DXI III - Trauma Quiz Questions

ACL tear

A 22-year-old patient tackled while his foot was planted. The force came into the lateral aspect of his knee resulting in a valgus stress and rotation. Which of the following is present?

Impaction

A 43-year-old male pedestrian is struck in the side of the knee by the bumper of a motor vehicle. Which type of fracture is most likely to be present in the lateral tibial plateau?

APOM

A C1 fracture can be difficult to identify on a plain film. Which view listed below is best to identify the key sign associated with the fracture?

Dinner fork

A colles fracture has a physical appearance, due to the wrist and distal forearm deformity, similar to the following?

Kocher's

A small osteochondral fracture may be sheared off the convex surface of the capitullum producing a loos body that will float in the joint. This fracture is known as a ________ fracture.

Transverse ligament

A total offset of the lateral masses >8mm signifies what structure is involved in the injury?

Rectus femoris

An avulsion at the AIIS is from the _________?

Sartorius

An avulsion at the ASIS is from the ________?

Hamstrings

An avulsion at the ischial tuberosity is from the ________?

Osteoarthrosis (DJD) of the facets

Anterolisthesis of L4 is most commonly secondary to?

Stress fracture

Anterolisthesis of L5 is most commonly secondary to?

Must consider metastasis, myeloma, and lymphoma

Any concern here?

Talus

As we talked about earlier the scaphoid is prone to avascular necrosis when fractured due to its distal blood supply. Which tarsal is prone to the same complication?

20%

At what frequency do Down's syndrome patients exhibit transverse ligament laxity or agenesis?

Throwing motion

Avulsion of the medial epicondyle is a similar injury in a developing child or adolescent know as Little Leaguer's elbow. What action is the injury strongly associated with?

Subclavian artery

Childhood and adolescent clavicle fractures heal without sequelae in up to 95% of cases. In adults the incidence of complications increases. Associated injury to the underlying neuromuscular structures most frequently involves which of the following?

Spiral Fracture

Choose the fracture that results from rotational stresses and has an oblique fracture plane encircling the long axis of the bone.

Type III (severe sprain)

Classify the AC joint separation seen in the image provided.

Measured in percentage

How is the loss of apposition of a fracture quantified in a report?

Facet dislocation

Identify..

Lateral tibia and femur

If the anterior cruciate ligament and medial collateral ligament are torn, where would you most likely see a kissing contusion on MRI?

Old images

If the typical signs of an acute compression fracture are not present it does not imply that it is old. The best way to evaluate a new versus old compression fracture is with?

Mets

If this patient was elderly there is concern for?

Sprain of the anterior talofibular ligament.

Inversion of the ankle would most likely result in which of the following?

Posterior

Most hip dislocations are ________?

Lower thoracic spine

Most thoracic fractures are located?

Radial head

Olecranon fracture account for approximately 20% of adult elbow fractures, ranking second in frequency to ________ fractures.

Stress fracture

Repetitive applications of compressive, rotational, or tensile forces to normal bone may lead to which of the following types of fractures?

All terms provided are associated with the image.

Select all terms that are applicable regarding the image provided.

Hyperextension

Select the most appropriate mechanism of injury associated with the image provided.

Interphalangeal

The _________ joint in the most common joint in the body to dislocate.

FLAP

The greater tuberosity of the humerus may be avulsed by connecting tendons or fractured by direct trauma. It is frequently fractured during anterior humeral dislocation. This fracture is frequently referred to as which of the following?

Posterior dislocation

The image seen below depicts a double cortical surface located on the medial aspect of the humeral head (arrows). This sign is called the trough line and represents impaction of the humeral head against the gleaned. Which of the following injuries is associated with the trough sign line?

Pie sign

The image seen here demonstrates a dislocated carpal bone which produces a unique shape on the PA image. What is the named sign associated with this finding?

Anterior humeral dislocation

The lesion, indicated by the arrow, is a result of what type of injury?

Hyperextension

The lunate is the most common carpal bone to dislocate, usually following a ________ injury.

Poor immobilization

The most common cause of improper healing of a fracture is?

Pars interarticularis

The most common location for a stress fracture is?

Knee forced into an object while the knee and hip are flexed

The most common mechanism of injury for a hip dislocation is?

Knee forced into an object while the knee and hip are flexed.

The most common mechanism of injury for a hip dislocation is?

Bar room fracture

The phalanges and metacarpals are the most common sites of skeletal injury in the entire skeleton. Phalangeal fractures are more common than metacarpal fractures. The images provided below demonstrates the most common metacarpal fracture. From the list provided select the fracture name.

