chapters1-8

chapters1-8 - All the following are true about an AP spine...

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Unformatted text preview: All the following are true about an AP spine projection except A. A) gonadal shielding is required B. B) the film must be taken non bucky C. C) There must be filtration of the upper 1/3 of the film D. D) The projection is not suitable for assessment of the pathology A. B) the film must be taken non bucky All the following are used in evaluation slipped femoral capital ephysis except A. B. C. D. A) Kleins Line B) Skinners Line C) Iliofemoral Line D) Shentons Line A. B) Skinners Line The angle formed by the intersection of the femoral shafts long axis and the line tangential to the articular surfaces of both femoral condyles is the A. B. C. D. A) Q angle B) Tibial Angle C) Femoral angle of the knee D) condylar Angle A. C) Femoral angle of the knee Evaluation of the AC joint is optimal with A. A) B/L weighted and non weighted AP AC projections B. B) weighted PA clavicle projections C. C) AP abduction shoulder projection D. D) weighted and non weighted AP internal rotation shoulder projections A. A) B/L weighted and non weighted AP AC projections The dorsiplantar foot projection requires A. B. C. D. A) 10 degree caudal tube tilt B) no tube tilt C) 10 degree cephalic tube tilt D) 20 cephalic tube tilt A. C) 10 degree cephalic tube tilt In the Lumbar spine the normal canal/body ratio should be equal to or greater than? A. B. C. D. A)1:2 B)1:4 C)2:3 D)1:3 A. D)1:3 A right posterior oblique Lumbar projection will display A. A) L parsinteracticularis and the R facets B. B) L pars interarticularis and the L facets C. C) R pars interarticularis and the R facets D. D) R pars interarticularis and the R facets A. C) R pars interarticularis and the R facets The method of Bull Is a means of evaluating A. B. C. D. A) L lordosis B) scoliosis C) C curve D) Odontoid malposition A. D) Odontoid malposition The best way to see Lumbar sacral joint clearly in the coronal plane is the A. B. C. D. A) via an AP sacral projection with 15 degee caudal tube tilt B) via an AP sacral projection with 45 degree cephalic tube tilt C) via an AP projection with caudal tube tilt set to make the central ray perpendicular to the sacral body D) via an AP projection with cephlad tube tilt set to make the central ray perpendicular to the sacral body A. D) via an AP projection with cephlad tube tilt set to make the central ray perpendicular to the sacral body The preferred method for measuring a scoliosis is A. B. C. D. A) Risser-Ferguson method B) Jochumsen’s method C) Drexlers method D) Cobb-Libbman method A. D) Cobb-Libbman method For a full AP projection the optimum TFD A. B. C. D. A) 200cm B) 82 inches C) 72 inches D) 300 cm A. A) 200cm On an AP hip projection Shentons line is useful in evaluating all the following except: A. B. C. D. Fracture Slipped femoral epiphysis Degerative arthristis of hip Femoral dislocation A. Degerative arthristis of hip The normal femoral angle of the knee should be A. B. C. D. 75-85 90-100 60-75 56-60 A. 75-85 PA clavicle projection is not A. Taken with a 10 degree caudal tube tilt B. Sometimes taken as an AP with a 10 degree cephald tube tilt C. Taken with the head rotated to the contralateral side D. Taken during active respiration A. Taken during active respiration In addition to an AP projection a study of the ankle requires a medial oblique projection to A. B. C. D. Better visulize the medial malleolus Better visualize the mortice joint Better visualize the talar dome and head Better visualize the metatarsal heads A. Better visualize the talar dome and head Interpedicular distance may be increased by A. B. C. D. Intraspinal neoplasms Spinal stenosis Congential malformation Arthritides A. Intraspinal neoplasms Using Eisensteins saggital canal measurment spinal stenosis may be indicated with a measurement of A. B. C. D. Less than 25 mm Less than 20 mm Less than 18 mm Less than 15 mm A. Less than 15 When evaluating a lateral cervical projection pharyngeal prevertebral soft tissue at the C2 level should be no wider than A. B. C. D. 20 mm 7mm 4mm 10mm A. 7mm All of the following statements about scoliosis are true except A. Any curve greater than 40 degree must be braced B. When there is a double curve each component must be measured seperately C. Is important to use the same landmarks each time the curve is evaluated D. Base line films must include upper and lower extremities of the curve A. Any curve greater than 40 degree must •Any curve greater than 40 degree must be braced be braced A decreaed Boehler’s angle indicates A. B. C. D. Impaction fracture of the calcaneus Platybasia Genu varum Genu Valgum A. Impaction fracture of the calcaneus There is a stong likelhood of Down’s Syndrome if the iliac index of an infant is A. B. C. D. <60 >60 >68 Down’s syndrome is apparent at birthm, and the iliac index has no relationship to its diagnosis A. <60 Kohler Line is contructed A. Along the inferior margin of the superior pubic ramus and inferomedial femoral neck B. Tangential to the superior lateral and inferior lateral acetabular margins C. Tangential to the superior margin of the femoral neck D. Tangential to the lateral obturator foramen and the cortical margin of the pelvic inlet A.Tangential to the lateral obturator foramen and the cortical margin of the pelvic inlet The AP knee projection is modified by taking it upright with the knee flexed 45 degrees and with a 10 degree caudal tube tilt to evaluate for A. B. C. D. Chondromalasia patella Osteochondritis dissecans Joint instability Ochronosis A. Joint instability The “baby arm projection” is A. Performed with the arm abducted 90 degree and the elbow flexed 90 degrees B. Taken to demonstrate the complex interconnections of the elbow C. Another name for an AP internal rotation shoulder projection D. Another name for a lateral Elbow projection A. Performed with the arm abducted 90 degree and the elbow flexed 90 degrees At the ankle the tibial angle and fibular angle should each measure A. B. C. D. Between 60-80 Between 10-15 Between 23-45 Between 43-65 A. Between 43-65 The structures that form the Hadley’s “S” cure are A. The transverse process, inferior articular process and superior articular process B. The transverse process inferior articular process and mamillary process C. The inferior articular process mamillary process and superior articular process D. The transverse process the mamillary process and superior articular process A. The transverse process, inferior articular process and superior articular process Meyerdinges spondylolisthesis grading is reported with reference to A. Quarters of the subadjacent vertebral body endplate B. Percentages of the subadjacent vertebral body endplate C. Mm of anterior translation D. Inches of anterior translation A. Quarters of the subadjacent vertebral body endplate Townes projection requires A. B. C. D. 35 ˚caudal tube tilt 15 degree caudal tube tilt 35 degree cephalad tube tilt 15 degree cephalad tube tilt A. 35 ˚caudal tube tilt A patient with scoliosis should be monitored A. Every 6 months until age 40 b/c the curve can continue to progress after the birth years B. With an AP film done every 3 months during the years of rapid growth C. Every 3 months until age 18 D. At least once a year with upright AP and lateral views With an AP film done every 3 months during the years of rapid growth Macnabs line A. B. C. D. Is usually applied on lateral L films Requires oblique views Is used to evaluate lumbar stenosis Is used to evaluate discogenic spondylosis Is usually applied on lateral L films On an AP pelvis projection the iliac angle is measured by the intersection of A. The Y-Y line and a vertical line tangential to the inner acetabular margin B. The Y-Y line and the vertical line of Ombredanne C. The Y-Y line and a line tangential to the lateral iliac wing and iliac body margin D. The veritcal line of Ombredanne and a line tangential to the lateral iliac body margin The Y-Y line and a line tangential to the lateral iliac wing and iliac body margin Kohlers line is used for the assesment of A. B. C. D. Reterolysithesis