Lect. 5 Pelvis SI and HIP Ankle Knee Foot
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____ View of Pelvis: Shows entire pelvis, sacrum, coccyx, and lumbosacral articulation, and bilateral hip joints
____ View of Hip: Shows acetabulum, femoral head, neck and proximal 3rd of shaft, greater trochanter and angle
of inclination of femoral neck
Lateral ____ ____ of Hip: Shows femoral head, neck and proximal 3rd of femoral shaft and greater and lesser
trochanters from medial aspect
- A/P of pelvis
- A/P of Hip
- Lateral frog leg of hip
6 important lines
- AP radiograph shows:
- 1. Iliopubic line (short arrows on (R)hip)
- 2. Ilioischial line (long arrows on R hip)
- 3/4. anterior/posterior acetabular rims (long and short arrows on L hip)
- 5. Radigraphic teardrop (curved arrow L hip)
- 6. Acetabular Roof (not mentioned)
Angle of Pubic Arch:
Male = __ d
______ ______: osteoporosis of periarticular areas; symmetrical and concentric joint space narrowing; articular erosions; synovial cysts located within nearby bone; periarticular swelling and joint effusions; axial migration of femoral head; acetabular protrusions; unlike the hallmark signs of ___, ____ has minimal evidence of bone trying to repair itself and your won't see a lot of sclerotic bone or osteophytes.
_______ ______ _____ ______: weakening of epiphyseal plate that leads to slipping of femoral head.
Clinical Symptoms: pain in ____ and ____. Limited hip ___, antalgic gt, and limb shortening.
2x more prevalent in boys than girls
Onset usually around growth spurts and puberty.
- Slipped Capital Femoral Epiphysis
- Pain in hip and knee; limited hip ROM, antalgic gt, limb shortening
____ impingement: femoral head-neck junction is offset, and femoral head doesn't fully clear the acetabular rim.
____ impingement: overcoverage of femoral head by acetabulum, caused by deep socket or other malformations
-both can lead to or be associated with labral tears
- CAM impingement
- Pincer impingement
Symptoms of Femoral Acetabular Impingement: 5 total
- snapping, clicking, limited hip ROM, hip flexion contractures, painful provocation tests
- -true hip locking is associated with labral tears
Knee: Routine Views
–____ View: distal femur, proximal tibia, femorotibial
articulation and head of fibula
–______View: PF joint profile, suprapatellar
bursa, quad tendon, patellar tendon. Maysee a “_____”
–P/A _____ ____ View of Intercondylar Fossa: used to see posterior aspect of condyles and detect loose bodies
–______View: axial view showing PF joint space and articular surfaces of patella and femur
- - A/P view
- -Lateral View--"Fabella"
- -P/A axial tunnel view
- -Sunrise view
Pittsburgh Knee Rules: conventional radiographs should be ordered for pts with the following characteristics:
-Pt has ___ ___ or a ___ plus either or both of the following:
-age under __ or over ___ and/or
-inability to walk __ wb steps in ER
- -pt has blunt trauma or a fall plus either or both of the following:
- -under 12 or over 50
- -inability to walk 4 wb steps in ER
Ottawa Knee Rules :conventional radiographs should be order after trauma to the knee for pts with any of the following characteristics:
-age greater than or equal to __
-tenderness to ____ ___
-isolated tenderness of _____
-inability to flex knee to ___d
-inability to walk __ wb steps immediately after or in ER.
- 1. age greater tha nor equal to 55
- 2. tenderness to fibular head
- 3. isolated tenderness of patella
- 4. inability to flex knee to 90 d
- 5. inability to walk 4 wb steps immediately after or in ER
________ _______: seen in younger, active people; dull pain and jt effusions exacerbated with wt bearing activities; considered a chronic form of osteochondral fracture; shearing and rotatoin forces detach fragments of articular cartillage and subchondral bone.
Ottawa Ankle Rules :Conventional radiographs should be ordered after trauma to the foot or ankle for pts wit hany of the following characteristics:
-Pain in the malleolar zone AND:
-tenderness at ___ aspect or __ of ______ malleolus OR
-tenderness at ___ aspect or __ or ______ malleolus OR
-inability to ___ ____ both immediately and in the ER.
- -tenderness at post aspect or tip of lateral malleolus
- -tendernss at post aspect or tip of medial malleolus
- -inability to bear weight both immediately and in the ER
Ottawa Ankle Rules: Foot
Pain in the midfoot zone AND:
-tenderness at the ___ ______ base OR
-tenerness at the ______ bone OR
-inability to ____ ____ both immediately and in the ER
- -tenderness at the 5th metatarsal base OR
- -tendernss at the navicular bone
- - inability to bear weight both immediately and in the ER
Knee stuff: ______ check for avulsion fractures
______ MRI best view for cruciates\
___: striated appearance with some high siganal within it, especially at it's insertion on the tibia
___: low signal structure, gently curving between posterior
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