view good for
anterior or posterior dislocation, as well as fractures of coracoid, scapula, acromion, and proximal huemral shaft
62
view useful for finding hill-sach's deformity
Stryker notch view (arm overhead, elbow flexed, hand supported by back of head)
63
proximal humeral fractures are most common in which age group?
age 50+ | one-part fractures are most common
64
Soft tissue injuries of the capusule and labrum are best evaluated with what?
MRI
65
Y view helpful for
impingment because it views the acromion -- differnt acromion types can cause impingement
66
best type of xray for arthritis
conventional radiography
67
imaging type for amyloid arthropathy and deposits
MRI

Fall Semester PM Exam 2 (1 decks)

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