Skeletal Radiology: Lower Limb Flashcards


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Skeletal Radiology
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1

How many tarsal bones are found in the foot?

7

2

Which metatarsal bone of the foot has a prominent tuberosity frequently fractured?

5th

3

What term describes the top or anterior surface of the foot?

Dorsum

4

Where would the interphalangeal joint be found in the foot?

Between the phalanges of the first digit

5

Which structure or bone contains the sustentaculum tali?

Calcaneus

6

How many articular facets make up the subtalar joint?

Three

7

What are the two arches of the foot?

Longitudinal and transverse

8

The medial malleolus is part of the:

tibia

9

The ankle joint is a ____ joint with a ____ type of movement.

synovial; sellar

10

Another term for the intercondylar sulcus is the:

patellar surface.

11

True/False:

The patella is drawn into the intercondylar sulcus when the knee is overextended.

False

12

A tear of the tibial (medial) collateral ligament (MCL) caused by a trauma injury is frequently associated with tears of the:

anterior cruciate ligament (ACL) and the medial meniscus.

13

Saclike structures found in the knee joint that allow smooth articulation between ligaments and tendons are called:

bursae.

14

To decrease the angle between the anterior surface of the foot and anterior surface of the lower leg is described as:

dorsiflexion.

15

The patellofemoral joint is a ____ joint with a ____ type of movement.

synovial; sellar

16

Which tendon attaches directly to the tibial tuberosity?

Patellar

17

The calcaneus articulates with the talus and the:

cuboid.

18

A radiographic appearance of a highly malignant and extensively destructive lesion that usually occurs in long bones and produces a
sunburst pattern describes:

an osteogenic sarcoma

19

A radiographic appearance of a well-circumscribed lucency within bones describes:

a bone cyst.

20

True/False:

With cassette-less digital systems, you can use a grid for a foot projection if it is impractical to remove it.

True

21

True/False:

When multiple exposures are placed on a single computed radiography image receptor (IR), lead masking should not be placed on
the unexposed regions of the imaging plate.

False

22

The best method of evaluating injuries to the menisci and ligaments of the knee joint involves:

a magnetic resonance imaging procedure.

23

True/False:

The adductor tubercle is located on the posterior aspect of the medial femoral condyle.

True

24

The distal tibiofibular joint is classified as a ____ joint.

fibrous

25

Which joint is a modified ellipsoidal or condyloid joint?

Metatarsophalangeal

26

Extending the ankle joint or pointing the foot and toes downward is called:

plantar flexion.

27

How much central ray (CR) angulation (if any) should be used for an AP projection of the toes?

10 to 15 degrees toward calcaneus

28

Which routine should be performed for a study of the second toe?

AP, AP oblique with medial rotation, lateromedial projection

29

How much is the foot dorsiflexed with the tangential projection for the sesamoid bones if the CR remains perpendicular to the
image receptor?

15 to 20 degrees from vertical

30

A lateral knee radiograph that is overrotated toward the image receptor can be recognized by:

The fibular head will appear less superimposed by the tibia than a true lateral.

31

True/False

A correctly positioned AP 45 degree medial oblique ankle projection frequently may also demonstrate a fracture of the base of the fifth
metatarsal if present.

True

32

To properly visualize the joint spaces with the AP projection of the foot, the CR must be:

perpendicular to the metatarsals.

33

Which position of the foot will best demonstrate the lateral (third) cuneiform?

AP oblique with medial rotation

34

What is one advantage of the lateromedial projection of the foot?

The foot assumes a more true lateral position.

35

What CR angulation is required for the AP oblique projection of the foot?

CR is perpendicular to the image receptor.

36

How much CR angulation to the long axis of the foot is required for the plantodorsal (axial) projection of the calcaneus?

30 to 35 degrees

37

Where is the CR placed for a mediolateral projection of the calcaneus?

1 inch (2.5 cm) inferior to medial malleolus

38

Which joint surfaces of the ankle joint are open with an AP projection of the ankle?

Medial and superior

39

How much rotation from an AP position of the ankle will typically produce an AP mortise projection?

15 to 20 degrees

40

Which projection of the ankle will best demonstrate the open joint space of the lateral aspect of the ankle joint?