Hip dysplasia Slipped Femoral Capital Ephiphysis Protrusio Acetabuli Protrusio Acetabuli The AP knee projection requires A. B. C. D. A cephalad tube tilt of 5 degrees A 10 degree cephalad tube tilt A caudal tube tilt of 5 degrees No tube tilt A cephalad tube tilt of 5 degrees An increased AC joint space is likely to be caused by any of the following except A. B. C. D. RA Degenerative arthritis Hyperparathyroidism Trauma Degenerative arthritis The sunrise projection always allows good evaluation of A. B. C. D. Patella Alta Genu Varum Genu Valgum Lateal displacement of the patella Lateal displacement of the patella Filtration should be used on the lower half of the T spine in a A. B. C. D. Swimmers lateral projection AP T spine projection PA chest film Lateral T spine projection Lateral T spine projection Mcnabs line is drawn A. Through the superior margin of the superior fact and the inferior margin of the inferior facet B. Tangentail to the superior anteiro and posterior S1 enplate margins C. Tangential to the inferiro anterior and posterior vertebral endplate margins D. Tangential to the L posterior vertebral body margin Tangential to the inferiro anterior and posterior vertebral endplate margins The AP open mouth projection (APOM) best deomonstrates: A. The maxiallary sinuses B. The integrity of the C1 spinous process C. The alignment of the atlas lateral margins with the axis body D. C1 Anterolisthesis The alignment of the atlas lateral margins with the axis body Scoliosis may require a surgial stabilization if the curve A. Shows progression within a 6 month peror B. Is at least 15 degrees and progressing C. Is greater than 40 degrees D. Is between 20-30 degrees Is greater than 40 degrees The most accurate radiographic meausrement for evaluating L spine stenosis is A. B. C. D. Eisensteins method The canal/body ration The interpediculate distance Van Akkerveeken’s measurment The canal/body ration The normal acetabluar angle for infanct averages around A. B. C. D. 20 10 30 45 20 Acetabular dysplasia may bne indicated by: A. Acetabular depth less than 9mm or a ceter edge angle less than 36 degrees B. An iliac index greater than 68 degrees C. An iliac index of <60 degrees D. An acetabular angle of 20 degrees or an iliac angle of 50 degrees Acetabular depth less than 9mm or a center edge angle less than 36 degrees On a frog leg projection one can evaluate A. B. C. D. Kohler’s line and Kleins line Shentons line and Kohlers line Kleins line and Shentons Line Kohler’s line and Skinner’s line Kleins line and Shentons Line Normal acromiohumeral Joint space is A. B. C. D. 1.5-2cm 1-1.5cm 7-11mm 12-16mm 7-11mm The intercondylar projection is A. B. C. D. An AP projection A lateral projection PA projection Done as either AP or PA An AP projection For optimal clarity an AP T spine projection should be made with? A. Filtration of the upper half to 2/3 of the T spine B. Filtration of the upper 1/3 of the T spine C. Filtration of the lower ½ of the T spine D. Filtration of the lower 1/3 of the T spine Filtration of the upper half to 2/3 of the T spine The gravitational line from L3 should not A. Pass through the Sacral promotory B. Pass more than 5 mm anterior to the Sacral promotory C. Pass posterior to the Sacral promotory D. Pass more than 10 mm anterior to the sacral poromotory Pass more than 10 mm anterior to the sacral poromotory When preparing to take an APLC (lower Cervical spine) projection A. B. C. D. Tilt the tube 15 degrees caudad Tilt the tube 30 cephalad Tilt the tube 15 degree cephalad Do not tilt the tube Tilt the tube 15 degree cephalad The Cobb (Cobb-Libman) method of scoliosis evaluation requires A. The location of the uppermost vertebra that tilts toward the concavity B. Location of the vertebra at the apex of the scoliotic cruve C. Location of the center of the vertebral body at the apex of the scholiotic curve D. Location fothe center of the lowerst vetebral body that is tilted toward the concavity The location of the uppermost vertebra that tilts toward the concavity The L posterior oblique projection of the C spine A. Shows the R intervertebral foramina B. Shows the L intervetebral foramina C. Is positioned with the anterior R shoulder against the bucky D. Is positioned with the posterior R shoulder against the bucky Shows the R intervertebral foramina Decreased Acromiohumeral joint space may indicate A. B. C. D. Rotator cuff tear Stroke GHJ effusion Brachial plexus lesion Rotator cuff tear Skinners line would not be a good indicator of A. B. C. D. Femoral neck fracture Coxa Vara SFCE RA of the hip RA of the hip The center edge (CE) angle is also called A. B. C. D. The angle of Kopitz The angle of Wyberg The iliac angle The acetabular Angle The angle of Wyberg The Y-Y line (on an AP pelvis projection) is drawn A. Horizontally through both L and R upper outer acetabular margins B. Horizontally through the L and R cotyloid notches C. Horizontally above both L and R triradiate cartilages D. Horizontally through the superior margins of the teardrop Horizontally through the L and R cotyloid notches When performing a lateral film of a scoliosis patient one should A. Take a cross table lateral with the curve concavity adjacent to the bucky B. Take a cross table lateral with the curve convexity adjacent to the bucky C. Take and upright lateral with the curve concavity adjacent to the bucky D. Take an upright lateral with the curve convexity adjacent to the bucky Take an upright lateral with the curve convexity adjacent to the bucky Ferguson’s gravitional line has not been called A. B. C. D. The gravitational line from L3 Ferguson’s weight bearing line The Lumbar gravity line Ferguson’s vertical line Ferguson’s vertical line The articular pillars projection is taken with A. The pt facing the bucky and head turned 45-50 away from the side of interest B. The marker beneath the mandible on the side of interest C. A 15 d cephalad tube tilt D. A 15 d caudal tube tilt The pt facing the bucky and head turned 45-50 away from the side of interest The intercondylar projection is also known as A. B. C. D. Sunrise projection Tangential knee projection Skyline Projection Tunnel knee projection Tunnel knee projection The optimal projection for the evaluation of the frontal and maxiallary sinuses is A. B. C. D. Townes projection APOM Waters projection Calwells projection Waters projection PA chest films taken on full exhalation are helpful in visualizing A. B. C. D. Atelectasis Pleural effusion Apical lesions Pneumothorax Pneumothorax For an AP shoulder projection either internal or ext rotation the pt should A. Have the elbow flexed 90 with the forearm resting on the abdomen B. Stand rotated about 45 so that the shoulder is almost parallel to the surface of the bucky C. Maintain the intraepicondylar line in a position perpendicular to the film surface D. Maintain the intraepiconeylar line in a position parallel to the film surface Maintain the intraepicondylar line in a position perpendicular to the film surface The angle of incidence is used in evaluation for A. B. C. D. Malum coxae senilis Protrusion acetabuli Coxa vara or coxa valga Legg Calve Perthes disease Coxa vara or coxa valga When the acetabular depth of an infant’s hi is A. 12mm it is considered average B. Greater than 9 mm it is considered anomalous C. <9mm considered average D. 15mm is considered average 12mm it is considered average Although the range of normal is fairly wide the symphisis pubis width is average A. B. C. D. About 6mm 3cm 6cm 1 inch About 6mm To obtain a clearer view of a questionable area involving the SI joint one may take A. B. C. D. AP tilt up Lumbosacral spot projection A lateral lumbosacral spot projection An oblique SIJ spot projection A frog leg projection AP tilt up Lumbosacral spot projection A normal Sacral base angle may be A. B. C. D. 45 15 145 120 45 When taking a C posterior oblique projection place the marker A. B. C. D. Behind the spine At the top L corner of the film Under the mandible At the top R corner of the film Under the mandible Patella alta is evaluated on A. B. C. D. AP knee Sunrise projection Lateral knee Tunnel knee projection Lateral knee Radiographic