CLinical imaging

why is marfan's syndrome so dangous

could cause heart issues ( atrial septal defect, aortic arch aneuryusm OR c1-c2 instability (wide ADI)

what radiographic feature does osteogensis imperfecta have

diffuse decrease in bone density, pencil-thin cortices and multiple fracture

Where are the most common location for a bathroom fracture

first and fifth digits

What is assoicated with a proximal fibula fractures

fratures of the lateral tibial plateau or ankle

Achondroplasia is a rhizomelic dwarfism, which means... the spinal column is more shortened than the limbs. the proximal bones of the limbs are more shortened than the distal bones .the limbs are more shortened than the spinal column. the distal bones of the limbs are more shortened than the proximal bones.

he proximal bones of the limbs are more shortened than the distal bones.

What finding is pathognomonic for Nail-Patella (Fong) syndrome?

iliac horns

Most common site of OCD (be specific)

lateral aspect of the medial Femoral condyles (95%) Talus (superomedial corner of talar dome

Who do you refer to for osteonecrosis

orthopedic surgeon

4 criteria for osteogensis

osteoporosis wiht abnormal fragility of skeleton blue sclera abnormal dentition premature otosclerosis (must have 2 to confirm

how does the dancer fracture occur

plantar flexion and inversion of peroneus brevis tendon

define steinberg sign

protrusion of the thumb beyond the cofines of clenched fist

What is associated what ligamentous peroneal nerve syndrome

proximal fibula fractures

WHen you have achondroplasia you many also have lumbar ---- and ---- ----- plevis

stenosis champage glass

If someone has a calcaneal compression fracture what else could be assicated with it

thoracolumbar spinal fracture

What usually causes Subtrochanteric Extracapsular fracture

use of bisphosphonates for over 5 years or patholigic

With Freiberg disease is a patient is in an active phase there is ----- in later phases shows signs of ---- and -----

widening of joint space DJD joint space narrowing

Give one (1) 'named' sign of the appearance of the pelvis of an individual with Achondroplasia. If you list more than one answer, the first answer will be accepted.

"champagne glass" pelvis

Give one (1) 'named' sign of Osteopetrosis. If you list more than one answer, the first answer will be accepted.

"sandwich" vertebra

What must be present to diagnose someone with Kohler disease (3)

- male - 4-6 age - local pain, swelling and decrease motion Not clinical feature but navicular is "wafer-like" thin

Straddle Fractures are also assoicated with what kind of damge

20% result in bladder/urethra damage

Which metatarsal is most commonly involved with Freiberg disease

2nd metatarsal

Match the radiographic characteristics describing the navicular bone with the diagnosis it is associated with .Patchy sclerosis Dorsal or medial displacement Comma-shaped Wafer-like thinness A. Kohler disease B. Mueller-Weiss disease

A B B A

A 9-year-old undergoes an ankle inversion injury during softball practice. On radiographs, there is a lucency at the proximal aspect of the 5th metatarsal that is longitudinally parallel to the shaft. What is this most likely to represent? A stress fracture A Jones fracture A dancer fracture A normal apophysis

A normal apophysis

Sever disease must be carefully differentiated from what entity? Kohler disease A normal calcaneal apophysis Calcaneal compression fracture Freiberg disease

A normal calcaneal apophysis

What views are needed for Chandler disease? What imaging is best in early stages?

AP and Frog leg views -> at anterosuperior femoral head Early stage: MRI and bone scan

What 2 views are essential for SCFE and why

AP: shows medial slippage Frog leg: shows posterior slippage Klein's line is also used ; )

Kohler disease and Mueller-Weiss disease are both conditions of __________________ of the _________________ bone. Kohler disease classically appears with excessive ____________________________ density change and collapse to a ______________________ appearance. Mueller-Weiss disease classically appears as collapse of the ________________ aspect of the bone into a _____________ appearance.

AVN Navicular sclerotic "wafer-like" lateral" comma-like"

Which of the following is NOT a feature of Cleidocranial Dysostosis? Absent or hypoplastic patellae Abnormal dentition Spina bifida occulta Congenitally widened pubic symphysis

Absent or hypoplastic patellae

Which of the following is NOT a possible complication of Achondroplasia? Low back pain due to sagittal curve alterations (lordosis/kyphosis) Lower extremity radicular symptoms due to lumbar stenosis Neurological deficits due to a narrowed foramen magnum Aortic arch aneurysm

Aortic arch aneurysm

What sign results in posterolateral instability

Arcuate sign

Describle the 3 different type of proximal 5th metatarsal fracture

Avulsion fracture -> "dancer fracture" most common Jone fracture -> AT metadiaphyseal junction Stress fracture -> most distal/least common

What is a Rider's Bone?

