Radiologic Exam of Pelvis and Hip Flashcards Preview

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Flashcards in Radiologic Exam of Pelvis and Hip Deck (44)
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1

Signs and Symptoms of slipped femoral capital epiphysis (SFCE):

  1. Vague pain in ___ or ____
  2. Limited _____
  3. _____ leg and limp
  4. _____ onset
  5. twice as common in boys => _____ and delayed maturation are common characteristics

  1. hip or knee
  2. limited ROM
  3. Shortened leg and limp
  4. insidious onset
  5. obesity

2

Fractures to the proximal Femur

  1. ____ =  in capsule
  2. ____= out of capsule

  1. Intracapsular
  2. Extracapsular

3

Which type of imaging is uses to typically assess hip fractures?

Convential Radiographs

4

The image is an example of which type of MRI and which imaging plane?

T2 coronal MRI hip

5

Which imaging plane allows for visulization of the following with CT of the hip:

  • anterior inclination of acetabular cup
  • acetabular roof
  • iliopsoas muscle
  • sacroiliac joints
  • pubic symphysis

Sagittal Plane CT of Hip

6

Radiographic eval of avascular necrosis

  1. ____ = appear normal for several weeks
  2. ____ = identify increased uptake soon after injury
  3. ____ = earliest senstivity and specificity => considered most appropriate study

  1. Radiographs
  2. Bone scans
  3. MRI
  • on image, you can no longer see ball and socket  => arrows are pointing to "cresent" sign = sign which shows the collapse of subchondral bone

7

Which imaging view of the hip is described by the following:

  • greater trochanter is superimposed behind the neck
  • lesser trochanter is anterior

Lateral Frog-Leg

8

Different presentations of avascular necrosis of the hip:

  1. _______ _____ = localized
  2. _____ _____ _____ = affect entire epiphysis

  1. osteochondritis dissecans
  2. epiphyseal ischemic necrosis

9

Stable fractures

  1. ____ is often the direct result of an impact to the iliac crest due:
  • to contact during sporting activity
  • fall onto hip

2. this injury could result in a bruise or ____ fracture.

  1. Hip pointer
  2. avulsion fracture

10

Classification for trauma to the pelvis

  1. ___ = low energy injuries (no disruption to joint)

2. ___ = high energy injuries

  1. stable
  2. unstable

11

Posteromedioinferior displacement of the proximal femoral epiphysis that occurs during childhood or adolescence

Slipped Femoral Capital Epiphysis

12

DJD of the Hip

  1. ___ = develops without a precursor
  2. ___ = pre-existing conditions include:
  • paget's
  • fracture
  • epiphyseal disorders
  • congential dislocation
  • avascular necrosis
  • other inflammatory arthritides

  1. Primary
  2. Secondary

13

Complete the following ABCDs for MRI at the hip:

  1. Alignment and Anatomy = head/neck of femur ____ and alignment
  2. Bone density = ____ signal intensities (e.g. bone brusies or marrow edema)
  3. Cartilage Space: normal appearnce of labrum, tears will image as a ___ ___ signal
  4. soft tissues = edema = ___ look for inflammatory components (bony and soft tissue)

  1. contour
  2. irregular
  3. high bright signal
  4. T2

14

_____ _____ of the hip = complicated process initiated by an interrupted blood supply causing tissue death

Avascular necrosis

15

Complete the following ABCDs for CT at the pelvis and hip

  1. Alignment and Anatomy = ____ or dislocation
  2. Bone Density = ____ of bone; breaks in corticol margins
  3. Cartilage Space = Loose bodies or free fragments (not visible unless with ____); spacing betwen femoral head, acetabulum, and labrum
  4. Soft tissues = ____ (most commonly seen with deistension of bursa and joint capsule)

  1. fracture
  2. destruction
  3. arthography
  4. effusion

16

Which imaging view of the hip assesses the following:

  • shenton's line = big arch that forms a part of the obturator foramen
  • iliofemoral line = look for smooth curve off of ilium onto the neck of the femur
  • Femoral neck angle = decrease in angle could indicate fracture
  • disruptions associated with fracture
  • dislocation (e.g. SCFE)