It is an open fracture.

The radiolucent areas overlying the soft tissues adjacent to the fracture site tell you what about this fracture?

Chip

These two patients had hyper flexion injuries to their fingers resulting in the x-rays provided. What type of fracture do these most likely represent?

Kummels (AVN)

What condition does this individual likely have?

Avascular necrosis of a vertebral body

What is Kummels disease?

Osteochondral defect

What is the diagnosis, which left untreated/unstable can result in serious future debilitation?

Normal

What is the diagnosis?

Golfer

What is the likely mechanism of injury in the 24-year-old male?

Remodeling

What is the longest phase in bone healing?

Impacts the treatment and prognosis.

What is the major benefit to using the Salter-Harris classification?

Hypolordosis

What is the most common finding observed on post-whiplash radiographs?

Supracondylar

What is the most common location of fracture to occur around the elbow in a child (60%)?

Hyper flexion with fulcrum at the anterior abdomen (Chance).

What is the most common mechanism of injury and the eponym?

Transverse

What is the most common orientation of a patellar fracture?

Type II

What is the most common type of Salter-Harris fracture?

Acute

What is the most likely age of this fracture?

Failure of osteoblastic activity to keep up with osteoclastic activity

What is the most likely cause of injury?

Hyperextension

What is the most likely mechanism of injury associated with the fracture indicated by the arrow?

Neer

What is the name of the classification system for fractures seen at the proximal humerus?

5 mm

What is the normal ADI in children?

3 mm

What is the normal measurement of the space indicated by the yellow line?

Bankart's lesion

What is the proper name of the finding seen on this film?

Insufficiency fracture

What is the proper term for a fracture of abnormal bone that results from normal loading forces?

Fat-pad sign

What is the sign depicted in the image provided?

None

What is the treatment for a single uncomplicated rib fracture?

Valgus

What mechanism of injury did this person most likely have in the past?

100%

What percentage of loss of apposition is present?

ABC (aneurismal bone cyst)

What tumor may arise at the site of previously traumatized bone?

Type I

What type of Salter-Harris fracture does this image represent?

Stress

What type of fracture does this x-ray represent?

Lisfranc

What very debilitating injury with high susceptibility for osteoarthritis is present?

Sir Geoffrey Jefferson

What was the name of the doctor who first described the bursting fracture of the atlas?

Cross table lateral, fat blood interface (FBI).

When evaluating a knee x-ray series a/an ________ image may be beneficial to elicit a closer search for a fracture when you see a ________ sign.

Proximal fibula

When there is disruption of the tibiofibular syndesmosis, or a mechanism of injury that would suggest this injury, what other x-ray should be included?

Scaphoid

Which of the following carpal bones is the most common to fracture?

Bucket handle fracture

Which of the following fracture patterns involves unilateral fracture of the superior and inferior pubic ramus and a third fracture near, or separation of, the contralateral sacroiliac joint?

Comminuted fracture

Which of the following fractures generates more than two fragments?

Straddle

Which of the following fractures involves all for pubic rami?

Torus

Which of the following fractures is an incomplete fracture of long bones seen in children that presents as a cortical bulge on the concave side of the bone?

Decreased grip strength

Which of the following is a good physical indicator of wrist fracture?

Pneumothorax Lung contusion Hemothorax Lung laceration

Which of the following is a potential complication with rib fracture?

The fracture is orientated perpendicular to the long axis of the bone.

Which of the following is a reliable method to tell a fracture at the base of the fifth metatarsal from a growth plate?

Malgaigne

Which of the following is a type of pelvis fracture?

Normal

Which of the following is present here?

Posterior arch

Which of the following is the most common fracture of the Atlas?

Middle

Which of the following is the most common location for a clavicle fracture?

High signal within the vertebral body on T2 weighted MRI Step defect Zone of condensation Paraspinal mass Hot on bone scan

Which of the following is/are suggestive of an acute vertebral fracture?

Clavicle fracture

Which of the following represents the most common location for fractures during birth and childhood?

Meyerding system

Which of the following roentgenometric evaluations is most often used to address the extent of anterior displacement with spondylolisthesis?

There does not appear to be a correlation between the two.

Which statement best describes the relationship between spondylolisthesis and low back pain?

Calcaneus

Which tarsal bone is most commonly fractured?

Comminuted

Which type of fracture does this represent?

Someone who carries a heavy backpack Golfer's A seatbelt strap

Who gets theses types of fractures?