AP mortise projection

41

The purpose of the AP stress views of the ankle is to demonstrate:

possible joint separations or ligament tear.

42

To ensure that both joints are included on an AP projection of the tibia and fibula on an adult, the technologist should:

turn the image receptor diagonally.

43

What CR angulation is required for an AP projection of the knee on a patient with an ASIS-to-tabletop measurement of 18 cm?

3 to 5 degrees caudad

44

Which projection of the knee will best demonstrate the neck of the fibula without superimposition?

AP oblique with medial rotation

45

What CR angle should be used for a lateral projection of the knee on a short, wide-pelvis patient?

7 to 10 degrees cephalad

46

What is the major disadvantage of using 45 degrees of flexion for the mediolateral projection of the knee?

Draws the patella into the intercondylar sulcus

47

True/False:

The superoinferior, tangential (Hobbs modification) projection requires a CR angle of 5 to 10 degrees posterior.

False

48

True/False:

The AP mortise projection of the ankle is commonly taken in surgery during open reductions.

True

49

True/False:

Follow-up radiographs for a fractured tibia and fibula may include only the joint closest to the site of injury.

True

50

What type of CR angle is required for the PA axial weight-bearing bilateral knee projection (Rosenberg method)?

10 degrees caudad

51

Which special position of the knee requires that the patient be placed supine with 40 degrees flexion of knee with the CR angled 30 degrees from
the long axis of the femur?

Bilateral Merchant method

52

How much flexion of the knee is recommended for the lateral projection of the patella?

5 to 10 degrees or less

53

What is the recommended SID for the superoinferior sitting tangential (Hobbs modification) method?

48 to 50 inches (123 to 128 cm)

54

A radiograph of an AP projection of the second toe reveals that the interphalangeal joints are not open. What is the most likely
cause for this radiographic outcome?

Incorrect CR centering or angle

55

A radiograph of an AP medial oblique projection of the foot, if positioned correctly, should demonstrate:

third through fifth metatarsals free of superimposition.

56

A radiograph of an AP ankle projection reveals that the lateral joint space is not open (lateral malleolus is partially superimposed by
the talus). The superior and medial joint spaces are open. What should the technologist do to correct this problem and improve the
image?

Nothing; this is an acceptable image.

57

True/False:

The adductor tubercle is present on the medial, posterior aspect of the femoral condyle and can be used to determine possible
rotation of a lateral knee projection.

True

58

The profile appearance of the adductor tubercle and excessive superimposition of the fibular head and neck on a lateral knee
projection indicate:

the CR should be angled 5 to 7 degrees cephalad.

59

A radiograph of a lateral projection of the patella reveals that the femoropatellar joint space is not open. The patella is within the
intercondylar sulcus. The most likely cause of this is:

excessive flexion of the knee.

60

A radiograph of an AP knee reveals rotation with almost total superimposition of the fibular head and the proximal tibia. What must
the technologist do to correct this positioning error on the repeat exposure?

Rotate the knee medially slightly.

61

A radiograph of a PA axial projection for the intercondylar fossa does not demonstrate the fossa well. It is foreshortened. The
following positioning factors were used: patient prone, knee flexed 40 to 45 degrees, CR angled to be perpendicular to the femur, 40-inch
SID, and no rotation of the lower limb. On the basis of the factors used, what changes need to be made to produce a more diagnostic
image?

CR must be perpendicular to lower leg.

62

A radiograph of a AP mortise projection of the ankle reveals that the lateral malleolus is slightly superimposed over the talus and
the lateral joint space is not open. What is most likely the cause for this radiographic outcome?

Insufficient medial rotation of the foot and ankle

63

A patient comes to radiology with a clinical history of osteoarthritis of both knees. The referring physician wants a projection to
evaluate the damage to the articular facets. Which of the following projections will provide the best image of this region of the
knee?

PA axial weight-bearing bilateral knee projection (Rosenberg method)

64

A patient comes to the radiology department for a knee study with special interest in the region of the proximal tibiofibular joint and
the lateral condyle of the tibia. Which positioning routines should the technologist obtain?

