EVMS Unofficial Radiology Reading for Jan 2020

MSK Requisites - Ch 16-20

December 2019 Reading Quiz

It's December - That Means It Is Quiz Time!

1. Why are 12 year olds predisposed to lateral Salter-Harris ankle fractures?

2. Axial loading intraarticular fracture of the distal tibial fracture is called what?

3. "Jimmy has an OCD of the talar dome, a transverse fracture of the base of the 5th metatarsal and tenosynovitis of the Achilles tendon". Which part of this statement is wrong and why?

4. What 2 things may cause a posterior impingement?

5. How many views should be obtained in a foot x-ray series to properly evaluate bones of the mid and forefoot?

6. Why is surgery often indicated for Lisfranc fracture/ligament injuries?

7. Why is it important to distinguish a Jones fracture from an avulsion fracture of the base of the 5th metatarsal?

8. The presence of Heel spurs indicates plantar fasciitis - True or False?

9. What is a growth arrest line? What can be a cause?

10. What is a widened metaphyseal band? What can be a cause?

11. What is an Erlenmeyer flask deformity? What are possible etiologies?

12. Why don't we have an updated Gruelich and Pyle?

13. The patient has a butterfly vertebra, what type of scoliosis may this patient have?

14. Patient has kyphosis, dural ectasia and rib anomalies. What etiology of scoliosis should we consider? Why is it important to determine this etiology?

15. The patient has painful scoliosis - should I tell the patient that they likely just have idiopathic scoliosis and not worry about it? Why or why not?

16. If I say, this scottie dog has a collar, what am I saying?

Bonus - What song would be the theme song for your life? - please share youtube video as part of your response

November 2019 Unofficial EVMS Reading Answers

Congrats to - Dr. Yoni, Dey, Vosburgh, Lussier, and Bonney!

1. Layering in the joint space - lipohemarthrosis. This signifies either fracture or bone bruise (2 points)

2. Schatzker II. Depression and gap at the articular surface. CT - better define the fracture preoperatively (3 points)

Large arrow shows depressed portion. The smaller arrow points to the vertical cleft.

Image source - Orthopedics and Traumatology Vol 99, Issue 7, Nov 2013

3. Double PCL sign. Bucket handle tear of the meniscus. Medial (3 points)

4. Anteromedial tibia and fibular styloid. MRI to evaluate for cruciate injury and posterolateral corner injury (1 each for fracture; 1 for MRI, 1 for why; 4 points)

5. Soft tissue mass anterior to the ACL reconstruction - Arthrofibrosis - cyclops lesion; Hates him. Limited extension. ACL reconstruction (3)

6. Comminuted patellar fracture. No. ORIF - Often with circlage wires and sometimes additional screws (3 points)

Bipartite and multipartite patellas - typically are more lateral than diffuse. There is a type involving the inferior patella - but medial is rare. This example is extensively fragmented - therefore it is more likely to be fractured.

Source - Multipartite patella EPOS

7. Quadriceps tear. Rectus femoris (superficial), conjoint vasus lateralis and medialis (middle), vastus intermedius (deep) - (2 points)

8. Prepatellar bursitis. Maid, carpenter, someone working long periods on their knees. (2 points)

same knee as the x-ray

9. Limits abduction and may result in anterior dislocation (when hip is placed in forced abduction) (1 point)

10. Stress Shielding - the bone that is not under stress is resorbed (1 point)

11. migration of component, change in alignment of a component with adjacent bone, lucency at bone-hardware interface > 2mm, fracture of cement or hardware in setting of cemented hardware. (2 points)

12. Scapular notching along axillary border of the scapula is often a precursor to loosening and failure (1 point)

bonus - variable answers (2 points possible)

Total possible - 27 points + 2 possible bonus points

December Reading

Reading for December 2019. MSK Requisites Ch. 14, 15, 42, 43

November 2019 Unofficial EVMS Quiz

It's November - Let's Do This

1. 

What about this image makes me think of Neapolitan Ice Cream? What is the significance?

2. What Schatzker classification would you give this case? What significant findings would you want to comment on? What next study would you recommend and why?

3. 

What is the sign on the lateral images? What is the diagnosis? Which side is most likely involved?

4. 

This is an oblique view. What is fractured? Based on imaging findings - what would you recommend and why?

5.  

What is the significant finding? How does this finding feel about Odysseus? How would this patient present? What surgery did they have previously?

6. 

What is the finding? Is it a normal variant? How is it treated?

7. 

What is the finding? What are the layers and list them superficial to deep?

8. 

What is the finding? What are possible occupations?

9. In hip arthroplasty, why do we not want a decreased lateral opening angle?

10. What is stress shielding?

11. What are 2 findings that suggest loosening?

12. What is the significance of scapular notching in the setting of a reverse total shoulder arthroplasty?

Bonus:
Share a Youtube video of your current favorite song or song that has greatly inspired you and give short no more than 3 sentence reason as to why. All styles and genres are acceptable. 

October 2019 Quiz Answers

Congrats to - Dr. Dey, Bonney, Vosburgh, Lussier, and The Great Yoni

Answers!

Spine

1. 3; Anterior (anterior 1/2 of vertebral body and ALL), Middle (posterior 1/2 of the vertebral body and PLL), and posterior (posterior elements, facets, associated ligaments) (4 points)

2. 2 to 3 columns (1 point)

3. 2/3 width of C2 body level at C3 and C4 and no more than 14 mm at C6 (1 point)

4. 1 - Anterior vertebral line, 2. Posterior vertebral line, 3. spinal laminar line, 4 - posterior spinous line; Posterior spinous line is least likely to be associated with significant instability (2 points)

5. 2.5 mm; 5 mm (1 point)

6. Hypoglossal canal or jugular foramen; Cranial nerves IX and XII (2 points)

7. Type 1 - Tip; 2 - waist or base; 3 - extend into the body (1 point)

8. Flexion teardrop (1 point)

9. c (1 point)

10. b (a would have been 100%) (1 point)

15 points

Pelvis

11. d (1 point)

12. inferior (1 point)

13. AP compression, lateral compression, vertical shear (1 point)

14. iliac crest (abdominal muscles), anterior superior iliac spine (sartorius), anterior inferior iliac spine (rectus femoris), inferior pubic ramus (adductor muscles), ischial tuberosity (hamstrings) - (5 points)

15. Anterior wall, posterior wall, transverse, anterior column, posterior column (1 point)

16. Separates the upper hemipelvis from the lower hemipelvis and can occur above, at, or inferior to the roof of the acetabulum (1 point)

10

Hip and Femur

17. medial and lateral circumflex femoral arteries from the profunda femoris artery (1 point)

18. Greater in profile; lesser - hidden (1 point)

19. AVN (1 point)

20. e (1 point)

21.  10-16; males, AA, obese, delayed skeletal maturation (2 points)

6

Total - 31 points +/- bonus

November 2019 Reading

MSK Requisites Ch. 12, 13, 24