Skeletal Radiology: Lower Limb Flashcards
How many tarsal bones are found in the foot?
Which metatarsal bone of the foot has a prominent tuberosity frequently fractured?
What term describes the top or anterior surface of the foot?
Where would the interphalangeal joint be found in the foot?
Between the phalanges of the first digit
Which structure or bone contains the sustentaculum tali?
How many articular facets make up the subtalar joint?
What are the two arches of the foot?
Longitudinal and transverse
The medial malleolus is part of the:
The ankle joint is a ____ joint with a ____ type of movement.
Another term for the intercondylar sulcus is the:
The patella is drawn into the intercondylar sulcus when the knee is overextended.
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.
Saclike structures found in the knee joint that allow smooth articulation between ligaments and tendons are called:
To decrease the angle between the anterior surface of the foot and anterior surface of the lower leg is described as:
The patellofemoral joint is a ____ joint with a ____ type of movement.
Which tendon attaches directly to the tibial tuberosity?
The calcaneus articulates with the talus and the:
A radiographic appearance of a highly malignant and extensively
destructive lesion that usually occurs in long bones and produces
sunburst pattern describes:
an osteogenic sarcoma
A radiographic appearance of a well-circumscribed lucency within bones describes:
a bone cyst.
With cassette-less digital systems, you can use a grid for a foot projection if it is impractical to remove it.
When multiple exposures are placed on a single computed
radiography image receptor (IR), lead masking should not be placed
the unexposed regions of the imaging plate.
The best method of evaluating injuries to the menisci and ligaments of the knee joint involves:
a magnetic resonance imaging procedure.
The adductor tubercle is located on the posterior aspect of the medial femoral condyle.
The distal tibiofibular joint is classified as a ____ joint.
Which joint is a modified ellipsoidal or condyloid joint?
Extending the ankle joint or pointing the foot and toes downward is called:
How much central ray (CR) angulation (if any) should be used for an AP projection of the toes?
10 to 15 degrees toward calcaneus
Which routine should be performed for a study of the second toe?
AP, AP oblique with medial rotation, lateromedial projection
How much is the foot dorsiflexed with the tangential projection for
the sesamoid bones if the CR remains perpendicular to the
15 to 20 degrees from vertical
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.
A correctly positioned AP 45 degree medial oblique ankle
projection frequently may also demonstrate a fracture of the base of
metatarsal if present.
To properly visualize the joint spaces with the AP projection of the foot, the CR must be:
perpendicular to the metatarsals.
Which position of the foot will best demonstrate the lateral (third) cuneiform?
AP oblique with medial rotation
What is one advantage of the lateromedial projection of the foot?
The foot assumes a more true lateral position.
What CR angulation is required for the AP oblique projection of the foot?
CR is perpendicular to the image receptor.
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
Where is the CR placed for a mediolateral projection of the calcaneus?
1 inch (2.5 cm) inferior to medial malleolus
Which joint surfaces of the ankle joint are open with an AP projection of the ankle?
Medial and superior
How much rotation from an AP position of the ankle will typically produce an AP mortise projection?
15 to 20 degrees
Which projection of the ankle will best demonstrate the open joint space of the lateral aspect of the ankle joint?
AP mortise projection
The purpose of the AP stress views of the ankle is to demonstrate:
possible joint separations or ligament tear.
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.
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
Which projection of the knee will best demonstrate the neck of the fibula without superimposition?
AP oblique with medial rotation
What CR angle should be used for a lateral projection of the knee on a short, wide-pelvis patient?
7 to 10 degrees cephalad
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
The superoinferior, tangential (Hobbs modification) projection requires a CR angle of 5 to 10 degrees posterior.
The AP mortise projection of the ankle is commonly taken in surgery during open reductions.
Follow-up radiographs for a fractured tibia and fibula may include only the joint closest to the site of injury.
What type of CR angle is required for the PA axial weight-bearing bilateral knee projection (Rosenberg method)?
10 degrees caudad
Which special position of the knee requires that the patient be
placed supine with 40 degrees flexion of knee with the CR angled 30
the long axis of the femur?
Bilateral Merchant method
How much flexion of the knee is recommended for the lateral projection of the patella?
5 to 10 degrees or less
What is the recommended SID for the superoinferior sitting tangential (Hobbs modification) method?
