Ortho Home UnitFinal Quiz

RAH Radiology

QuizFormat:

Sets of cases – 2-5 at a time

Write down key findings

Review results

Total 18 cases, see how we go with time.

QuizTemplate for answers:

• Location of injury, structure involved

• Key prognostic features

• Any recommendations for further imaging or management

Quiz - exampleTemplate:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Answers:• Mid shaft femoral fracture• Half bone width medial

displacement• Needs lateral view. Consider

further proximal / distal imaging as high impact mechanism likely.

Quiz – 1.1Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Quiz – 1.2Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Quiz – 1.3Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Quiz – 1.4Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Quiz – 1.5Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Quiz – 1.1Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Answers:• Distal shaft tibial fracture• One cortex width medial

displacement• Needs lateral view.

Quiz – 1.2Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Answers:• Distal radial (metaphysis)

fracture• One cortex width dorsal

displacement. May be intra-articular

• Needs frontal and oblique view.

Quiz – 1.3Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Answers:• Proximal / base of 5th middle

phalanx fracture• Mild displacement, intra-

articular.• Other views. Needs surgical

review.

Quiz – 1.4Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Answers:• Glenohumeral dislocation.

Humeral fracture (Hill’s Sacks).• Mild displacement.• Repeat imaging after reduction.

Possibility of glenoid injury (Bankhart), consider MRI.

Quiz – 1.5Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Answers:• Right neck of femur

(subcapital or proximal shaft)• Intracapsular• Needs surgical management

Quiz – 2.1Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Quiz – 2.2Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Quiz – 2.3Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Quiz – 2.4Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Quiz – 2.5Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Quiz – 2.1Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Answers:• Left sup. and inf. pubic ramus

fractures.• Half bone width displacement• Clinical assessment for

possible other injuries, consider CT.

Quiz – 2.2Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Answers:• Mid body scapular fracture.• Mildly displaced (one to two

cortical widths). • Needs CT, hard to see extent

of injury.

Quiz – 2.3Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Answers:• Left clavicle and scapular

fractures. • Scapular fracture is intra-

articular (involves glenoid).• Needs CT.

Quiz – 2.4Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Answers:• Right sup. and inf. pubic rami,

right iliac wing fractures.• 2 to 3 cortical widths superior

displacement. Likely right acetabular involvement.

• Needs CT, look for fracture extent and soft tissue injuries.

Quiz – 2.5Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Answers:• Bilateral pubic rami. Left

sacrum (disrupted arcades).• Comminuted, involvement of

neural foramina.• Needs CT for vessel damage,

review for other fractures. Needs surgical management

Quiz – 3.1Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Answers:• L2 anterior wedge fracture.• Mild disruption of posterior

spinal line. Possible widening of interspinous distance. Consider posterior element involvement.

• Needs CT scan.

Quiz – 3.1Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Quiz – 3.2Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Quiz – 3.1Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Quiz – 3.1Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Answers:• L2 anterior wedge fracture.• Possible widening of

interspinous distance. Consider posterior element involvement.

• Needs CT scan.

Quiz – 3.2Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Answers:• C6 on C7 anterolisthesis,

possible bilateral facet dislocation. No fracture seen.

• Central canal narrowing?• Needs CT scan.

Quiz – 4.1Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Quiz – 4.2Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Quiz – 4.3Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Quiz – 4.4Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Quiz – 4.1Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Answers:• Elbow effusion, likely radial head /

neck fracture• Can’t identify fracture, may be intra-

articular• Needs oblique / radial head view.

Repeat imaging in 2 weeks if no fracture seen, or consider MRI/CT/NMBS if need a diagnosis now.

Quiz – 4.2Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Answers:• Mid shaft femur fracture• Significant medial angulation,

callus formation suggests old injury (months)

• No further recommendations

Quiz – 4.3Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Answers:• 3rd distal phalanx tuft fracture• Mild displacement• Usually from crush injuries.

Confirm neurovascular status.

Quiz – 4.4Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Answers:• Left proximal neck of femur

fracture (sharp angle superior cortex)

• Intracapsular• CT to assess as not well seen.

Needs surgical management.

Quiz – 5.1Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Quiz – 5.2Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

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Quiz – 5.1Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Answers:• L1 oedema and height loss,

fracture.• Retropulsion, at least 2

columns. Possible high cord signal.

• Urgent spinal review.

Quiz – 5.2Template:• Location of injury, structure

involved• Key prognostic features• Any recommendations for

further imaging or management

Answers:• Right sided supraspinatus

tear, no fibres seen.• Probably complete tear.• Real-time assessment,

impingment and vascularity. Likely other tendon damage.

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