Avulsion of the ischial tuberosity

Match the radiographic description with the sclerosing bone dysplasia it describes. Thickened cortex in a waved pattern that resembles dripping candle wax Multiple small sclerotic lesions that are mostly positioned around the joints Multiple longitudinal sclerotic striae in the metaphysis of a long bone Characteristically appears as "sandwich vertebrae" in the spine and "bone within a bone" elsewhere A. Osteopoikilosis B. Melorheostosis C. Osteopathia Striata D. Osteopetrosis

B A C D

Match the following sclerosing bone dysplasias with the correct radiographic appearance .Cortical thickening and hyperostosis in an undulating or waved pattern. Generalized sclerosis and, in more severe cases, loss of differentiation of cortical and medullary bone .Longitudinal, linear opaque lines involving the metaphyses/diaphyses. Multiple small, round opacities involving the epiphyses/metaphyses. A. Osteopoikilosis B. Melorheostosis C. Osteopathia striata D. Osteopetrosis

B D C A

Match the name with the site of AVN A. Femoral head in childern B. Medial femoral condyle C. metatarsal head D. navicular in chlidhood E. Calcaneal apophysis Alback disease Legg Calve Pethes Sever disease Kohler's disease Freiberg disease

B. Alback disease A. Legg Calve Pethes E. Sever disease D. Kohler's disease C. Freiberg disease

What happens with a y shaped tibial bicondylar fracture

BOTH tibial plateus are fractured

How can you tell the difference between Legg-Calve-Perthes and SCFE

BY AGE! Legg-Calve-Perthes occurs in 3-12 SCFE occurs in 10-15

what line of mensentation is used from a calcenal compression fracture

Boehler angle

what imaging modality is most optimal for tarsometatarsal dislocation

CT

When examing a hip Fracture what imaging mordality is better for stress Fxs and which is better for fragement location

CT: fragement loction MRI: stress Fx

what is the difference between Congenita and Tarda osteogensis imperfecta

Congenita -> death Tarda -> living - effects lower extermities more than upper

True or False a tibial plateua fracture usually affects the medial plateau

FALSE!!! its the lateral plateau

True or false if you take an x ray of an knee and nothing shows up after 2 weeks you can rule out Spontaneous osteonecrosis of the knee (SONK) AKA Ahlback disease

FALSE!!! you need atleast 2 months to rule out disase

Extracapsular fractures of the proximal femur are at the most risk for complications, such as nonunion and AVN. True False

False

True or False a pubic Rami avulsion is a transverse fracture

False!!! it looks like simple roughening of the pubic cortex

True or False the lipohemarthrosis is assoicated with extraarticular fractures but does not rule out if there is or is not a fracture

False. It doesn't rule out fracture BUT it is assoicated with intrarticular fractures

3 common clinical features of achondroplasia

Genu varum -> bowed legs hyperlordosis Trident hand -> 3rd and 4th digits cant fully separate

When there is a pelvic trauma what is the most common Vascular injury?

Hemmorrahage

Slipped capital femoral epiphysis (SCFE) commonly presents as referred pain to what areas of the lower extremity? Ankle or Heel Knee or thigh Shin or calf Hip or buttocks

Hip or buttocks

Avulsion Fractures are due to muscle contractures or spasms what are the most common areas (3) for fractures and what muscle causes it?

Ilium - ASIS -> Sartorius - AIIS -> rectus femoris Ischium - ischial tuberosisty -> hamstrings Pubis - Pubic ramus -> adductors

what are the 2 types of osteopertrosis

Infantile autosomal recessvice type - fail to thrive benign adult autosomal dominant type - recurrent fractures

Endosteal surface is ___________ Periosteal surface is __________

Inner portion of bone Outer portion of bone

What is the classic mechanism of injury (MOI) of a Maisonneuve fracture of the proximal fibula? Inversion and rotation at the ankle Blunt trauma to the lateral leg Varus stress at the knee Valgus stress at the knee

Inversion and rotation at the ankle

What is the most common location of Osteochondritis Dissecans (OCD) of the distal femur? Medial aspect of the lateral femoral condyle Lateral aspect of the medial femoral condyle Lateral aspect of the lateral femoral condyle Medial aspect of the medial femoral condyl

Lateral aspect of the medial femoral condyle

Legg-Calvé-Perthes disease and slipped capital femoral epiphysis (SCFE) can present similarly as a painful limp. How can the patient's age be used to help differentiate these two conditions? SCFE tends to present in a younger age group than Legg-Calvé-Perthes disease These two conditions cannot be differentiated based on age. These two conditions do not present with similar symptoms. Legg-Calvé-Perthes disease tends to present in a younger age group than SCFE

Legg-Calvé-Perthes disease tends to present in a younger age group than SCFE

What is a possible complication of Marfan syndrome? Mark all choices that apply. Loss of thorax spacing due to scoliosis and chest wall contour anomaly Reduced joint motion Transverse ligament laxity or rupture Aneurysm of the aortic arch