evaluation of platybasia may involve all the following except A. B. C. D. Ulmann’s line Macrae’s line Chamberlains line Digastric (biventer) line Ulmann’s line For rib projections A. Respiration should always be suspended with full inspiration B. Respiration should always be suspended with full expiration C. For lesions below the diaphragm respiration should be suspended with full inspiration D. For lesions above the diaphragm respiration should be suspended on full inspiration For lesions above the diaphragm respiration should be suspended on full inspiration Boehlers angle helps to rule out A. B. C. D. Heel spurs Calcaneal fracture Occult fracture of the talar dome Occult facture of the distal fibula Calcaneal fracture On an AP hip projection constructing lines along the axis of the femoral neck and shaft will provide A. B. C. D. The angle of Wiberg Mikulicz’s angle The Q angle The acetabular angle Mikulicz’s angle When hip joint space is measured the distance from the acetabular surface to the acetabluar notch is A. B. C. D. Called the superior joint space Called the medial joint space Called the axial joint space Not measured Called the axial joint space To adequately demonstrate the femoral neck and trochanters on an AP pelvis projection A. B. C. D. Internally rotate the feet about 15 d Externally rotate the feet about 15 d Internally rotate the feet about 30 d Externally rotate the feet about 30 d Internally rotate the feet about 15 d A break in the normally smooth Hadley “S” curve may indicate A. B. C. D. Osteomalacia Osteoporosis Facet imbrication Fibrous Dysplasia Facet imbrication Ferguson’s angle is A. B. C. D. The sacral base angle The sacrovertebral angle The lumbar sacral disc angle The sacral vertebral disc angle The sacral base angle Oblique C projections are used to demonstrate all the following except A. B. C. D. Integrity of the C pillars Integrity fo the intervertebral foramina Degeneration of the facet joints Degeneration of the neurocentral joints Integrity of the C pillars Patella malalignement can be evaluated with the A. B. C. D. Carrying angle Q angle Femoral angle of the knee Tibial angle Q angle Steels rule of 1/3 is helpful in evaluation of A. B. C. D. L intervertebral disc diminution L stenosis caused by reterolisthesis Prevertebral soft tissue swellings Atlantoaxial subluxation Atlantoaxial subluxation The metacarpal sign is positive when a straight light tangential to both 4th and 5th metacarpal heads A. Passes distal to the 3rd metacarpal head B. Passes less than 3mm distal to the 3rd metacarpal head C. Passes through or proximal to the 3rd metacarpal head D. Passes tangential to the 3rd metacarpal head Passes through or proximal to the 3rd metacarpal head The average normal heel pad thickness is about A. B. C. D. 2.5cm 19mm 1cm 5mm 19mm Mikulicz’s angle A. Must be derived from films taken without internal rotation of the lower limb B. Is normally less than 120 d C. May indicate coxa valga or coxa vara D. Is also called the “Q” angle May indicate coxa valga or coxa vara The bilateral variation in teardrop distace should not exceed A. B. C. D. 5mm 2mm 11mm 1cm 2mm The lateral coccxgeal projection should be taken both seated and recumbent and the view should be compared A. To show hypermobility B. To show hypomobility C. To demonstrate the appearance of a vaccum phenomenon when flexion stress occurs D. To compress soft tissue around the bone especially in the obese patient To show hypermobility The scotty dog seen on the L oblique projection is formed by A. B. C. D. The transverse process, pedicle, mamillary process superior articular process and pars interarticularis The transverse process, pedicle, superior articular process and pars interarticularis and inferior articular process The pedicle, superior articular process pars interarticularis, SP and inferior articular process The transverse process, pedicle, SP, inferior articular process and pars interarticularis The transverse process, pedicle, superior articular process and pars interarticularis and inferior articular process L intevertebral disc height measurement may be meaningless if there is A. B. C. D. A central contained herniation A abdominal aortic anneurysm A significant anterolisthesis A significant segmental rotation A significant segmental rotation The oblique C projection demonstrates A. B. C. D. Intervertebral disc spaces Cervicle pillars Von Luschka joints Alterations in C curves Von Luschka joints The normal range of the Q angle is A. B. C. D. 85-100 75-58 15-20 30-40 15-20 The C lordosis may be evaluated by all except A. B. C. D. Hadleys curve Method of Jochumsen Angle of C curve Depth of cervical curve Hadleys curve PA ulnar flexion wrist projection is the optimal view for A. B. C. D. Evaluation of lunate Sx Evaluation of the scaphoid Evaluation of the radioulnar angle Evaluation of the ulnarcarpal joint Evaluation of the scaphoid To obtain a medial oblique projection of the foot the foot should be tilted A. Laterally to form an approx a 35 d angle with the film surface B. Medially to form an approx 35 d angle with the film surface C. Laterally to form an approx 15 d angle with the film surface D. Medially to form an approx 15 d angle with the film surface Medially to form an approx 35 d angle with the film surface All the following are true of the iliofemoral line except A. It simply traces the lateral margins of the ilium and femoral neck B. It should be smooth and B/L symmetrical C. It normally has a buldge for the femoral head D. Traces the margins of the medial femoral head and the lateral tear drop Traces the margins of the medial femoral head and the lateral tear drop On an AP hip projection the normal tear drop distace should be A. No more than 2mm from the lateral margin of the tear drop B. No less than 11 mm from the lateral margin of the tear drop. C. No more than 11mm from the lateral margin of the tear drop D. No less than 2mm from the medial margin of the tear drop No more than 11mm from the lateral margin of the tear drop In an adult the “presacral space” (as measured on the lateral sacral projection) should A. B. C. D. Be around .5cm Not exceed 2cm Be around 5cm Between 5-8cm Not exceed 2 cm In and anterior L oblique projection the side marker should be placed in A. B. C. D. The lower left hand corner In the upper left hand corner In front of the spine Behind the spine Behind the spine A lumber canal/body ration that is higher than normal may indicate A. B. C. D. SBO An increased interpedicular distance Spinal stenosis Spinal dysraphism Spinal stenosis Contraindications to C flexion or ext lateral projections include all the following except: A. Postural vertigo B. A loss in strength in muscles innervated by the R median nerve C. C sprain or strain w/out neuro symptoms D. Signs of vertibralbasilar ischemia C sprain or strain w/out neuro symptoms The angle formed by the intersection of the tibal shaft’s long axis and a line tangential to the tibial plateau anterior superior margins is the A. B. C. D. Q angle Tibial angle Femoral angle of the knee Condylar angle Tibial angle The subtle shift of a femoral capital epiphysis is best detected by a A. B. C. D. Macnabs line Kleins line Shentons line Skinners line Kleins line A synonym for Georges line is A. B. C. D. Posterior body line Spinolaminar junction line Posterior C line Central gravity line Posterior body line Monostotic lesions are most characteristic of A. B. C. D. Rickets Sickle Cell Anemia Perthes Disease Hyperparathyroidism Perthes Disease A smoky or “ground glass” appearance indicates? A. B. C. D. A fibrous lesion A cartilaginous lesion A fatty lesion An osseous lesion A fibrous lesion A neoplsm that may be expected to occur in patients younger than 20 years old is? A. B. C. D. Lumbosacral chordoma Hemangioma Fibrosarcoma chondrosarcoma Fibrosarcoma All the following all intradural intramedullary lesions except A. B. C. D. Astrocytoma Neurofibroma Ependymoma Lipoma Neurofibroma The periosteum is a A. Thin membrane enclosing the epiphysis and diaphysis of a long bone B. Thin membrane endlosing the diaphysis of a long bone C. Thein membrane iwht a fibrous outer layer into which Sharpey’s