MSK Imaging

Question 1

Q: What are the components used to name/classify a fracture?

Answer 1

A: Open vs. Closed, Type, Complete vs. Incomplete, Location, Deformity/Morphology, and Number of fragments.

Question 2

Q: What is the definition of an Open Fracture?

Answer 2

A: A fracture involving a break in the skin.

Question 3

Q: What is a Comminuted Fracture?

Answer 3

A: A fracture where the bone breaks into two or more places/fragments.

Question 4

Q: What does a Spiral Fracture often indicate in a child?

Answer 4

A: In children, a spiral shape around the bone may be a sign of abuse (twisting injury), and should be correlated with the clinical picture.

Question 5

Q: What is a Compression Fracture?

Answer 5

A: A fracture involving the collapse of bone, typically seen as an anterior vertebral body collapse in osteoporotic spinal fractures.

Question 6

Q: What is a Torus/Buckle Fracture?

Answer 6

A: An incomplete fracture usually seen in children where the bone bends or “buckles” instead of breaking entirely.

Question 7

Q: What is a Greenstick Fracture?

Answer 7

A: An incomplete fracture in immature bone where the bone breaks like a “green stick,” staying connected on one side.

Question 8

Q: What indicates a Displaced Fracture?

Answer 8

A: When the fracture fragments are out of normal anatomic alignment.

Question 9

Q: What type of fracture does the Salter-Harris classification apply to?

Answer 9

A: Epiphyseal fractures (fractures involving the growth plate).

Question 10

Q: Describe Salter-Harris Type 1.

Answer 10

A: Fracture is Straight across the growth plate only.

Question 11

Q: Describe Salter-Harris Type 2.

Answer 11

A: Fracture is Along the growth plate and into the diaphysis (the shaft of the bone).

Question 12

Q: Describe Salter-Harris Type 3.

Answer 12

A: Fracture is Along the growth plate and into the epiphysis.

Question 13

Q: Describe Salter-Harris Type 4.

Answer 13

A: Fracture is Across the diaphysis, growth plate, and epiphysis (Two or Through).

Question 14

Q: Describe Salter-Harris Type 5.

Answer 14

A: Crush/compression of the growth plate (Erasure of the growth plate).

Question 15

Q: What are the four hallmarks of Osteoarthritis (OA) on imaging?

Answer 15

A: Joint space narrowing, Osteophytes (bone spurs), Sclerotic borders, and Subchondral bone cysts.

Question 16

Q: How do Stress Fractures often appear on X-ray, and how are they typically diagnosed?

Answer 16

A: They may appear normal on X-ray. Diagnosis may require a bone scan.

Question 17

Q: What is a Segond Fracture and why is it important?

Answer 17

A: An avulsion fracture at the proximal lateral tibial plateau. It is significantly associated with ACL tears (75% of the time) and meniscus tears (66−75% of the time), requiring a follow-up MRI.

Question 18

Q: What are the common fractures of the 5th Metatarsal?

Answer 18

A: Jones fracture (through the base), and Avulsion fracture (common at the base).

Question 19

Q: What are the key elements of the Ottawa Ankle Rules?

Answer 19

A: Order an X-ray if there is tenderness to palpation (TTP) in the malleolar zone AND TTP of the posterior distal tibia/fibula OR the inability to weight-bear 4 steps immediately after the injury and during the exam.

Question 20

Q: What is the mnemonic used to remember the order of elbow ossification centers?

Answer 20

A: CRITOE.

Question 21

Q: What are the C and R in CRITOE and their approximate ages of ossification?

Answer 21

A: Capitelium (≈1 yr. old) and Radial head (≈3 yrs.).

Question 22

Q: What are the I and T in CRITOE and their approximate ages of ossification?

Answer 22

A: Internal (medial) epicondyle (≈5 yrs.) and Trochlea (≈7 yrs.).

Question 23

Q: What are the O and E in CRITOE and their approximate ages of ossification?

Answer 23

A: Olecranon (≈9 yrs.) and External (lateral) epicondyle (≈11 yrs.).

Question 24

Q: What is the general purpose of T1-weighted MRI?

Answer 24

A: To highlight anatomy, making fluid dark and fatty tissue bright.

Question 25

Q: What is the general purpose of T2-weighted MRI?

Answer 25

A: To highlight pathology; fluid is bright white (H2​O is white), making it ideal for visualizing inflammation and edema.

Question 26

Q: Which is the most commonly fractured carpal bone and what specialized view is used to visualize it?

Answer 26

A: The Scaphoid, visualized using a Scaphoid view (ulnar deviation).

Question 27

Q: What X-ray view of the ankle provides a clear view of the joint without tib/fib overlap?

Answer 27

A: The Mortise view (internal oblique).

Question 28

Q: What specialized X-ray view is used to evaluate the patella?

Answer 28

A: The Sunrise view.

Question 29

Q: When should imaging be recommended for Lumbar Spine pain?

Answer 29

A: If pain is persisting beyond 4-6 weeks of conservative treatment (PT) or if red flags (neurological deficit, cauda equina signs/symptoms, night pain) are present.

Question 30

Q: What imaging technique is needed for suspected soft tissue issues in the knee (ACL, MCL, menisci)?

Answer 30

A: MRI.