UNIT 4: Wk2

Question 1

Rheumatoid arthritis

Answer 1

Progressive, systemic, inflammatory connective tissue disease affecting primarily synovial joints, although heart muscle and lungs may be involved

Question 2

Radiologic features of RA

Answer 2

Soft tissue changes
Articular erosions
Osteoporosis
Joint deformities

Question 3

The typical RA deformities in hand

Answer 3

Swan neck : distal IP joint
Boutonnières deformity : proximal IP joint

Question 4

Osteoarthritis

Answer 4

Degenerative joint disease

Question 5

Radiologic features of OA

Answer 5

Joint space narrowing, asymmetrical
Subchondral sclerosis
Osteophyte formation
Pseudocysts
Temporary joint effusions

Question 6

Radiologic characteristics of osteoporosis

Answer 6

Cortical thinning
Loss of trabeculae
Fractures

Question 7

T score of 0 =

Answer 7

= bone density is equal to that of a healthy young adult

Question 8

T score of -1 to +1 means

Answer 8

Normal bone density

Question 9

Z score

Answer 9

A comparison of a persons bone density with that of an average person of the same agent sex

Question 10

Fracture

Answer 10

a break in the structural continuity of bone; occur in predictable patterns determined by viscoelastic properties and biomechanics of load

Question 11

most common type of epipheseal fracture

Answer 11

type II - growth plate and metaphasis

Question 12

What is the purpose of search pattern

Answer 12

Describes the methodology of looking at an image in an organized fashion

Helps ensure that everything possible to see has been accounted for

Question 13

What is that ABCS search pattern

Answer 13

Alignment
Bone density
Cartilage
Soft tissue

Question 14

What items are considered when performing search A?

Answer 14

Skeletal architecture, contour of bone, alignment of bones to another

Question 15

What items are considered when performing search B?

Answer 15

Bone density, textural abnormalities, local bone density changes in areas of stress

Question 16

What items are considered when performing search C?

Answer 16

Normal joint space width with proper disc thickness, subchondral, bone (smooth surface), epiphyseal plates

Question 17

What items are considered when performing search S?

Answer 17

Muscles, fat pads, joint capsules, periosteum

Question 18

PRACTICE DOING ABCS ON A FILM

Answer 18

Look some up or watch the lecture again… review that quiz

Question 19

Categories of skeletal pathology

Answer 19

Congenital
Inflammatory
Neoplastic
Metabolic
Traumatic
Vascular
Misc.

Question 20

How are skeletal pathologies described in terms of location?

Answer 20

Monostotic: 1 bone
Monoarticular: 1 joint

Polystotic: many joints
Polyarticular: many joints

Diffuse: nearly all bones/joints

Question 21

Characteristics seen on films of OSTEOPOROSIS

Answer 21

Cortical thinning

Loss of trabeculae

Fractures

Question 22

Characteristics seen on films of Osteomyelitis infection

Answer 22

Soft tissue swelling

Loss of tissue planes

Draining sinus tracts

Sequestration and involucra

Question 23

Characteristics seen on films of infectious ARTHRITIS

Answer 23

Soft tissue swelling

Periarticular rarefaction

Joint space narrowing

Subchondral erosion

Joint effusion

Question 24

Characteristics seen on films of infectious CELLULITIS

Answer 24

Soft tissue swelling
Radiolucent streaks or bubbles representing GAS GANGRENE

Question 25

Characteristics seen on films of TUMORS

Answer 25

BENIGN: narrowing zone of transition, well defined margins MALIGNANT: poorly defined margins

Question 26

RA or OA: bilateral involvement of hands, wrists, feet, elbow, knees, hips

Answer 26

RA

Question 27

RA or OA: unilateral involvement of synovial or cartilaginous joints of spine, hips, knees, first Mets, and phalanges

Answer 27

OA

Question 28

RA or OA: swan neck or boutonnier deformities common

Answer 28

RA

Question 29

RA or OA: nodes at DIP and PIPs, valgus/varus at knee

Answer 29

OA

Question 30

RA or OA: which one has generalized osteoporosis in its later stages?

Answer 30

RA

Question 31

RA or OA: which one has symmetrical joint space? Which one is asymmetrical?

Answer 31

Symmetrical RA Asymmetrical OA

Question 32

Define a fracture

Answer 32

A break in the structural continuity of bone or cartilage

Question 33

7 elements used to describe a fracture

Answer 33

1. Anatomic site and extent 2. Type of fracture 3. Alignment 4. Direction of fracture line 5. Presence of special features (avulsion) 6. Associated abnormalities (dislocation) 7. Secondary fractures that may occur (stress or pathological)

Question 34

How is fracture location described in the peds population?

Answer 34

Described by region of development (diaphyseal, metaphyseal, physeal, epiphyseal)

Question 35

Diaphyseal

Answer 35

Involves the central shaft

Question 36

Metaphyseal

Answer 36

Involves the expanding end

Question 37

Physeal:

Answer 37

involves the epiphyseal growth plate

Question 38

Epiphyseal

Answer 38

Involves the epiphysis

Question 39

Incomplete green stick fracture:

Answer 39

The shaft is fractured on the tension side whereas the Cortex and periosteum remain intact on the compression side

Question 40

Is a torus fracture complete or incomplete

Answer 40

Incomplete

Question 41

Torus fracture

Answer 41

An impaction fracture that results in buckling of the cortex

Question 42

Is plastic bowing fracture complete or incomplete fracture

Answer 42

Incomplete

Question 43

Plastic bowing fracture

Answer 43

Even when the force is removed, the bone remains bowed

Question 44

What are the two approaches to fracture management?

Answer 44

Reduction- returning fragments to normal anatomical position Fixation - maintaining fracture fragments in position after reduction to achieve healing

Question 45

What are the two methods of reduction?

Answer 45

Open: surgically exposed site when closed reduction fails Closed: fragments are physically guided into position by manipulation/traction

Question 46

What are the two types of fixation?

Answer 46

Internal - screws, plates, pins, wires External- cast immobilization/splint

Question 47

Creeping substitution

Answer 47

Fractures may heal by formation of callus or by direct osteoblastic activity

Question 48

Late effect during the process of fracture healing

Answer 48

Complex regional pain syndrome and bone length discrepancy

Question 49

What are commonly missed fractures on radiographs

Answer 49

Spine: C1/C2, C6/C7 UE: scaphoid and radial head LE: femoral neck, patella, calcaneis

Question 50

How do you treat a patient if it seems like there’s a fracture, but radiographs come back normal?

Answer 50

Treat as if there is a fracture with immobilization and re radiographs in 1-2 weeks to verify

Question 51

What is an eponym?

Answer 51

Convenient type of orthopedic shorthand used to describe orthopedic trauma Avoided due to anatomic in exactness