fibers insert D. Thin membrane endlosing the epiphysis and metaphysis of a long bone Thein membrane iwht a fibrous outer layer into which Sharpey’s fibers insert When the kilovolt setting is too high, the film will A. B. C. D. Appear too white Require longer exposure time Show poor contrast Demand higher mAs settings Show poor contrast The hounsfield unit is A. A measure of density used for CT B. A measure of density used for MRI C. A measure of depth of the slice of a single CT image D. A measure of thickness of shielding required A measure of density used for CT Rare earth film-screen systems enable the technician to: A. B. C. D. Use less sheilding for the patient Disperse with narro collimation Reduce the exposure time Reduce the kVp Reduce the exposure time Meningioma is considered to be: A. B. C. D. An intradural intramedullary lesion An extradural lesion An intradural extramedullary lesion An intramedullary lesion An intradural extramedullary lesion The kVp setting determine all the following except A. The force with which electrons are ejected B. The wavelength of the ejected electrons C. The frequency D. The number of electrons ejected The number of electrons ejected Nuclear scans are A. Very sensitive diagnostic tests B. Very specific diagnostic tests C. Very specific only if SPECT scanning is used D. Very specific only if PET scanning is used Very sensitive diagnostic tests A tumor with an osseous matrix A. May appear homogenously dense on x rays B. May show stippled calcifications C. May show flocculent calcification D. May show “eggshell” calcification May appear homogenously dense on x rays Arthritides that are typically seen in younger patients (younder than 40 years) include: A. B. C. D. DISH CPPD Reiter’s syndrome pseudogout Reiter’s syndrome Contraindications to MRI include all of the following except A. B. C. D. Breast enhancement implants Tattooed eyeliner Shrapnel shards Pacemaker Breast enhancement implants The most metabolically active area of a long bone is the A. B. C. D. Epiphysis Physis Zone of provisional calcification metaphysis metaphysis The function of wetting agents in film processing is to A. Swell the emulsion B. Drop the pH of the solution C. Rinse the emulsion of undeveloped silver halide D. Maintain the alkalinity of the devloping solution Swell the emulsion The initial CT image A. Is on a sagittal plane, but is reformatted by computer into other planes B. Is on an axial plane, bu tis reformatted by computer into other planes. C. Is always collimated to a 1m slice D. Is always collimated to a 2mm slice Is on an axial plane, but is reformatted by computer into other planes. The inverse square law deals with A. B. C. D. The amount of exposure to radiation The amout of time of the exposure The tube/film distance The kVP setting The amount of exposure to radiation Infectious spondylitis or epidural abcess are detected earlier by A. B. C. D. MRI than CT CT than by MRI Myelography than by MRI By Mylography than by CT MRI than CT In setting technique factors for taking xrays remember tha mAs A. Governs the number of electrons ejected B. Governs the speed at which the electrons are ejected C. Governs the force with which electrons are ejected D. Governs the number of electrons that reach the screen Governs the number of electrons ejected Nuclear bone scans require the detection of A. B. C. D. Xrays Gamma rays Larmor frequencies Beta rays Gamma rays Tumors that show a predilection for the spoine include A. B. C. D. Adamantinoma Chordoma Osteosarcoma Ewings sarcoma Chordoma The onset of gout usually is in patients A. B. C. D. More than 40 years old Between 20-40 More than 70 Less than 20 More than 40 years old The optimal imaging modality for accurate location of spinal cord tumors is A. B. C. D. Bone scans CT Myelography MRI MRI The physis A. Is a thin layer of bone that is calcified but not ossified B. Is seen on s rays as a thin line of increased density C. Is associated with lengthwise bone growth D. Is also know as the zone of provisional calcification Is associated with lengthwise bone growth X ray film may be “foggd by all the following except: A. B. C. D. Pressure Humidity Excessive cold light Excessive cold Flourescent lights are not suitable for a darkroom because A. They flicker too much B. They do not give a full spectrum of light C. They have an afterglow when they are extinguished D. They do not give off any heat They have an afterglow when they are extinguished The current MPD for whole body exposure is A. B. C. D. 10 Rems/yr 5 Rad/year 5 Rem/Year 10 Rad/yr 5 Rem/Year In cases of truma, MRI is the modality of choice for evaluating A. B. C. D. Spinal fractures Muscle spasm contracture Spinal cord contusion Fractures in areas of complex anatomy, which as cranial bones Spinal cord contusion Because of the anode heel effect A. Filtration must always be used B. The anode must be at the bottom of the tube C. The anode should be at the top of the horizontal beam D. The kVp must be greater than 80 The anode should be at the top of the horizontal beam Nuclear scans involve three phases which, in chronological order are: A. Blood pool phaed phase, angiogram phase, bone scan phase B. Blood pool phase, flow phase, delayed phase C. angiogram phase, blood pool phase, delayed phase D. Angiogram phyase, bone scan phase, delay phase angiogram phase, blood pool phase, delayed phase Multiple myeloma is perferentially found in A. B. C. D. Radius Scapula Femur Fibula Femur A periosteal cuff o fnew bone at the periphery of the cortx/lesion junction is not known as: A. B. C. D. A periosteal collar Codmans triangle A periosteal buttress An involucrum An involucrum Taking x rays with the kilovolt setting too low: A. Results in increased amouts of Comptom scatter B. Results in black film C. Results in need for very low mAs setting D. Results in a film with poor contrast Results in a film with poor contrast Epiphyseal lesions commonly include all of the following except: A. B. C. D. Gaucher”s disease Ischemic necrosis Chondroblastoma Legg Calve Perthese disease Gaucher”s disease Intensifying screens: A. B. C. D. Always have double emulsion Have single emulsion only Floresce when struck by photons Screen out scatter radiation Floresce when struck by photons All of the following may contribute to poor films except A. Poor or uneven contact between the film and the intensifying screen B. A miss match of spectra between the film and the intensifying screen C. Intensifying screens that are more than 7 years old D. Developer temperature greater than 88 Developer temperature greater than 88 On a T2 wighted MRI study A. B. C. D. The brightest signal will be emitted by fat Emitted by cortical bone Emitted by water Emitted by arterial blood Emitted by water The greatest majority of the energy from an xray tube is A. B. C. D. Bremsstrahulung radiation Heat X rays Characteristic radiation Heat Myelography involves all of the following except: A. Swimmers lateral projection for cerival studies B. Oblique projections for L studies C. Lateral decubitus projections D. AP open mouth projections AP open mouth projections Ewings sarcoma shows a predilection for A. B. C. D. The epiphysis Metaphysis Diaphysis Metaphysis/diaphysis Diaphysis A solid periosteal response might be expected with all of the following lesions except A. B. C. D. Venous stasis Osteoid osteoma Degenerative arthrits Osteosarcoma Osteosarcoma During x ray film developing the fixing agent serves all of the following functions except A. Hardening the emulsion B. Rinsing underdeveloped silver halide from the emulsion C. Preventing the image from being degraded D. Reducing the PH Reducing the PH The availability of parathormone, vitamine D and alkaline phosphatase all affect A. B. C. D. Renal clearance Bilirubin clearance Thyroid function Calcium deposition in bone Calcium deposition in bone Body tissues especially sensitive to radiation damage include all of the following except: A. B. C. D. Hematopoietic tissue Myofascial tissue Gastroinstestinal tissue Gonadal tissue Myofascial tissue To improve the detail on the film A. Use the longest object film distace possible B. Lengthen the focal