Lect. 5 Pelvis SI and HIP Ankle Knee Foot

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bcb2127
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Lect. 5 Pelvis SI and HIP Ankle Knee Foot
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2012-05-03 15:08:51
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Lect Pelvis SI HIP Ankle knee foot
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Lect. 5 Pelvis SI and HIP Ankle Knee foot
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  1. ____ 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
  2. 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)
  3. Angle of Pubic Arch:
    Female>__d
    Male = __ d
    • Female :>90d
    • Male = 90d
  4. ______ ______: 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.
    Rheumatoid arthritis
  5. _______ ______ _____ ______: 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
  6. Femoral-Acetabular Impingement:
    ____ 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
  7. 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
  8. 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
  9. 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
  10. 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
  11. ________ _______: 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.
    Osteochondritis dissecans
  12. 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
  13. 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
  14. 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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