48 to 50 inches (123 to 128 cm)
A radiograph of an AP projection of the second toe reveals that the
interphalangeal joints are not open. What is the most
cause for this radiographic outcome?
Incorrect CR centering or angle
A radiograph of an AP medial oblique projection of the foot, if positioned correctly, should demonstrate:
third through fifth metatarsals free of superimposition.
A radiograph of an AP ankle projection reveals that the lateral joint
space is not open (lateral malleolus is partially superimposed
the talus). The superior and medial joint spaces are open. What should the technologist do to correct this problem and improve the
Nothing; this is an acceptable image.
The adductor tubercle is present on the medial, posterior aspect
of the femoral condyle and can be used to determine
rotation of a lateral knee projection.
The profile appearance of the adductor tubercle and excessive
superimposition of the fibular head and neck on a lateral
the CR should be angled 5 to 7 degrees cephalad.
A radiograph of a lateral projection of the patella reveals that the
femoropatellar joint space is not open. The patella is within
intercondylar sulcus. The most likely cause of this is:
excessive flexion of the knee.
A radiograph of an AP knee reveals rotation with almost total
superimposition of the fibular head and the proximal tibia. What
the technologist do to correct this positioning error on the repeat exposure?
Rotate the knee medially slightly.
A radiograph of a PA axial projection for the intercondylar fossa
does not demonstrate the fossa well. It is foreshortened.
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
CR must be perpendicular to lower leg.
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
A patient comes to radiology with a clinical history of
osteoarthritis of both knees. The referring physician wants a
evaluate the damage to the articular facets. Which of the following projections will provide the best image of this region of the
PA axial weight-bearing bilateral knee projection (Rosenberg method)
A patient comes to the radiology department for a knee study with
special interest in the region of the proximal tibiofibular joint
the lateral condyle of the tibia. Which positioning routines should the technologist obtain?
AP, lateral, and medial oblique knee
A geriatric patient comes to the radiology department for a study of
the knee. The patient is unsteady and unsure of himself.
intercondylar fossa projection would provide the best results without risk of injury to the patient?
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
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
A patient enters the ED with an injury near the base of the first and
second metatarsals. The basic foot projections are
on demonstrating a fracture to the medial cuneiform. Which projections would best demonstrate this bone?
AP oblique with lateral rotation
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
A patient comes to radiology with a history of chondromalacia of the
patella. Her physician orders a projection of the
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
A radiograph of a plantodorsal (axial) projection of the calcaneus
reveals foreshortening. The technologist used 60 kV, 6
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.
Which projections will best demonstrate signs of Osgood-Schlatter disease?
AP and lateral knee
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
The disadvantage of the superoinferior sitting, tangential (Hobbs modification) method is that it requires acute flexion of the knee.
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.
The correct CR placement for an AP projection of the knee is midpatella.
The tangential projection for the sesamoid bones of the foot
should be performed with the patient prone rather than supine
minimize image magnification, if the patient condition allows it.
The foot must be force dorsiflexed so that the long axis of the
foot is perpendicular to the image receptor for AP and
projections of the ankle.
A correctly positioned lateral ankle will demonstrate the lateral malleolus superimposed over the posterior half of the tibia.
For the AP weight-bearing feet projection, the CR should be:
angled 15 degrees posteriorly
For the AP weight-bearing knee projection on an average patient, the CR should be:
perpendicular to the image receptor.
A patient comes to radiology with an infection involving the sesamoid
bones of the foot. Beyond the routine foot projections,
projection can be performed to best demonstrate these structures?
A patient enters radiology with a possible ligament tear to the
lateral aspect of the ankle. Initial ankle radiographs are negative
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
Which of the following imaging modalities and/or procedures will provide the best assessment for osteomyelitis of the foot?
A radiograph of an AP oblique foot with medial rotation demonstrates
considerable superimposition of the third through
metatarsals. How must the original position be changed to eliminate this problem?
Decrease obliquity of the foot.
Another term for osteomalacia is rickets.
The radiographic hallmark of Reiter’s syndrome seen in young men is:
erosion of the Achilles tendon insertion.
Another term for osteochondroma is:
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
How much knee flexion is required for the weight-bearing PA axial projection (Rosenberg method) of the knee?
45 degree flexion