Loss of thorax spacing due to scoliosis and chest wall contour anomaly Transverse ligament laxity or ruptureAneurysm of the aortic arch

If a patient has ankle pain what should you also check for

Maisonneuve fracture -> can cause ankle pain but is due to tibiofibular syndesmosis (gapping of medial malleolus = fibular issue)

What is the most common fracture of the pelvis? Straddle Apophyseal Avulsion Bucket handle Malgaigne

Malgaigne

Which is the most common pelvic fracture? Malgaigne Fracture Bucket Handle Fracture Staddle Fracture

Malgaigne Fracture

How do you make sure you do not over diagnose Sever disease

Must have clinical features!!! - active children -Heel pain -self limiting with rest

A "wafer-like" appearance is the characteristic radiographic appearance of AVN of which bone? Metatarsal Calcaneus Cuboid Navicular

Navicular

What are 2 key differences between DJD or SI joints and Osteitis Condensans ilii (OCI)

OCI is common in post partum female and Have a bilateral triangle shape of sclerosis

What condition can thin the tissues of the "whites" of the eyes and allow the grey-ish blue tint of blood vessels to show through? Osteopoikilosis Osteogenesis Imperfecta Marfan Syndrome Achondroplasia

Osteogenesis Imperfecta

Which condition can lead to deafness secondary to sclerosis of the ossicle of the inner ear? Cleidocranial Dysostosis Marfan Syndrome Achondroplasia Osteogenesis Imperfecta

Osteogenesis Imperfecta

Which of the following dysplasias appears as generalized osteoporosis?OsteopetrosisOsteopathia striataOsteogenesis ImperfectaOsteopoikilosis

Osteogenesis Imperfecta

Of the sclerosing bone dysplasias, which one has serious clinical implications? Melorheostosis Osteopathia Striata Osteopoikilosis Osteopetrosis

Osteopetrosis

What is Mueller Weiss aka Brailsford disease a combo of

Pes planus (flat foot) and Pes varus (distal tibia is turned inward toward the body) = pes planovarus

What is most commonly fractured with a posterior hip dislocation

Posterior acetabulum fracture

Indicate whether the radiographic signs below are associated with avascular necrosis (AVN) or osteochondritis dissecans (OCD). Sclerosis Lucency Fragmentation Contourchange Osteochondral fragment Arc-like cleft of separation A. AVN B. OCD C. Both

Sclerosis -Both Lucency - Both Fragmentation - Both Contour change -Both Osteochondral fragment - OCD Arc-like cleft of separation - OCD

Which fracture around the knee has a very high likelihood of concurrent cruciate ligament tears? Patellar Tibial plateau Supracondylar Segond

Segond

An AP view of the chest is acquired on a 30-year-old male due to a persistent cough following a recent flu. While the lung spaces are unremarkable, it is noted that the clavicles are not visualized, bilaterally. What other anomalous appearance might be present on the same PA chest view? Narrowed pubic symphysis AVN of the humeral heads Aortic arch aneurysm Spina bifida occulta

Spina bifida occulta

What AVN disease is assiocated with SUDDEN onset of knee pain that is unassociated with Trauma

Spontaneous osteonecrosis of the knee (SONK) AKA Ahlback disease

Which fracture of the femoral neck is the most common? Intertrochanteric Subtrochanteric Basicervical Subcapital

Subcapital

What are the 3 intracapsular hip fracture locations

Subcapital -> MOST COMMON (smushed snoopy face) Midcervical -> through neck Basicervical -> usually pathological

What is the most common location for osteochondritis dissecans of the talus?

Superomedial corner of talar dome

What possible adaptation can occur of a metatarsal if metatarsal head AVN is present? Decreased local sensation Thickened metatarsal shaft Bowing of the metatarsal Dislocation of the metatarsal base

Thickened metatarsal shaft

What is the definition of an unstable injury of the pelvis?

Trauma that results in the possibility of organ or vascular damage

The most common type of hip dislocation is a posterior dislocation. True False

True

True or False. A medial Malleolus fracture that is proximal to plafond (tibiotalar join line) is unstable

True

True or False. Patellar fracture are usually transverse or slightly oblique

True!

What are the 3 types of lateral malleolus fractures and how do you determine the difference

Type A -> below syndesmosis Type B -> at level of syndesmosis Type C -> above syndesmosis

What is the most common congeital dwarfism

achondroplasia (rhizomelic dwarfism -> long bone are wide at ends)

When there is a pelvic trauma what is the most common Organ injury?

bladder and urethra

what sketetal dyplasia has mutiple wormian bones

cleidocranial dysostosis

Achondroplasia is the most common __________________ type of dwarfism.

congenital