film distance C. Use a fast film screen combination D. Use a larger focal spot Lengthen the focal film distance Sivert (SV) is the unit sometimes used to express A. B. C. D. Exposure in air Rems Rads Absorption by tissue Rads On a T1 weighted MRI study the brightest signal will be A. B. C. D. Fat Cortical bone Water Arterial blood Fat The function of a grid is to A. B. C. D. Enhance film/screen contact Absorb scatter radiation Prevent excess motion Make the film appear lighter Absorb scatter radiation Intensifying screens: A. Should be selected in a green or blue spectrum to match the film used B. Have a useful screen life of about 10 years C. Always have emulsion on both sides D. Always luminesce in a green spectrum Should be selected in a green or blue spectrum to match the film used A stress fracture is most likely to produce A. B. C. D. A solid periosteal response An oinion-skin periosteal response A lamellated periostel response Codmans triangle A solid periosteal response Adamantinoma is A. A benign tumor that may be found in the mandible B. A benign tumor that may be found in the tibia C. A malignant tumor that may be found in the tibia D. A malignant tumor that is most often found in the sacrum A malignant tumor that may be found in the tibia In myelography, contrast material is injected into the A. B. C. D. Subarachoid space Sudural space Epidural space Neural canal Subarachoid space Before contrast studies are initated the pt must be screen for A. B. C. D. Elevated BUN and creatinine Elevated white cell count Elevated ESR Elevated leukocyte count Elevated BUN and creatinine When filming a pt with known sever osteopenia A. B. C. D. Raise the mAs about 50% Raise the mAs about 30% Lower the mAs about 50% Lower the mAs about 30% Lower the mAs about 30% The following choices are ture of acute radiation syndrome except A. It is especailly destructive to eyes, gonads, and CNS B. It is nonstochastic in nature C. It is lethal to 50% of exposed experimental animals within 30d of exposure D. It consists of stochastic effects It consists of stochastic effects In normal bone, the calcium phosphorus ratio is A. B. C. D. 3:1 2:1 1:2 1:3 2:1 When discussing the amount of radiation absorbed in tissue the units are expressed as A. B. C. D. Rads Sieverts Rems Coulombs/kg Rads Bening lesions usually are characterized by A. B. C. D. Cortical disruption Cortical expansion or thickening Imperceptible margins Laminated periosteal response Cortical expansion or thickening Comptom scatter radiation doe sall of the following except A. B. C. D. Reduces the energy of the photons Increases the wavelenght of the photons Fogs the film Reduces the wavelenght of the photons Reduces the wavelenght of the photons Cortical thickening is an indication of A. B. C. D. A slow growing malignancy Osteoporosis Pagets disease Medullary tumors Pagets disease Fibrous lesions of bone usually originate in A. B. C. D. Outer cortex Medullary bone Periosteal tissue Inner cortex Medullary bone MRI studies A. Are contraindicated in pregnancy, although the risks are very low B. Are contraindicated in pregnancy because of high risk of fetal damage C. Are contraindicated in pregancy because of risks are unknown D. Are not contraindicated in pregnancy Are contraindicated in pregancy because of risks are unknown Infusion of contrast material for a CT scan is contraindicated in patients with A. B. C. D. Claustrophobia Metallic implants Diabetes Metastatic disease of hematogenous spred Diabetes When filming a pt who is particularly large boned or heavily muscled: A. You should consider raising the mAs by about 50% B. You should consider raising the mAs by about 30% C. You should consider raising the kVp to about 100 D. You should consider reducing the mAs by about 30% You should consider raising the mAs by about 50% Nonstochastic effects of radiation include: A. B. C. D. Genetic aberrations Cataracts Carcinogenesis leukemia Cataracts The main mineral complex in bone is A. B. C. D. Calcium diphosphate Calcium phosphate Hydroxyapatite Calcium Chloride Hydroxyapatite Beam Hardening refers to A. The lower average intensity of remaining photons after attenuation B. The higher average intensity of remaining photons after attenuation C. The longer wavelenght of remaining photons after attenuation D. The lower frequency of photons after attenuation The higher average intensity of remaining photons after attenuation A tumor that shows a predilection fot he scapula includes A. B. C. D. Chondrosarcoma Osteochondroma Osteosarcoma Chondroblastoma Chondrosarcoma The image on the film is created by A. B. C. D. Scatter randiation Characteristic radiation Bremsstrahlung radiation Pair production Bremsstrahlung radiation A benign neoplams characteristcally has A. B. C. D. A laminated periosteal response A solid periosteal response An “onion skin” periosteal response A spiculated periosteal response A solid periosteal response Metastases are not commonly found in the A. B. C. D. Metaphysis Diaphysis Epiphysis Epiphysis/metaphysis Epiphysis Although difficult to diagnose, arachnoiditis may be detected by : A. B. C. D. CT Discography CT mylography myelography CT mylography Bone mineral density BMD is evaluated most effectively by: A. B. C. D. Bone scan QCT (quantitive computed tomography) MRI CT QCT (quantitive computed tomography) PA ches or abdomen films are usually taken: A. At a slightly lower kVp than that used for AP thoracic or lumbar films B. At a slightly lower kVp than that used fro lateral thoracic films. C. At a higher kVp than that used for spinal studies D. At about the same kVp as that used for AP thoracic or lumbar studies. At a higher kVp than that used for spinal studies Radiation burns and cataracts are both examples of A. Stochastic effects B. Nonstochastic effects C. Effects for which the risk is proportional to dose received D. Effects that do not become apparent for several years after exposure Nonstochastic effects Elevated acid phosphatase may be warning sign of A. B. C. D. RA Prostate metastasis Gout Multiple myeloma Prostate metastasis Half value layer (HVL) is a measure of A. Attenuation or absorption of energy from the x ray beam B. Photoelectric interaction C. Pair production D. photodistegration Attenuation or absorption of energy from the x ray beam Tumors of extraosseous origin A. Are separated from the cortical surface by a cleft that ay be visible on x ray B. Tend to expand the cortex C. Thin the endosteal cortex D. May scallop the endosteal cortex Are separated from the cortical surface by a cleft that ay be visible on x ray Involucrum, sequestrum and periostitis are all commonly associated with A. B. C. D. Arthritides Infections Tumors Endocrine disorders Infections Permeative lesions are characterized by A. B. C. D. A wide zone of transition Clear septation Slow growth Sharp margination A wide zone of transition An epiphyseal tumor suggests a dianosis of: A. B. C. D. Chondroblastoma Nonossifying fibroma Osteosarcoma Ewing’s sarcoma Chondroblastoma MRI limitations include A. B. C. D. A large dose of ionizing radiation Allergy to iodine based contrast media Long immobility required None of the above Long immobility required The modality of choice for visualization of calcified soft tissue lesions A. B. C. D. Contrast CT MRI Plain film CT CT Extremity films should be taken A. B. C. D. With a kVp between 80-90 With a kVp between 70-80 With a KVp between 50-65 With a kVp between 65-75 With a KVp between 50-65 Stochastic effects of radiation are those A. That show the actual damage of radiation at the time the patient is exposed B. Called direct threshold effect C. Are those for which the patient is at risk and the risk is proportional to dose received. D. Are those that become apparent within 30 days of exposure Are those for which the patient is at risk and the risk is proportional to dose received. HLA B27 is likely to e present with: A. B. C. D. RA Gout Seronegative arthritis DJD Seronegative arthritis The major effect of photoelectric interaction is A. B. C. D. Fogging of the film Creating the image on the film Increasing radiation dose Blurring the film image Increasing radiation dose