AP HIP

  • Shenton's line = orange
  • Iliofemoral line = green
  • Femoral Neck angle = red

17

Which imaging view assesses for the following at the pelvis:

symmetry

  • equal size of ililiac ala
  • equal size obturator foramina
  • sacral symmetry
  • sacrum, occyx, pubic symphysis aligned
  • femoral head line

AP Pelvis

18

DJD of the hip: clinical presentation

  1. Aymmetrical ____  ____ narrowing
  2. Sclerotic _____ bone
  3. Osteophytes at ___ _____
  4. ___
  5. Migration of the ____ _____

  1. joint space
  2. subchondral bone
  3. joint margins
  4. cyst
  5. femoral head

19

  1. The MRI protocol for the hip uses which 3 image views?
  2. FOV = entire pelvis and hips => ____ to the ____

  1. axial, sagittial, and coronal
  2. iliac crests to the lesser trochanters

20

RA of the Hip

  1. Osteoporosis of ______ area
  2. Symmetric and Concentric _____ ____ narrowing
  3. _____ erosions
  4. ____ ___ in nearby bone
  5. ____
  6. Axial migration of ____ ____
  7. Acetabular _____

  1. periarticular area
  2. joint space narrowing
  3. articular erosions
  4. synovial cysts
  5. effusion
  6. femoral head
  7. acetabular protrusion

21

The following are all indications for which type of imaging at the pelvis and hip:

  • severe trauma
  • fracture fragments
  • loose bodies
  • fractures of acetabulum or sacrum
  • congential hip dislocations or joint replacements

CT scan

  • also indicated for use if MRI is contraindicated

22

The image is an example of which type of MRI image of the hip?

Arthrogram (Arthrography) MRI of Hip

23

Routine imaging series

  1. Pelvis = ?
  2. Hip = ?

  1. AP
  2. AP and Lateral Frog-Leg

24

Unstable Pelvis Fractures: on the image,

What types of fractures/injuries on depicted?

  • A, B, C = vertical sheer fractures
  • D = straddle fracture
  • E = bucket-handle fracture
  • F = "open book" injury

25

Fractures of proximal Femur

  • Intracapsualr
  1. Potential injury to circumflex ____ arteries
  2. post-op complications including AVN and ____ (altered blood flow)
  3. to treat, younger = ____; older = _____
  • Extracapuslar
  1. Intertrochanteric make up ____ of proximal femur fractures
  2. treatment = ____

Intracapsular

  1. circumflex femoral arteries
  2. AVN and non-union
  3. younger = ORIF; older = THA

Extracapsular

  1. 50%
  2. ORIF

26

Which variation of MRI will allow for additional assessment of intra-articualr distension that will help identify labral tears or impingement disorders?

arthrography

27

Which imaging plane allows for visulization of the following with CT of the hip:

  • Bilateral hip joints
  • Femoral heads, necks, shafts
  • Greater and lesser trochanters
  • sacrum
  • ilia
  • SIJs

Coronal Plane CT of Hip

28

On the image:

  1. A = asymmetrical loss of ___ ___
  2. B (upper) = marginal _____
  3. B (lower) = ___
  4. C = sclerotic _____ bone
  5. D = loss of articular cartilage has caused the ____ of the femur to migrate superomedially (bone bulge)

  1. A = asymmetrical loss of joint space
  2. B (upper) = marginal osteophytes
  3. B (lower) = spur
  4. C = sclerotic subchondral bone
  5. D = loss of articular cartilage has caused the head of the femur to migrate superomedially (bone bulge)

29

  1. Axial MRI used to diagnose ____.
  2. Alpha angle of the head-to-neck is assessed on ___ ___ view.
  3. Cam, pincer, or mixed type of femoroacetabular ____ can be evaluated.

 

  1. FAI
  2. axial oblique
  3. impingement

30

What is the FOV for CT at the hip?

  1. Pelvis from ____ to ____
  2. bilateral ____
  3. One ____

  1. Pelvis from ilium to ischium
  2. Bilateral hips
  3. one hip