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Basic skeletal radio
Trauma, congenital anomalies, lines and measurements, dysplasias
| prompt | answer |
|---|---|
| McGregor’s Line | M < 10mm F < 8mm |
| Chamberlain’s Line | < 3mm |
| Atlantodental Interspace | Adult 1-3mm Kids 1-5mm |
| George’s Line | no interruptions |
| Posterior Cervical Line | no interruptions |
| Sagittal dimension cervical spine canal | Min 12-16 mm C1-C7 |
| Atlantoaxial alignment | B-P:O-A <1 |
| Cobb Angle | <20 degrees |
| Risser Ferguson | <10 degrees |
| Sacral inclination | 30-72 deg |
| Sacral base angle | 26-57 deg |
| Lumbosacral disc angle | 10-15 deg |
| Lumbar gravity line | < 10mm ant to sacrum |
| Meyerding’s method | spondylolisthesis grading |
| Interpediculate distance | >21mm |
| Eisenstein’s method for sagittal canal measurement | not <15 |
| Teardrop distance | 6-11mm No greater than 2mm diff. btwn sides |
| Presacral space | Adult 2-20mm Kids 1-5mm |
| Shenton’s line | uninterruprted between pubis and femoral neck |
| Iliofemoral line | symmetrical |
| Femoral angle | 120 -130 deg |
| Skinner’s line | should pass below fovea |
| Klein’s line | should intersect femoral head |
| Patellar position | patellar tendon no more than 20% greater than patella |
| Heel pad measurement | F 19-23mm M 19-25mm |
| Boehler’s angle | 28-40 deg |
| Glenohumeral joint space | 4-5mm |
| Acromiohumeral joint space | 7-11mm |
| Acromioclavicular joint space | F 2.1-3.7mm M 2.5-4.1mm |
| Coracoclavicular distance (pg. 896) | 11-13mm |
| Axial relationship of the wrist | PA radioulnar 72-95 deg Lat radius 79-94 deg |
| Achondroplasia Pathological hallmark: | spinal stenosis |
| Achondroplasia Pedicles: | short and thick |
| Achondroplasia IPD in the lumbar spine | decreases as it descends |
| Achondroplasia Sagittal canal diameter: | narrowed |
| Achondroplasia Posterior vertebral bodies: | scalloped / concave |
| Achondroplasia Ilia: | short , square |
| Achondroplasia Greater sciatic notch is | small |
| Achondroplasia Ischia: | short, broad |
| Achondroplasia Pubic bones: | short, broad |
| Achondroplasia Sacrum | articulates low on ilium |
| Cleidocranial Dysplasia Skull and clavicle findings: | Open Sutures, open Fontanelles, Wormian bones, Brachycephaly |
| Cleidocranial Dysplasia Foramen magnum: | large |
| Cleidocranial Dysplasia Maxilla/Facial bones: | hypoplastic |
| Cleidocranial Dysplasia Sinuses: | small |
| Cleidocranial Dysplasia Palate: | narrow, high arch |
| Cleidocranial Dysplasia CLAVICLES: | Deficiency or Absence |
| Cleidocranial Dysplasia Pubic symphysis: | diastasis |
| Marfan’s Syndrome is a: | Defective collagen disorder (quality not quantity) |
| Marfan’s CLINICAL MANIFESTATIONS | Skeletal, Ocular, Cardiovascular |
| Marfan’s Extremities: | markedly elongated with sparse soft tissue |
| Marfan’s Height: | usually > 6 feet |
| 1/3 of patients with Marfan’s: | congenital heart disease (atrial septal defect) |
| >95% of patients with Marfan’s: | death due to complications related to cardiovascular pathology (aortic aneurysm) |
| Marfan’s RADIOGRAPHIC FINDINGS Skeletal: | Arachnodactyly, Osteopenia Acetabular protrusion Pectus excavatum, Slipped capital femoral epiphysis |
| Marfan’s RADIOGRAPHIC FINDINGS Spine: | Tall vertebrae, Posterior scalloping, Widening of the IPD in lumbar spine, Thinning of pedicles, laminae (2* to dural ectasia),Transverse ligament may be lax |
| Ehler’s-Danlos Syndrome symptoms: | Skin fragility/hyperelasticity, Vascular fragility, Articular Hypermobility |
| Ehler’s-Danlos RADIOGRAPHIC FEATURES Soft tissue findings: | Calcified subcutaneous spherules of necrotic fat tissue, Ligamentous laxity |
| Ehler’s-Danlos RADIOGRAPHIC FEATURES Spinal: | Platyspondyly, Posterior scalloping, Scoliosis, Flattening of thoracic curve |
| Ehler’s-Danlos Cardiovascular complications: | dissections, aneurysms |
| Ehler’s-Danlos other complications: | Spontaneous pneumothorax |
| Ehler’s-Danlos Disc herniations: | may produce cauda equina |
| Ehler’s-Danlos Osseous and soft tissue manipulations may produce: | vascular injury, subcutaneous hematoma formation |
| Osteogenesis Imperfecta is a: | Generalized connective tissue disorder, Quantitative and qualitative defect in collagen |