Polyostotic lesions might suggest a diagnosis of: A. B. C. D. Paget’s disease Eosinophic granuloma Staph infection Osteoid osteoma Paget’s disease Alignment, apposition, and comminution are all terms one might use in a report concerning A. B. C. D. An arthritic patient A patient with a hematologic disorder A trauma patient A metabolic disorder A trauma patient A solitary, sharply marginated lytic lesion might be described as: A. B. C. D. An aggressive lesion A moth eaten lesion A premeative lesion A geographic lesion A geographic lesion Lesions tend to be a fairly symmetrically distrubuted in A. B. C. D. Paget’s disease Psoriasis Metastasis Leukemia Leukemia Nausea and vomiting, radiculitis, meningitis symptoms, CNS ischemia are possible side effects of A. B. C. D. MRI Myelography Bone scan Ct CT contrast studies are used to visualize all of the following except: A. B. C. D. Intrathecal lesions Intradiscal lesions Occult fractures Gastrointestinal lesions Occult fractures Compton scatter increases when A. B. C. D. mAs is increased mAs is reduced kVp is reduced kVp is increased kVp is increased The bergoni Tribondeau law refers to A. B. C. D. The genetically significant dose The inverse square law The maximum permissible dose The fetus exposure during the first trimester The fetus exposure during the first trimester Elevated alkaline phosphatase is an indication of the presence of: A. B. C. D. Bony disease Kidney disease Pancreatic disease Ovarian disease Bony disease Classic scatter radiation on an xray is also called A. B. C. D. Coherent scatter Incoherent scatter Compton scatter Bremsstrahlung Coherent scatter Patients may be protected from excessive irradiation by all of the following except A. B. C. D. Using grids Using close collimation Using rare earth film screen systems Using high frequency generators Using grids Encroachment into the foramen magnum by the odontoid is called A. B. C. D. Primary platybasia Basilar impression. Tonsilar ectopia Arnold Chiari syndrome Basilar impression. A helpful radiologic sign in distinguishing congenital from acquired vertebral fusion is: A. The “wasp waist” of the acquired fusion B. The fused spophyses of the acquired fusion C. The “wasp waist” of the congential block vertebrae D. The lack of rudimentary disc space in a congenital fusion The “wasp waist” of the congential block vertebrae Congenital hemivertebrae are apparently caused by A. Exaggerated lateral bending of the fetus during the second and third months of gestation B. Failure o fdevelopment of the anterior ossification center C. Failure of devlopment of the apophysis D. Failure of the development of a lateral ossification center. Failure of the development of a lateral ossification center. Clinical indications of Morton’s syndrome may include A. A shortened Achilles tendon B. Severe pain at the first metatarsal phalangeal joint C. A callus under the second and thrid metatarsal heads D. Excessive pronation A callus under the second and thrid metatarsal heads Differential consideration with pseudoarthrosis of the first rib must include A. B. C. D. Elongated transverse process Stress fracture Cervical rib Bifurcated rib Stress fracture The most commonly encountered forms of mucopolysaccharidoses are A. B. C. D. MPS-I-H (hurler) and MPS-II (Hunter) MPS-II (Hunter) and MPS IV (Morquio) MPS-I-H (hurler) and MPS IV (Morquio) MPS-II (hunter) and MPS VI (Sly) MPS-I-H (hurler) and MPS IV (Morquio) Linear opacities in a fanlike sunburst from the acetabulum to the iliac crest may by a sign of: A. B. C. D. Pagets disease Osteopoikilosis Melorheostosis Osteopathia striata Osteopathia striata Holt Oram Syndrome features all of the following radiologic abnormalites except A. Periosteal new bone formation on the ulna B. Sprengles deformity C. Thumb agensis D. Triphalangeal thumb All of the following diseases are considered phakomatoses except: A. B. C. D. Multiple sclerosis Cerebroretinal angiomatosis Tuberious sclerosis Neurofibromatosis Multiple sclerosis Chondrodystrophia calcificans congenita is also known as: A. B. C. D. Spondyloepiphyseal dysplasia congenita Munchmeyer’s disease Stippled epiphyses Cardio-limb syndrome Stippled epiphyses Platybasia is determined by: A. B. C. D. Martins basilar angle less than 140 Martins basilar angle less than 120 Martins basilar angle greater than 152 Martins basilar angle greater than 125 Martins basilar angle greater than 152 The radiologic finding of a dense and hypertrophied C1 anterior tubercle: A. Helps in differentiation of odontoid fracture and os odontoideum B. Indicates the presence of an odontoid fracture C. Indicates cervical osteopetrosis D. Is of no diagnostic significance Helps in differentiation of odontoid fracture and os odontoideum Multiple butterfly vertebrae are associated with A. B. C. D. Myelomeningocele Aberrant intraosseous blood vessels Arnold Chiari syndrome Peristent notochord Myelomeningocele Tarsal coalition may result from any of the following except A. B. C. D. Congential malformation Trauma Neoplastic overgrowth Inflammatory arthritis Neoplastic overgrowth The radiologic appearance of tropism may be simulated by: A. B. C. D. Spondylolysis Intersegmental lateral flexion Intersegmental rotation spondylolisthesis Intersegmental rotation A young or middle aged adult with extensive pathologic fractures, normal laboratory studies and no family history of similar conditions may be suspected of having A. B. C. D. Massive osteolysis of Gorham Pyles’ diesase HOOD Holt Oram syndrome Massive osteolysis of Gorham Osteopathia striata is thought by some to be a variant of A. B. C. D. Osteopoikilosis Osteopetrosis Melorheostosis Tuberous sclerosis Osteopoikilosis Chiropractic spinal manipulation is contraindicated for the patients with A. Holt Oram syndrome B. Munchmeyer’s disease C. Hereditary osteo-onychodysplasia (HOOD) D. Conradi-Hunermann Syndrome Munchmeyer’s disease Epiloia is a greek work meaning A. B. C. D. Flowing bone Vanishing bone Mindless epileptic Above (or over) bone Mindless epileptic The hot cross bun look referes to the widely separated cranial sutures seen in: A. B. C. D. Conradi-Hunermann syndrome Trevor’s disease Cleidocranial dysplasia Infantile cortical hyperostosis Cleidocranial dysplasia Third condyles (condylus tertius) may articulate with: A. B. C. D. The paracondyloid process The C1 lateral mass The C1 posterior arch The C1 anterior arch The C1 anterior arch The anomaly known as “os odontoideum” A. Is also called “os terminale” B. Is of little or no clinical significance C. Represents a potentially significant risk of cord compression from trivial trauma D. Requires CT or MRI imaging for definitive diagnosis Represents a potentially significant risk of cord compression from trivial trauma Congential agenesis of the pedicle is A. Invariably unilateral B. Most frequently seen at C4 C. Always associated with neck pain and upper limb paresthesia D. Frequently associated with “butterfly vertebra” Always associated with neck pain and upper limb paresthesia The radiologic features of hypoplastic patellae, elbow malformations and iliac horns are seen in A. B. C. D. Putti’s triad Morton’s syndrome Fong’s syndrome Klippel Feil Syndrome Fong’s syndrome Bertolotti’s syndrome is associated with all of the following except A. B. C. D. Scoliosis Transitional vertebrae Sciatic pain Autonomic dysfunction Autonomic dysfunction Spontaneous bowl perforation, spontaneous pneumothorax, aortic aneurysim, genu recurvatum and molluscoid fibrous subcutaneous tumors might be expected in a pt with: A. B. C. D. Marfans syndrome Fong’s syndrome Holt-Oram syndrome Ehlers-Danlos syndrome Ehlers-Danlos syndrome When melorheostosis is manifested in carpal or tarsal bones, it may resemble A. B. C. D. Endosteal hyperostosis Osteopoikilosis Osteopetrosis Fibous dysplasia Osteopoikilosis Calcified, hypoplastic intervertebral discs, and ectopic ossification in soft tissues are indicative of: A. B. C. D. Metaphyseal dysplasia Morquio’s syndrome Fibrodysplasia ossificans progressiva osteopoikilosis Fibrodysplasia ossificans progressiva Faulty dentition with dental carries is a feature of A. B. C. D. Melorheostosis