AP, lateral, and medial oblique knee

65

A geriatric patient comes to the radiology department for a study of the knee. The patient is unsteady and unsure of himself. Which
intercondylar fossa projection would provide the best results without risk of injury to the patient?

Camp-Coventry method

66

A patient comes to radiology for an evaluation of the longitudinal arch of the foot. Which projections would
provide the best information about the arch?

AP and lateral weight-bearing projections of foot

67

A patient enters the emergency department (ED) with a possible transverse fracture of the patella. Which routines
would safely provide the best images of the patella?

AP and horizontal beam lateral, no flexion of knee

68

A patient enters the ED with an injury near the base of the first and second metatarsals. The basic foot projections are inconclusive
on demonstrating a fracture to the medial cuneiform. Which projections would best demonstrate this bone?

AP oblique with lateral rotation

69

A patient comes to radiology with a history of chondromalacia of the patella. The orthopedic surgeon is concerned about possible
loose bodies in the femoropatellar joint space. She wants the best projection to demonstrate this joint space. What projection should
be performed?

Merchant method

70

A patient comes to radiology with a history of chondromalacia of the patella. Her physician orders a projection of the patellofemoral
joint space. Due to advanced emphysema, the patient cannot lie recumbent for this projection. Which projection
would be best for this patient?

Superoinferior sitting tangential method

71

A radiograph of a plantodorsal (axial) projection of the calcaneus reveals foreshortening. The technologist used 60 kV, 6 mAs,
40-inch (102 cm) SID, and a 30 cephalad CR angle from the long axis of the foot. Which modification will
produce a more diagnostic image of the calcaneus?

Increase CR angulation.

72

Which projections will best demonstrate signs of Osgood-Schlatter disease?

AP and lateral knee

73

A patient comes to radiology with a clinical history of a Lisfranc joint injury. Which projections would best
demonstrate this condition?

Weight-bearing foot series

74

True/False:

The disadvantage of the superoinferior sitting, tangential (Hobbs modification) method is that it requires acute flexion of the knee.

True

75

True/False:

A 3 to 5 degree caudad CR angle should be used for an AP knee projection for patients with an ASIS-to-tabletop measurement of 20 cm.

False

76

True/False:

The correct CR placement for an AP projection of the knee is midpatella.

False

77

True/False:

The tangential projection for the sesamoid bones of the foot should be performed with the patient prone rather than supine to
minimize image magnification, if the patient condition allows it.

True

78

True/False:

The foot must be force dorsiflexed so that the long axis of the foot is perpendicular to the image receptor for AP and mortise
projections of the ankle.

False

79

True/False:

A correctly positioned lateral ankle will demonstrate the lateral malleolus superimposed over the posterior half of the tibia.

True

80

For the AP weight-bearing feet projection, the CR should be:

angled 15 degrees posteriorly

81

For the AP weight-bearing knee projection on an average patient, the CR should be:

perpendicular to the image receptor.

82

A patient comes to radiology with an infection involving the sesamoid bones of the foot. Beyond the routine foot projections, which
projection can be performed to best demonstrate these structures?

Tangential projection

83

A patient enters radiology with a possible ligament tear to the lateral aspect of the ankle. Initial ankle radiographs are negative for
fracture or dislocation. Because the clinic is in a rural setting, the patient cannot have an MRI performed to evaluate the ligaments
of the ankle. Which techniques may provide an assessment of the soft tissue structures of the ankle?

AP stress projections

84

Which of the following imaging modalities and/or procedures will provide the best assessment for osteomyelitis of the foot?

Nuclear medicine

85

A radiograph of an AP oblique foot with medial rotation demonstrates considerable superimposition of the third through fifth
metatarsals. How must the original position be changed to eliminate this problem?

Decrease obliquity of the foot.

86

True/False:

Another term for osteomalacia is rickets.

True

87

The radiographic hallmark of Reiter’s syndrome seen in young men is:

erosion of the Achilles tendon insertion.

88

Another term for osteochondroma is:

exostosis.

89

Which projection of the patella requires the patient to be placed in a prone position, a 55 degree flexion of the knee, and
a 15 to 20 degree angle of the CR?

Bilateral Merchant method

90

How much knee flexion is required for the weight-bearing PA axial projection (Rosenberg method) of the knee?

45 degree flexion