Upper Limb

Question 1

ABCs of radiograph examinations

Answer 1

alignment, bone cortices & texture, cartilage, soft tissues

Question 2

what should be checked for alignment

Answer 2

lines which suggest # / dislocation

Question 3

what should be checked for bone cortices & texture

Answer 3

breach in cortex, change in density / trabecular patterns

Question 4

what should be checked for cartilage

Answer 4

joint space & osteophytes

Question 5

what should be checked for soft tissues

Answer 5

swelling

Question 6

what is the salter-harris classification of physeal #

Answer 6

• Straight across
• Above
• Lower / Below
• Through / Two
• ERasure of growth plate

Question 7

what are the main # in pediatrics

Answer 7

• torus / buckle
• bowing
• greenstick
• salter harris

Question 8

signs of torus / buckle #

Answer 8

bulge in cortex

Question 9

signs of bowing #

Answer 9

bending bone shaft

Question 10

signs of greenstick

Answer 10

shaft bent with # on convex surface

Question 11

signs of salter harris #

Answer 11

growth plate #

Question 12

classifications of # include:

Answer 12

• Transverse
• Linear
• Oblique displaced / non-displaced
• Spiral
• Greenstick
• Comminuted

Question 13

what is the WWH when describing fractures

Answer 13

• what is the abnormality?
• where is the abnormality?
• how is it displaced & angulated in which direction?

Question 14

distal radius is assessed using:

Answer 14

• radial height
• radial inclination
• ulnar variance

Question 15

what is radial height

Answer 15

distance between 2 lines drawn perpendicular to long axis of radius (radial styloid & CRP); normally 10 - 14mm

Question 16

what is radial inclination

Answer 16

angle between one line drawn perpendicular to long axis of radius & tip of radial styloid to Central Reference Point (CRP); normally 20 – 25 degrees

Question 17

what is ulnar variance

Answer 17

distance between second line through CRP & line through distal articular surface of ulnar head; normally 0+/- 2mm

Question 18

what is the importance of volar tilt

Answer 18

evaluate distal radius # & radial deformities

Question 19

what forms the volar tilt

Answer 19

Formed by line drawn perpendicular to axis of radial shaft & line passes through tip of dorsal & volar rims

Question 20

wrist abnormalities are seen if

Answer 20

• Radial inclination change of > 5 degrees [normally 20 - 25 degrees]
• Radial shortening of > 5mm
• Volar tilt with dorsal angulation of > 5 degrees

Question 21

what does a positive ulnar variance indicate

Answer 21

longer ulna to radius

Question 22

If radial articular surface & ulna styloid process intact are not intact, what does it suggest

Answer 22

undisplaced #

Question 23

If scapholunate distance > 2mm wide, what does it suggest

Answer 23

suspected tear of scapholunate ligament

Question 24

If radial articular surface is not distal to ulna, what does it suggest

Answer 24

suspected disruption at radioulnar joint

Question 25

If radial cortex shows angulation or bulge, what does it mean

Answer 25

greenstick / torus #

Question 26

If bone fragment lies posterior to carpal bones, what does it mean

Answer 26

triquetral #

Question 27

If bone is not sitting in cup of lunate, what does it mean

Answer 27

carpal dislocation involving lunate

Question 28

For elbows, displaced anterior fat pad suggests

Answer 28

highly likely #

Question 29

For elbows, displaced posterior fat pad suggests

Answer 29

suspected #

Question 30

For elbows, undisplaced fat pad suggests

Answer 30

occasionally #

Question 31

how are fat pads seen

Answer 31

black stripe against anterior cortex of humerus

Question 32

what is the radio-capitellar line

Answer 32

line drawn down neck of radius & intersect capitellum; line should be drawn down radial neck & not shaft due to slight angulation at radial neck

Question 33

If RC line does not pass through capitellum, what does it mean

Answer 33

ulna dislocated from trochea

Question 34

For shoulders, if humeral head lies directly below coracoid process, what does it mean

Answer 34

anterior dislocation

Question 35

For shoulders, if humeral does not have a walking stick shape & articular surface is not parallel to glenoid margin, what does it mean

Answer 35

use 2nd view TRO posterior dislocation

Question 36

if AC joint is not normal, what does it mean

Answer 36

subluxation / dislocated AC joint

Question 37

if coracoclavicular distance > 1.3cm, what does it mean

Answer 37

stretched / ruptured CC ligaments