Osteopoikilosis Pyknodyostosis Tuberous sclerosis Pyknodyostosis Chondrodysplaisa punctata is characterized by: A. Stippling of the epiphyses. B. Accessory epiphyses on the second metacarpals C. Hypoplastic epiphyses D. Asymmetrical focal overgrowth of the epiphyses Stippling of the epiphyses. Paracondyloid and epitransverse processes are examples of A. B. C. D. Atlas occipitalization Block vertebrae Occipital vertebrae Supernumerary zygapophyses Occipital vertebrae The clinician working with a patient who has clinical sign of trisomy 21 should be especially aware of the possibility of: A. B. C. D. Underdeveloped paranasal sinuses Cervical ribs Atlanto-axial instability Lumbar stenosis Atlanto-axial instability Cervical ribs most commonly: A. Lie above the brachial plexus B. Divide the brachial plexus from the subclavian vein C. Lie inferior to the brachial plexus and subclavian vessels D. “split” the brachial plexus. Lie inferior to the brachial plexus and subclavian vessels The most commonly seen form of multipartite patella is A. B. C. D. U/L tripartite patella B/L bipartite patellae B/L tripartite patellae U/L bipartite patella U/L bipartite patella Clinical manifestations of diastematomylia include all of the following except A. B. C. D. Intermittent low grade fever Asymmetrical lower extremeity size Lipoma Hairy lumbar patch Intermittent low grade fever Defective mentation is a feature of all of the following dysplasias except: A. B. C. D. Familial metaphyseal dysplasia Rhizomelic chondrodysplasia punctata MPS I Hurler syndrome Tuberous sclerosis Familial metaphyseal dysplasia Flowing hyperostosis is a term applied to: A. B. C. D. Melorheostosis Osteopoikilosis Osteopetrosis Osteogenesis imperfecta Melorheostosis All of the following are synonyms for fibrodysplasia ossificans progressiva except: A. B. C. D. Munchmeyers disease Fibrositis ossificans progressiva Epiphyseal dysplasia multiplex Myositis ossificans progressiva Epiphyseal dysplasia multiplex Progressive diaphyseal dysplasia (PDD) A. Manifests around pruberty, with symmetrical b/ l involvement B. Manifests before age 10 with b/l symmetrical involvement C. Manifests before age 10, with asymmetrical involvement D. Manifests around puberty with asymmetrical involvement Manifests before age 10 with b/l symmetrical involvement “Trident Hand” is characteristic of A. B. C. D. Achondroplasia Caffey’s syndrome Marquio’s syndrome Holt Oram syndrome Achondroplasia The clinical signs of atlas occipitalization A. Are usually negligible B. May include mental retardation C. May include vertigo, visual difficulties and auditory abnormalities D. Are usually caused by atlantoaxial instability May include vertigo, visual difficulties and auditory abnormalities The arcuate foramen transmits A. B. C. D. The basilar artery The first cervial nerve The external carotid artery The recurrent nerve of Luschka The first cervial nerve Bilaterally enlarged cervical neural foramina may suggest the presence of A. Neurofibroma B. Vertebral artery aneurysm C. Congential spondylolisthesis caused by agenesis of pedicles D. Hyperplastic articular processes Congential spondylolisthesis caused by agenesis of pedicles The normal angle of incidence of the proximal femur is A. B. C. D. 115-120 105-115 120-130 130-145 120-130 Spinal dysraphism is most commonly seen in A. B. C. D. The C spine T/L spine L spine T spine T/L spine Synonyms for HOO include all of the following except: A. B. C. D. Osteo-onychodysostosis Nail patella syndrome Fong’s syndrome Holt-Oram syndrome Holt-Oram syndrome “overlap syndrome” refers to cases in which a single patient has signs of: A. Marfan’s symdrome, osteogenesis imperfeta, and mucoploysaccharidosis B. Osteopoikilosis, osteogenesis imperfecta, and osteopathia striata C. Mucopolysaccharidosis, osteogenesis imprefecta dn osteopoikilosis. D. Melorheostosis, osteopoikilosis and osteopathia striata Melorheostosis, osteopoikilosis and osteopathia striata In spinal films of a pt with spondyloepiphyseal dysplasia tarda, one might expect to see: A. Normal disc heights but “beaked” vertebrae with posterior scalloping B. Thin disc spaces, with “heaped up” vertebrae and non ossifed ring epiphyses C. Tall vertebrae with posterior scalloping and normal disc heights D. Widened disc spaces with centrally beaked, flattened vertebrae. Thin disc spaces, with “heaped up” vertebrae and non ossifed ring epiphyses Progessive diaphyseal dysplasia most prominently involves: A. B. C. D. The endosteum The periosteum The medullary cavity The articular surface The endosteum The spine of an achondroplastic dwarf may typically have: A. B. C. D. Anteriorly scalloped vertebral bodies Heaped up vertebrae Bullet nosed vertebra Rugger jersey vertebra Bullet nosed vertebra Putti’s triad is a group of radiologic features assocaited with A. B. C. D. Congential hip dislocation Malum coxae senilis Protrusio acetabulum Coxa valga Congential hip dislocation The cervical vertebra most commonly involved in congenital spondylolisthesis is A. B. C. D. C5 C2 C4 C6 C6 The kimmerly anomaly is commonly known as: A. B. C. D. Posterior ponticle Agenesis of the C1 posterior arch Atlanto-occiptial fusion A nuchal bone Posterior ponticle Acroosteolysis is a feature of A. B. C. D. Pyknodysostosis Massive osteolysis of Gorham Osteogenesis imperfecta Rheumatoid arthritis Pyknodysostosis Englemann’s disease is commonly called A. B. C. D. Nail patella syndrome Metaphyseal dysplasia Progressive diaphyseal dysplasia Osteopathia striata Metaphyseal dysplasia Diagnosis of osteogenesis imperfecta requires: A. Osteoporosis with abnormal dentition B. Osteoporosis with blue sclera C. Premature otosclerosis with skeltal fragility D. At least 2 of the 4 major criteria to be present At least 2 of the 4 major criteria to be present Paired posterior iliac horns are pathognomonic for: A. B. C. D. Gaucher’s disease Metaphysieal dysplasia Nail patella syndrome Ehlers-Danlos syndrome Nail patella syndrome Agenesis of the anterior sacrum may be seen on x ray as: A. B. C. D. The scimitar sacrum sign The inveted Napoleon hat sign The domed sarum sign The clasp knife appearance The inveted Napoleon hat sign The clinical picture of a young boy (younger than 10 years) with u/l hard, painless swelling in the distal tibia and distal femur suggests a diagnosis of A. B. C. D. Epiphyseal dysplasia mutiplex Dysplasia epiphysealis hemimelica Morquio’s syndrome Spondyloepiphyseal dysplasia tarda Spondyloepiphyseal dysplasia tarda The rhomboid fossae are anomalies that may be seen: A. B. C. D. Along the superomedial border of the scapulae Along the inferomedial border of the scapulae Along the inferomedial border of the clavicles Along the transverse prcesses of T3 and T4 Along the transverse prcesses of T3 and T4 Ortolani’s test and Barlow’s test are used to help diagnose A. B. C. D. Protrusio acetabulae Hip dislocation Legg Calve Perthese disease Slipped femoral capital epiphysis Legg Calve Perthese disease An omovertebral bone A. Projects from the hyoid bone to the thyroid cartilage B. Is always present in Klippel Feil syndrome C. Consists of cartilage, fibrous tissue, or bone attached to the superior angle of the scapula. D. Descends from the transverse process of C2, C3, C4 to the superior scapular angle The modality of choice for diagnosis of Arnold chiari malformation is A. B. C. D. CT CT myelography MRI Tomography MRI Bone density is generally increased but the medullary canal is preserved in A. B. C. D. Osteoporosis Osteopetrosis Pyknodysostosis Ehlers-Danlos syndrome Pyknodysostosis All of the following are true of patients with osteopetrosis except: A. They have fragile, brittle bones and suffer multiple pathologic fractures B. They may be completely asymptomatic C. They are subject to blindness or deafness when the skull is involved D. Their condition is always diagnosed at birth Their condition is always diagnosed at birth All of the following of are true of osteogenesis imperfecta except: A. It may be detectable at birth B. The tarda form has a life expectancy of two to three decades C. It affects skin, ligaments, the sclera, the inner ear and the skeleton D. May be caused by an