RADIOLOGY ARRT EXAM 2024 Q & A (A+ GRADED )

RADIOLOGY ARRT EXAM 2024 Q & A (A+ GRADED ) What is the Salter-Harris Classification? Most common Salter-Harris fracture? - CORRECT ANSWER-The Salter-Harris Classification of Fractures is for the prognosis of the fracture. Type I offers the best prognosis and Type V the worst. Type II - Most common fracture. Through the epiphyseal plate and extends into the metaphysis. The most common type of shoulder dislocation is? - CORRECT ANSWER-Anterior is the most common type of shoulder dislocation. The shoulder is the most common joint in the body to dislocate and most of the dislocations are anterior. The humeral head dislocates anterior and inferior to the glenoid fossa and commonly is located beneath the coracoid process. Lateral radiograph -- look down the spine, looks more lucent. If it looks more dense? - CORRECT ANSWER-Pleural effusion or something The CP angles should be sharp, blunting may indicate pleural effusion Pleural effusion is first seen int he posterior costophrenic gutters on the lateral view. Positive fat pad sign? - CORRECT ANSWER-Falls down on their elbow, fat pad sign -- elevation of the fat pad along the anterior aspect of the humerus, visualization of the posterior fat pad, strongly suggestive of a fracture w/in the elbow. Posterior and anterior fat pads - CORRECT ANSWERColles Fracture? - CORRECT ANSWER-Colles' Fracture - this is a fracture of the distal radius, which is usually within one inch of the articular surface with posterior displacement of the distal fragment. Frequently there is accompanying fracture of the ulnar styloid. What is the most common bone in the wrist to fracture? - CORRECT ANSWERScaphoid - pain at the anatomical snuff box with scaphoid fracture a. Most commonly Fx carpal bone b. Proximal pole has no blood supply :: usually can see aseptic necrosis of the proximal fragment = increased density of the proximal fragment Wrist bones - CORRECT ANSWER- Elderly patient can't bear wait on pelvis? - CORRECT ANSWER-Fracture unless proven otherwise. plain film may not show the fracture. Which of the following isn't associated w/ child abuse? (1) Spiral fractures of the femur (2) Posterior Rib Fractures (3) Metaphyseal corner fractures (4) Spiral fractures of the tibia (5) All of these - CORRECT ANSWER-Spiral fracture of the tibia = Toddler's fracture. Toddler's Fracture - A fracture of the tibia in young children beginning to walk. Most commonly a spiral type fracture involving the distal shaft of the tibia. Buckle type fracture involving the metaphyseal portion of the proximal tibia is also common. Maissoneuve Fx? - CORRECT ANSWERWhat is a DEXA Scan? - CORRECT ANSWER-The preferred method for determining bone mass is the Dual Energy X-Ray Absorptiometry Scan or DEXA. This utilizes two X-Ray energy sources to determine the bone mineral content or bone mass. The DEXA scan defines osteoporosis as a bone mineral density (T Score) that is 2.5 SD below the mean peak value in younger adults. The Z Score is also determined and is a comparison with the mean value in normal subjects the same age and sex. The severity of osteoporosis is determined by the bone values. * -1.0 to -2.0 mild * -2.0 to -3.0 moderate * -3.0 to -4.0 marked * -4.0 to -5.0 severe Hyperparathyroidism - Hallmark? - CORRECT ANSWER-The hallmark of hyperparathyroidism in the skeleton is **subperiosteal resorption of bone,** which is particularly pronounced on the **radial side of the middle phalanx, middle finger.** Views of the hand are very important in demonstrating subperiosteal resorption. There is also penciling of the tufts of the distal phalanges and penciling of the distal aspects of the clavicles. Subperiosteal resorption may occur along the medial aspects of the neck of the humerus and femur as well as in the hand. There is loss of the lamina dura about the teeth and there is a generalized lucency of the skeleton. As finer trabecula disappear, the cortex also thins. Localized destructive areas may occur and are known as brown tumors. Paget's disease -- what is it? What is markedly elevated? - CORRECT ANSWER-This disease is due to the imbalance of osteoclastic and osteoblastic activity. It is very rare in patients under 50. Paget's disease may be monosteal or generalized. Pathologically, there is increased resorption with disorganization of bone in a characteristic mosaic appearance. The resorption is rapidly followed by new bone formation. Usually in pelvis and bowing of long bones. Large lytic areas in skull. The alkaline phosphatase is markedly elevated in most patients with active Paget's disease. Paget's disease radiographic features? - CORRECT ANSWER-Course, too dense often the pelvis Radiographic findings: a. There is actual expansion of involved bone. b. There is thickening of the cortex, particularly in the pelvis. c. Deformities may occur with bowing of long bones and intrapelvic protrusion of the aceabulae of the hips. d. There is an abnormal trabecular pattern in Paget's disease with patchy areas of radiolucency and sclerosis. The trabeculae appear very large and irregular. e. A "candle flame" lytic process may be seen in the early stages of Paget's disease, particularly in the long bones and is particularly common in the femur and midshaft of the tibia. f. Large lytic areas in the skull may be seen initially followed by irregular sclerotic lesions. The **lytic (NOT SCLEROTIC)** process is known as **osteoporosis circumscripta.** Osteoporosis circumscriptia - CORRECT ANSWER-Paget's Disease: Large lytic areas in the skull may be seen initially followed by irregular sclerotic lesions. The lytic process is known as osteoporosis circumscripta. What are the radiographic characteristic of osteoarthritis or degenerative arthritis? - CORRECT ANSWER-Radiographically, the characteristic changes are **narrowing of the joint space with associated hypertrophic spurring, subchonral cyst formation, and sclerosis about the joint.** Sendesmophytes and bamboo spine? - CORRECT ANSWER-Ankylosing spondylitis Why order plain film? - CORRECT ANSWER-Trauma, pain, instability, impingement, suspected abuse, metabolic diseases, benign and malignant neoplasm, arthropathies, infections, preop/postop, congenital syndromes, vascular lesions, eval of soft tissues in extremities, corr abnormal skeletal findings on other images Plain film views - PA - CORRECT ANSWER-Posterior anterior. This view is usually obtained at a 6 foot target to film distance in order to reduce magnification. With tis view, the film is against the anterior aspect of the patient and the x-ray beam is directed towards the posterior aspect of the patient. Plain film views - AP - CORRECT ANSWER-anterior posterior. The film is against the posterior aspects of the patient and the x-ray beam is directed toward the anterior aspect of the chest. This is the view commonly obtained with portable technique and the target to film distance is usually 40 inches. The cardiac silhouette is magnified in this projection. Hallmark of airspace disease? - CORRECT ANSWER-Air bronchograms (air spaces and distal bronchial structures w/in an area of consoldation, which still contain air rather than fluid) What is air space disease? - CORRECT ANSWER-Fluid (exudates, transudate, blood) replaces the air in the pulmonary acinus. The pulmonary acinus represents that portion of lung to a terminal bronchiole and consists of respiratory bronchioles, alveolar ducts, alveolar sacs, and alveoli. Pneumonia looks like what? - CORRECT ANSWER-Pneumonia lokos patchy. Most pneumonias are manifest as air space disease. It is helpful to look for t