Phase 1

What do you call the end of a long bone

epiphysis

what do you call the area that provides longitudinal growth on a long bone

physis, growth plate, epiphyseal plate

junction between physis and metaphysis of a long bone with thin line of increased density

zone of provisional calcification

area where opposing cortices are not parallel

metaphysis

area where opposing cortices are parallel

diaphysis

area of most metabolic activity in long bone

metaphysis

normal secondary ossification center located on non-weight bearing portion

apophysis

densest, strongest portion of bone

cortex

internal cavity of bone

medulla

thin membrane around diaphysis and metaphysis

periosteum

between cortex and medullary space

endosteum

what imaging modality is best for deep internal structures

MRI

what imaging modality is best for fractures

CT

what imaging modality is best for superficial structures

ultrasound

Grashey view of shoulder is good for what

glenohumeral joint space

What type of view is this

external rotation AP shoulder

what type of view is this

AP internal rotation shoulder

what type of view is this

grashey

what type of view is this

Y view

What view is this

medial oblique elbow

what type of view is this

AP elbow

what type of view is this

lateral elbow

what type of view is this

PA wrist

what type of view is this

medial oblique wrist (intermetacarpal spaces are uneven)

what type of view is this

lateral wrist (metacarpals are stacked)

what type of view is this

PA wrist

what type of view is this?

PA hand

what type of view is this

medial oblique hand (digits included and intermetacarpal spaces are uneven)

what type of view is this

lateral hand

what is this measurement called and what are the normal limits

glenohumeral joint space

4-5mm

what is a decreased glenohumeral joint space suggestive of

arthritic conditions wha

what is an increased glenohumeral joint space measurement suggestive of

joint effusion, posterior shoulder dislocation, acromegaly

what measurement is this called and what are the normal limits?

acriohumeral space

7-11mm

what is a decreased acromiohumeral joint space suggestive of

rotator cuf injury or degeneration

what is an increased acriohumeral space suggestive of

subluxation, joint effusion, stroke, brachial lesion

what measurement is this called and what are the normal ranges

acromioclavicular joint space

3 mm/no more than 2-3 mm difference between sides

what is a decreased acromioclavicular joint space suggestive of

degeneration

what is an increased acromioclavicular joint space suggestive of

traumatic separation, osteolysis, inflammatory conditions

what is this measurement called and what are the normal ranges

coraclavicular distance

11-13 mm/no more than 5mm difference between sides

what is the coracoclavicular distance used for

determining degree of Rockwood type of AC joint injury

what is this measurement called and what are the normal ranges

anterior humeral line

line hsould intersect the middle third of the capitellum

if anterior humeral line is abnormal what is implied

fracture through supracondylar portion of distal humerus

what is this measurement called and what is the normal range

fat pad assessment

anterior fat pad is slim, no posterior fat pad

if the anterior fat pad is raised what is that sign called

sail sign

what is indicated if the posterior fat pad is present

joint effusion due to an occult fracture

what is this measurement called and what are the normal ranges

radiocapitellar line

line from neck of radius toward elbow joint should intersect the capitellum

if the radiocapitellar line does not intersect the capitellum what is suggested?

radial head dislocation/subluxation

what is this measurement called and what is considered normal

carpal arcs

smooth lines from all 3 arcs

what is indicated if the carpal arcs are uneven

ligamentous laxity or fracture

what is this measurement called and what are the normal ranges

captiolunate angle

less than 30 degrees

what is the significance of an increased captiolunate angle

increased dorsal or volar intercalated segment instability

how do you determine whether an increased capitolunate angle is due to dorsal or volar intercalated segment instability

take scapholunate angle

what is this measurement and what is considered normal

scapholunate angle

30-60 degrees

if scapholunate angle is increased what is implied

dorsal intercalated segment instablity

if scapholunate angle is decreased what is implied

volar intercalated segmental instability

what is this measurement and what is considered normal

intercarpal joint space

1-2 mm, all should be about equal

if intercarpal joint space is increased what is suggested

ligamentous laxity or injury

what is the scapholunate interval called and what does it mean

terry thomas sign

greater than 2mm between scaphoid and lunate

what are the limits for the scapholunate interval

2mm is suspicious

4mm is definitely abnormal

what is this measurement and what is considered normal

metacarpal sign

line through the distal articular surfaces of the fourth and fifth metacarpals should be distal to the third metacarpal head

what is indicated if the line through the 4th and 5th metacarpal heads passes through the third metacarapal head

gonadal dysgenesis (Turner’s syndrome) or fracture deformity

what is this measurement and what is considered normal

radioulnar variance

distal ulnar and radial surfaces should align with each other

what is a short ulna called and what are the ramifications

negative ulnar variance

avascular necrossis of lunate (Kienbock’s disease)

what is a long ulna called and what are the ramifications

positive ulnar variance

mechanical impingement of triangular fibrocartilage coplex (TFCC) and/or lunate and triquetral bones

what is this anomaly called

rhomboid fossa

what is this anomaly called

supraclavicular foramen

what is this anomaly called

vacuum phenomenon

what is this anomaly called

os acromiale

what is this anomaly called

what syndrome is it often associated with when other factors are present

Sprengel’s deformity

Klippel Feil Syndrome

what other factors must be present with a sprengel’s deformity to diagnose klippel fiel syndrome

omovertebra

multiple block vertebra

spina bifida oculta

what is this anomaly called

pseudotumor/pseudocyst of humerus

what is this anomaly called

pseudotumor/pseudocyst of humerus

what is this anomaly called

supracondylar process

what is this anomaly called

olecranon foramen

what might a supracondylar process cause

neurovascular compression of struther’s ligament, median nerve, and brachial artery

what is this anomaly called

radioulnar synostosis

what might a radioulnar synostosis cause

limited pronation/supination

what is this anomaly called

Madelung’s deformity

what is madelung’s deformity characterized by

short, bowed radius angled toward ulna

v shape configuration of the carpus

widening of distal radioulnar joint

this physical appearance is characteristic of what?

Madelung’s deformity

what is this anomaly called

carpal coalition (of triquetrum and lunate)

what is this anomaly called

carpal coalition of capitate and hamate

what is this anomaly called and what action might cause this patient pain

carpal boss

extension

what is this anomaly called

central polydactyly

what is this anomaly called

pre-axial polydactyly

what is this anomaly called

syndactyly

where is syndactyly most common?

thrid and fourth digits or second and third

syndactyly occurs due to what

defect in mesenchymal organization

what is the most common developmental anomaly of the hand

syndactyly

what is this anomaly called

polysyndactyly (combo of polydactyly and syndactyly)

what is this anomaly called

symphalangism

what might symphalangism cause

stiffness, lack of volar skin folds at knuckles, reduced range of motion

what is this anomaly called and what does it mean

brachydactyly

disproportionately short fingers and toes

what is this anomaly called

Kirner’s deformity

Kirner’s deformity typically affects what digit and causes curvature in what direction(s)

5th

palmar AND radial

what is this anomaly called

clinodactyly

clinodactyly is typically found at what digit and caused angulation in what direction(s)

5th

radial OR palmar

what is this anomaly called

campodactyly

campodactyly is characterized by what

permanent flexion of digit usually at proximal interphalangeal joint

(permanent extension in distal interphalangeal joint in response)

what is this anomaly called

nutrient foramen