Radiographic Image Interpretation Flashcards

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flashcards for radiographic image interpretation
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Describe the alignment of metatarsal 2 There is no angulation nor displacement of the distal segment relative to the proximal segment.
Describe the alignment of metatarsal 3 The distal segment is displaced laterally (50% apposition) and angulated medially.
Describe the alignment of metatarsal 4 The distal segment is displaced laterally (75% apposition) but there is no apparent angulation.
Describe the tubulation of the metatarsals Metatarsals are overtubulated - decreased girth.
Describe the tubulation of the metatarsals Metatarsals are undertubulated - increased girth.
Describe the normal variation of the sesamoid bones Tibial sesamoid is bipartite
What is this? Bipartite medial cuneiform
What is this? Bipartite navicular
What is this? Where is it typically found? Os interphalangeus. Typically found on the inferior aspect of the hallux IPJ. It is rare to see this ossicle at the IPJs of the lesser toes.
What is this? Accessory sesamoids.
What is this? Os Intermetatarseum
What is this? Tibialis Anterior Tendon Sesamoid
What is this? Os Vesalianium
What is this? What tendon is it found in? Os Peroneum. Sesamoid bone found in peroneus longus tendon.
What is this? Os Infranaviculare
What is this? Os Supranaviculare
What is this? Os Supratalare
What is this? What type is it? Accessory navicular (Os tibiale externum) Type 1: Sesamoid in the tendon
What is this? What type is it? Accessory navicular (Os tibiale externum) Type 2: Articulating accessory ossification centre
What is this? What type is it? Accessory navicular (Os tibiale externum) Type 3: Fused accessory ossification centre
What is this? What is it called when fused to the talus? Os trigonum Called trigonal (Steida's) process when fused to the talus
What is this? Os calcaneus secundarius
What is this? Os supracalcaneum
What is this? Os subtibiale
What foot type does this calcaneal inclination angle indicate? Pes cavo-varus
What foot type does this calcaneal inclination angle indicate? Pes plano-valgus
What is this angle called? What foot type does it indicate? Talar - 1st MT or Meary's Angle Pes plano-valgus
What is this angle called? What foot type does it indicate Talar - 1st MT or Meary's Angle Pes cavo-varus
What is this angle called? What is normal? What does an increased angle indicate? Talo-calcaneal angle. 25-45 degrees. Increased angle = hindfoot valgus
What is this angle called? Is this normal or abnormal? AP - Talo-calcaneal angle This is normal
What is this angle called? Is this normal or abnormal? AP-Talo-calcaneal angle This is abnormal. The angle is reduced indicating pes cavo-varus
What is this angle called? Is this normal or abnormal? Talo-navicular coverage. This is normal.
What is this angle called? Is this normal or abnormal? Talo-navicular coverage. This is abnormal as the talus is laterally deviated with medial overhang of navicular indicating pes cavo-varus
What is this called? What does an anterior break indicate? What does a posterior break indicate? Cyma Line/Midtarsal joint. Anterior break = pronated foot type Posterior break = supinated foot type
What is this? What foot type is this visible in? Sinus tarsi/bullet hole sign. Pes cavo-varus
What is this? What foot type is this visible in? Double talar dome sign. Pes cavo-varus
What angle is this? Is this normal or abnormal? 1st intermetatarsal angle Abnormal. Greater than 9 degrees is abnormal. Usually due to metatarsus primus varus
What deformity is this? Metatarsus Adductus
What deformity is this? Metatarsus Adductovarus (ladder like arrangement of the metatarsals in lateral view)
What deformity is this? Skew foot
What disease is this? Osteoarthritis
What disease is this? Rheumatoid arthritis
What disease is this? What does the arrow indicate? Rheumatoid arthritis. Arrow = Bone erosion secondary to inflammation of retrocalcaneal bursa.
What disease is this? Gout
What disease is this? What do the arrows indicate? Gout Arrows = 'punched out' erosions
What disease is this? What indicates this? Tophaceous gout. Soft tissue swelling surrounding the index finger PIPJ, with associated erosion and bone resorption
What disease is this? Tophaceous gout.
What disease is this? What is shown by A, B and C? Psoriatic arthritis. A = destructive changes B = Pencil in cup deformity C = IPJ fusion
What disease is this? Psoriatic arthritis
What disease is this? What does the arrow show? Non-articular psoriatic arthritis Arrow = 'fluffy spur'
What is this? Calcaneonavicular coalition (AKA calcaneonavicular bar or anteater's nose)
What is this? Calcaneonavicular coalition (AKA calcaneonavicular bar or anteater's nose)
What is this? Calcaneonavicular coalition (AKA calcaneonavicular bar or anteater's nose)
What is this? What is shown by A and B? STJ coalition A = talar neck spurring B = Halo or 'C' sign
What is this? Posterior talocalcaneal coalition
What is shown by A and B? A = Talonavicular coalition B = Calcaneocuboid coalition
What is this? Cuboid-navicular coalition
What type of fracture is shown at the 2nd metatarsal? Transverse fracture
What type of fracture is this? Oblique fracture
What type of fracture is this? Spiral fracture
What type of fracture is this? Comminuted fracture
What type of fracture is this? Osteochondral fracture
What type of fracture is this? Impaction fraction
What type of fracture is this? Intra-articular fracture
What type of fracture is this? Avulsion fracture
What do the arrows show? Stress fracture
Describe what has happened at the shaft of the 3rd met Exuberant periosteal new bone production. May have resulted if a stress fracture was not treated and the patient continued weight bearing activities.