| 5 places affected by Osteogenesis Imperfecta | Skeletal, Skin, Sclera, Dentition, Inner ear |
| 2 FORMS of Osteogenesis Imperfecta : | Osteogenesis Imperfecta Congenita, Osteogenesis Imperfecta Tarda |
| 4 Major Clinical Manifestations of Osteogenesis Imperfecta | 1. osteoporosis with abnormal fragility of the skeleton, 2. blue sclera, 3. abnormal dentition, 4. premature otosclerosis |
| Radiographic Findings of Osteogenesis Imperfecta: | Osteopenia, Gracile bones, Bowing of bones, Multiple fractures |
| With Osteogenesis Imperfecta, osseous and deep soft tissue manipulation is | contraindicated |
| Osteogenesis Imperfecta decreases posterior fossa leading to: | Basilar impression, cerebellar compression, hydrocephalus |
| Osteopetrosis is a Failure of resorption which replaces: | calcified cartilage with mature bone |
| in Osteopetrosis, Medullary space | does not form |
| Osteopetrosis RADIOGRAPHIC FEATURES: | Generalized osteosclerosis of skeleton, Dense homogenous bones – marble bones, “Bone within bone” appearance, “Sandwich” vertebrae, Erlenmeyer flask deformity |
| Osteopetrosis COMPLICATIONS | Leukemia / sarcoma, Hemorrhage, Infection, Blindness, Deafness |
| Osteopetrosis Persistent hip pain | Rule out ischemic necrosis |
| Osteopetrosis Foramen magnum may be narrowed due to | thickening of osseous structures |
| Osseous manipulation may be contraindicated in Osteopetrosis patients with | generalized involvement in skeleton |
| Majority of OSTEOPOIKILOSIS cases are | – asymptomatic |
| OSTEOPOIKILOSIS 15-20% may experience | mild joint pain with or without joint effusion |
| OSTEOPOIKILOSIS HISTOLOGICALLY: | Foci of compact lamellar bone |
| OSTEOPOIKILOSIS Radiographic | Multiple rounded/ovoid radio-opacities scattered in epiphyseal and metaphyseal regions |
| OSTEOPOIKILOSIS Predilection for | long tubular bones, carpals, tarsals |
| fracture Alignment: | position of the distal fragment in relation to the proximal fragment |
| fracture Apposition: | concerns the closeness of the bony contact at the fracture site |
| fracture Rotation: | rotational deformity; inclusion of proximal and distal joints is necessary |
| Complications to Healing: | Delayed Healing, Non- union, Mal- union, Aseptic Necrosis, Disuse Osteoporosis, Reflex Sympathetic Dystrophy, Infection, Traumatic Arthritis, Joint Derangements |
| Cervicocranial Dislocation is | Rarely seen clinically because these patients sustaining these injuries usually do not survive |
| Cervicocranial Dislocation MECHANISM: | a distractive force to the craniocervical joint by hyperextension-flexion |
| Jefferson’s Fracture MECHANISM: | Force is applied through skull vertex through occipital condyles through lateral masses of atlas then bursts. |
| Jefferson’s Fracture RADIOGRAPHIC FEATURES: | Lateral displacement of lateral masses, Increase paraodontoid spaces bilaterally, Prevertebral soft tissue swelling |
| Jefferson’s Fracture >8 mm total offset: | transverse ligament rupture |
| SIMULATED JEFFERSON FX 4 circumstances: | 1. Atlas grows more rapidly than axis (children 4 years of age), Developmental anomalies (eg. Localized lateral mass malformation; spina bifida of atlas both anteriorly & posteriorly), Rotary atlantoaxial subluxation, Torticollis |
| Neural Arch Fracture MECHANISM: | Hyperextension injury-Posterior arch of C1 is pinched between occiput and large spinous process of C2 |
| Neural Arch Fracture present, Look for | other cervical fractures |
| Neural Arch Fracture significance | Vertebral artery in close proximity |
| Stable Pelvic Fractures | ASIS, AIIS, Ischial tubes, Transverse sacral, acetabular |
| Fascial Plane-Superior medial | Obturator |
| Fascial Plane-Superior lateral | Glut med. |
| Fascial Plane-Inferior medial | Iliopsoas |
| Unstable Pelvic Fractures | Malgaigne, Bucket-handle Fracture, Dislocation (unilateral and bilateral), Straddle Fracture |
| Rolando’s- | comminuted fx of base of 1st metacarpal |
| DJD radiologic features (general) | non-uniform loss of joint space, intra-articular loose bodies, osteophytes, subchondral sclerosis, subchondral cyst, articular deformities |
Created by:
stigmatamarty
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