Knee Imaging

Question 1

A 60-year-old patient falls and presents with knee pain and inability to bear
weight. According to ACR guidelines, what is the MOST appropriate first imaging
study? A. MRI without contrast B. CT scan C. X-ray D. Ultrasound

Answer 1

C. X-ray — ACR guidelines rate knee radiographs as usually appropriate (rating
9) as the first imaging study after acute trauma.

Question 2

Which radiographic view BEST demonstrates overall joint space narrowing in knee
osteoarthritis? A. AP weight-bearing view B. Axial MRI C. Sagittal MRI D.
Ultrasound

Answer 2

A. AP weight-bearing view — This view clearly demonstrates joint space narrowing
seen in OA.

Question 3

A patient has suspected internal derangement after a normal X-ray. According to
ACR guidelines, what is the next imaging study? A. MRI without contrast B. CT
with contrast C. Ultrasound D. Bone scan

Answer 3

A. MRI without contrast — MRI is rated most appropriate when internal
derangement is suspected after normal radiographs.

Question 4

Which structure is visualized between the femoral condyles on an AP radiograph?
A. Patella B. Tibial plateau C. Intercondylar notch D. Fibular shaft

Answer 4

C. Intercondylar notch — Located between the femoral condyles on AP view.

Question 5

A 25-year-old athlete has knee trauma and isolated tenderness of the fibular
head. According to the Ottawa Knee Rule, what is indicated? A. MRI immediately
B. No imaging needed C. Knee radiograph D. Ultrasound

Answer 5

C. Knee radiograph — Fibular head tenderness meets Ottawa Knee Rule criteria for
radiography.

Question 6

Which MRI plane BEST visualizes the ACL from anterior to posterior? A. Coronal
B. Sagittal C. Axial D. Oblique

Answer 6

B. Sagittal — The sagittal view clearly demonstrates ACL orientation.

Question 7

Which structure is anterior to the tibia on sagittal MRI? A. PCL B. ACL C. MCL
D. Fibula

Answer 7

B. ACL — The ACL lies anterior to the PCL and attaches anterior tibia.

Question 8

A Segond fracture on radiograph is MOST associated with which injury? A. MCL
tear B. ACL tear C. Meniscal tear D. PCL tear

Answer 8

B. ACL tear — Segond fracture is commonly associated with ACL rupture.

Question 9

Which structure appears as a dark wedge between femur and tibia on MRI? A.
Patella B. Meniscus C. Fibula D. Femur

Answer 9

B. Meniscus — The meniscus appears as a wedge-shaped structure.

Question 10

A 70-year-old patient has chronic knee pain. According to ACR guidelines, what
is the initial imaging study? A. MRI B. CT scan C. Radiograph D. Ultrasound

Answer 10

C. Radiograph — Knee radiographs are usually appropriate initial imaging for
chronic pain.

Question 11

Which MRI plane provides a cross-sectional view of structures? A. Coronal B.
Sagittal C. Axial D. Oblique

Answer 11

C. Axial — Provides transverse cross-sectional imaging.

Question 12

Which structure articulates with femoral condyles on AP radiograph? A. Patella
B. Tibial plateau C. Fibular head D. Meniscus

Answer 12

B. Tibial plateau — Forms articulation with femoral condyles.

Question 13

Which Ottawa Knee Rule criterion requires imaging? A. Pain only B. Age ≥55 years
C. Swelling only D. Bruising

Answer 13

B. Age ≥55 years — This is one of the Ottawa Knee Rule criteria.

Question 14

Which ligament is posterior in the knee joint on MRI? A. ACL B. MCL C. LCL D.
PCL

Answer 14

D. PCL — Posterior cruciate ligament is posterior.

Question 15

A Baker’s cyst is BEST visualized on which radiographic view? A. AP view B.
Lateral view C. Axial MRI D. Coronal MRI

Answer 15

B. Lateral view — Baker’s cyst is visualized posteriorly.

Question 16

Which radiographic view shows patella in profile? A. AP view B. Lateral view C.
Axial view D. Oblique view

Answer 16

B. Lateral view — Patella is clearly visualized.

Question 17

Which imaging modality BEST visualizes ligament tears? A. Radiograph B. MRI C.
Ultrasound D. CT

Answer 17

B. MRI — Provides best soft tissue visualization.

Question 18

Which structure is anterior in axial MRI? A. Patella B. PCL C. Popliteal artery
D. Tibia

Answer 18

A. Patella — Located anterior to joint.

Question 19

Joint space narrowing indicates which pathology? A. Fracture B. Osteoarthritis
C. Tumor D. Infection

Answer 19

B. Osteoarthritis — Caused by cartilage degeneration.

Question 20

Which structure is lateral on AP radiograph? A. Fibula B. Patella C. Tibia D.
Femur

Answer 20

A. Fibula — Located lateral to tibia.

Question 21

Which MRI view best visualizes collateral ligaments? A. Axial B. Sagittal C.
Coronal D. Oblique

Answer 21

C. Coronal — Best shows medial and lateral ligaments.

Question 22

A patient cannot flex knee to 90°. According to Ottawa Knee Rule, what should be
done? A. MRI B. CT C. X-ray D. No imaging

Answer 22

C. X-ray — Meets criteria for radiography.

Question 23

Which structure is located superior to tibia? A. Femur B. Fibula C. Patella D.
Meniscus

Answer 23

A. Femur — Forms superior articulation.

Question 24

Which ligament prevents posterior tibial translation? A. ACL B. PCL C. MCL D.
LCL

Answer 24

B. PCL — Prevents posterior translation.

Question 25

Which imaging is most appropriate for detecting fracture? A. MRI B. Radiograph C. Ultrasound D. Bone scan

Answer 25

B. Radiograph — First-line imaging for fracture detection.

Question 26

Which MRI structure appears bright in T2 when fluid present? A. Bone B. Ligament C. Fluid D. Muscle

Answer 26

C. Fluid — T2 highlights fluid.

Question 27

Which structure lies between tibia and femur? A. Meniscus B. Patella C. Fibula D. Quadriceps

Answer 27

A. Meniscus — Provides cushioning.

Question 28

What imaging is best for chronic pain initial evaluation? A. MRI B. CT C. Radiograph D. Ultrasound

Answer 28

C. Radiograph — Initial imaging per ACR.

Question 29

Which structure stabilizes medial knee? A. ACL B. PCL C. MCL D. LCL

Answer 29

C. MCL — Provides medial stability.

Question 30

Which MRI view best visualizes patellar cartilage? A. Axial B. Coronal C. Sagittal D. Oblique

Answer 30

A. Axial — Shows patella cartilage.

Question 31

Which imaging is best for soft tissue visualization? A. CT B. Radiograph C. MRI D. Ultrasound

Answer 31

C. MRI — Best soft tissue contrast.

Question 32

Which structure is inferior to femur? A. Tibia B. Fibula C. Patella D. Meniscus

Answer 32

A. Tibia — Articulates below femur.

Question 33

Which condition shows joint degeneration on radiograph? A. ACL tear B. OA C. Meniscus tear D. PCL tear

Answer 33

B. OA — Causes joint degeneration.

Question 34

Which ligament is anterior to PCL? A. ACL B. MCL C. LCL D. Patella

Answer 34

A. ACL — Located anteriorly.

Question 35

Which Ottawa Knee Rule criteria indicates imaging? A. Ability to bear weight normally B. Age under 40 C. Inability to bear weight 4 steps D. No swelling

Answer 35

C. Inability to bear weight 4 steps — Requires radiography.