What type of fracture is this? Greenstick fracture (common in paediatric patients)
Describe what the arrows are showing Torus fracture of the 1st met. "Buckling" of the proximal one third diaphysis is seen both medially and laterally. Common in paediatric patients
What is the Salter Harris classification used for? What is the mnemonic for the 5 types? Used to classify fractures involving the growth plate. S - slipped = type I A - above = type II L - lower = type III T - through = type IV R - ruined/rammed = type V
What type of fracture is this? Salter-Harris Type II
What type of fracture is this? Salter-Harris Type III
What type of fracture is this? How does it occur? Tillaux fracture - a fracture of the anterolateral tibial epiphysis that is commonly seen in adolescents. The fragment is avulsed due to the strong ATF ligament in an external rotation injury of the foot.
What type of fracture is this? Jones fracture - fracture of the diaphysis of the 5th metatarsal. More distal than an avulsion fracture.
What classification system is this? Describe the 3 classifications Weber Ankle Fracture Classification A = Fracture below syndesmosis B = Fracture begins at joint level & extends proximally in an oblique fashion C = Fracture above the joint line
What do the arrows indicate? Infectious periostitis
What disease is this? What signs indicate this? Osteomyelitis. Osteolysis (fragmentation), sequestra (dead/necrotic bone fragments floating in pus), rarefacation (loss of bone density).
What does the arrow show? Soft tissue emphysema
What disease is this? What do A, B & C show? Osteomyelitis. A = Soft tissue swelling B = Periosteal reaction C = Bony destruction
What disease is this? Gas gangrene
What disease is this? Gas gangrene
What disease is this? What causes it? Brodie's abscess - chronic bone abscess caused by organisms of low virulence. Patient most likely did not go through an acute phase (just chronic osteo)
What disease is this? Monckeberg’s arteriosclerosis
What does this indicate? Increased signal and enhancement of the soft tissue plantar to the proximal phalanx suggestive of subcutaneous infection without abscess
What does this indicate? Increased signal and soft tissue distension dorsally representing subcutaneous abscess communicating with associated with plantar ulcerative defect.
What disease is this? Atrophic neuroarthropathy
What disease is this? Atrophic forefoot neuropathy (diabetic osteolysis)
What disease is this? Charcot Neuroarthropathy
This patient has taken a short course of prednisone. What does the image show? Osteonecosis of the talus
What does this image show? Avascular necrosis of the talus, secondary to a talar neck fracture
What do these images show? What is this disease called? How does this differ from Meuller Wiess Syndrome? Osteochondrosis of the navicular. Kohler's disease. Kohler's disease only appears in children, Meuller Wiess Syndrome only appears in adults and is a spontaneus osteonecrosis of the navicular, not a true osteochondrosis.
Describe what is occurring at the head of the 3rd met Freiberg’s infarction (avascular necrosis of the metatarsal head)
What disease is this? Sever's disease
What is this? What else could it be? Iselin’s disease Traction apophysis, Os peronei, avulsion fraction, lis francs dislocation
Describe the patterns of destruction in A, B, C. Which is more malignant? A = geographic destruction B = moth eaten destruction C = permeative destruction Malignancy = C>B>A
What type of lesion is this? Geographic - slow growing lesion
What type of lesion is this? Moth eaten and permeative (mixed increased and decreased density throughout the entire calcaneus)
Describe this lesion A lytic lesion of the proximal phalanx that appears quite aggressive due to bone loss; however, the well-defined margins of the bone suggests a soft tissue tumor causing pressure atrophy against adjacent bone
What type of lesion is this? What type of periosteal reaction is this? Geographic. Continuous shell
What type of periosteal reaction is this? Interrupted
What type of periosteal reaction is this? Complex
What type of lesion is this? Unicameral bone cyst
What type of lesion is this? Giant cell tumour
What type of lesion is this? Aneurysmal bone cyst
What type of lesion is this? Chondromyxoid fibroma
What type of lesion is this? Osteogenic
What type of lesion is this? Chondrogenic
What disease is this? What are the signs of this? Osteogenesis imperfecta (“Brittle bone disease”) Diffuse cancellous osteopenia (coarse primary trabeculae), diminished tubular bone girth
What disease is this? What are signs of this? Osteopoikilosis Defined homogeneous circular foci of increased density (bone islands), cortical-like densities in cancellous bone
What disease is this? What is it caused by? What indicates this? Osteopetrosis ("marble bone disease") Diffuse bone sclerosis due to osteoclasts dysfunction. "Bone within bone" appearance
What disease is this? Osteochondromatosis (multiple cartilaginous exostoses)
What disease is this? Melorheostosis
What disease is this? Rickets
What disease is this? Osteogenesis Imperfecta
What does this image show? What causes it? Regional bone loss Disuse, immobilisation, paralysis
In an ultrasound, what colour is bone, tendon and water (oedema)? Bone = white Tendon = grey Water = black
What does the arrow indicate? A cleft (tear) in the tendon
What does the red arrow show? What does the yellow arrow show? Red arrow = fluid Yellow arrow = tendon tear
What does the arrow indicate? Fluid
Describe the tendon pathology as seen in an MRI of A-D A = normal tendon B = Tenosynovitis C = Tendonitis D = Tendon Dysfunction (Functional Rupture)
What do the arrows indicate? Tenosynovitis
What do the arrows indicate? Tendonitis
What do the arrows indicate? Tendon Dysfunction – Functional Rupture
What does this show? Ganglion in lateral ankle soft tissue
What does the arrow show? What could this be? Teardrop-shaped hypointense lesion in third interspace. Could be morton's neuroma
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