ATPase deficiency The tarda form has a life expectancy of two to three decades Platyspondyly, hyperostotic calvarium and mandible, ocular hypertelorism, and Erlenmeyer flask deformities (esp. in the femur, tibia and fibula) are radiologic features common to: A. B. C. D. Marfan’s syndrome Fong’s syndrome Metaphyseal dysplasia Holt-Oram syndrome Metaphyseal dysplasia By the 18th week of gestation, alpha fetoprotein in the amniotic fluid may indicate: A. B. C. D. The presence of spina bifida occulta The presence of meningocele The presence of Down’s syndrome The presence of a neurofibroma The presence of meningocele All of the following are correct about Trevor’s disease (dysplasia epiphysealis hemimelica) except: A. It is monostotic B. It is polystotic C. In its classical form, it is present in more than one area in an extremity D. Is known to be a genetic disorder Is known to be a genetic disorder Syndactyly has a clear predilection for: A. B. C. D. White females Black females White males Black males White males A chest wall anomaly commonly associated with Morquio’s syndrome is: A. B. C. D. Pectus carinatum Pectus excavatum Straight back syndrome Srb’s anomaly A. Pectus carinatum The normal scapula usually is positioned with its inferior angle: A. B. C. D. At the T7 level Below the T7 level Above the T7 level Above the T6 level At the T7 level The clinical picture of a patient with a Type I Arnold-Chiari malformation may involve: A. Autonomic dysfunctions, such as anhidrosis and hyperhidrosis B. Impotence C. Headaches and neck pain D. dyspnoea Headaches and neck pain A patient with tuberous sclerosis has a poor prognosis if there: A. B. C. D. Is epilepsy Is peau-chagrin Is honeycomb lung Are renal hamartomas Is honeycomb lung Because of the pathological process involved in osteopetrosis, these patients will develop: A. B. C. D. Irritable bowel syndrome Hepatosplenomegaly Adult respiratory distress syndrome Bleeding disorders Hepatosplenomegaly A “no-neck” appearance, wide-set eyes set beside a depressed nose bridge, deformed teeth, and deafness but normal mentation characterise: A. B. C. D. An achondroplastic dwarf Hurler’s syndrome Morquio’s syndrome Klippel-Feil syndrome Morquio’s syndrome Pyle’s disease (metaphyseal dysplasia): A. Is familial and involves autosomal recessive transmission B. Primarily involves the upper extremities and spares the lower extremities C. Is manifested at birth D. Is a form of dwarfism Is familial and involves autosomal recessive transmission Spina bifida occulta: A. B. C. D. Is most common at C1 Is most common at T1 Is most common at L5 and S1 Is most common at T12 and L1 Is most common at L5 and S1 Premature DJD, short thick hands, and bilaterally, symmetrically shortened legs characterise: A. B. C. D. Epiphyseal dysplasia multiplex Dysplasia epiphysealis hemimelica Spondyloepiphyseal dysplasia Metaphyseal dysplasia Epiphyseal dysplasia multiplex The most common carpal coalition connects the: A. B. C. D. Scaphoid and trapezoid Lunate and triquetrum Trapezium and trapezoid Hamate and pisiform Lunate and triquetrum “Pancake heart” is a common complication of A. B. C. D. Srb’s anomaly Pectus carinatum Cobbler’s chest Intrathoracic rib Cobbler’s chest Sprengle’s deformity is: A. B. C. D. An omo-hyoid bone Congenital elevation of the scapula Congenital cervical block vertebra Scoliosis with an elevated shoulder Congenital elevation of the scapula Downward displacement of the brainstem and cerebellar tonsils through the foramen magnum is known as: A. B. C. D. Platybasia Arnold-Chiari malformation Basilar impression Basilar invagination Arnold-Chiari malformation Café-au-lait spots are characteristic of neurofibromatosis, A. Fibrous dysplasia, and tuberous sclerosis B. Fibrous dysplasia, and epilepsy C. Tuberous sclerosis, and osteopoikilosis D. Fibrous dysplasia, and pyknodysostosis Fibrous dysplasia, and tuberous sclerosis Juxtaarticular small, round, or ovoid opacities are pathognomonic for: A. B. C. D. Bone islands Osteoid osteoma Osteopathia striata osteopoikilosis osteopoikilosis Morquio’s syndrome is also known as A. B. C. D. MPS IV Gargoylism Dysostosis multiplex Sly syndrome MPS IV A patient with protrusio acetabulae, tall vertebrae, pectus excavatum, and atlantoaxial hypermobility may be suspected of having A. B. C. D. Metaphyseal dysplasia Fong’s syndrome Holt-Oram syndrome Marfan’s Syndrome Marfan’s Syndrome The cupids bow contour seen on an AP lumbar or thoracic film indicates the presence of: A. B. C. D. Persistent notochord Schmorles node Butterfly vertebra Congential hemivertebra Persistent notochord Trevors disease and tarsoepiphyseal aclasis are both symptoms for A. B. C. D. Dysplasia epiphysealis punctata Dyplasia epiphysealis hemimelica Multiple epiphyseal dysplasia Spondyloepiphyseal dysplasia congenita Dyplasia epiphysealis hemimelica A beaklike bony spur at the anteromedial distal humeral metaphysis that angles toward the elbow is most likely A. B. C. D. An osteosarcoma A chondrosarcoma An osteochondroma A supracondylar process A supracondylar process Srb’s anomaly involves A. B. C. D. Lumbar ribs Involuted ribs Cervical ribs Agenesis of the first ribs Involuted ribs The pterygium coli is the: A. Low hairline seen in Klippel-Feil syndrome B. Short webbed neck seen in Klippel Feil syndrome C. Omovertebral bone D. Triad of features seen in Klippel Feil syndrome Short webbed neck seen in Klippel Feil syndrome Primary basilar impression is generally caused by A. B. C. D. Pagets disease Osteomalacia Fibrous Dysplasia Congential malformations Congential malformations The classic clinical triad of tuberous sclerosis is: A. Mental retardation, visual abnormalities and hepatosplenomegaly. B. Mental retardation, skin lesions and kidney failure C. Mental retardation, epilepsy and skin lesions D. Epilepsy, lung hamartomas and visual abnormalities Mental retardation, epilepsy and skin lesions Osteopokilosis involves A. B. C. D. Microfractures Abnormally low serum calcium levels Abnormally high serum calcium levels Autosomal dominant transmission Autosomal dominant transmission Frontal bossing, an enlarged “J” shaped sella turnica, inferiorly beaked thoracolumbar vertebrae, “paddle ribs” and a “trident hand” are all characteristic of the radiologic features of: A. B. C. D. Morquio’s syndrome Achondroplasia Hurlers syndrome Holt-Oram syndrome Hurlers syndrome Marfan’s syndrome A. Seldom involves the spine B. Has a 3:1 male predilection C. Is essentially a connective tissue disorder D. May involve significant mental retardation Is essentially a connective tissue disorder The VATER syndrome may involve all of the following except: A. B. C. D. Vascular anomalies Retinal dysplasia Anal atresia Vertebral anomalies Retinal dysplasia Conradi-Hunermann syndrome is a form of: A. B. C. D. Chondrodysplasia punctata Metaphyseal dysplasia Ehlers-Danlos syndrome Mucopolysaccharidoses Chondrodysplasia punctata Although probably genetic in etiology, Caffey’s disease may not be detectable until A. puberty. B. A child begins weight bearing (ie standing and walking) C. The third decade fo life D. A child is 2 or 3 months old A child is 2 or 3 months old A subtrochanteric femoral fracture (about 2 inches distal to the lesser trochanter) A. Is rare and usually pathologic B. Is the most common femoral fracture C. Is seen most commonly in young athletes D. Is if all femoral fractures most prone to subsequent ischaemic necrosis Is rare and usually pathologic The FBI sign is a radiographic indication of: A. B. C. D. Hematoma Lipoma Lipohemarthrosis Bilateral fracture to the ilia Lipohemarthrosis Choparts dislocation is: A. B. C. D. A rare midtarsal dislocation A proximal fibular dislocation A femorotibular dislocation A superolateral dislocation A rare midtarsal dislocation Posterior humeral capsule fat pads A. Are normally not visible on lateral elbow projections B. Are normally oriented horizontally on lateral elbow projections C. Are normally oriented obliquely on lateral elbow projections D. Are obliterated completely when there is significant swelling at the elbow Are normally not visible on lateral elbow projections Radiographic evidence of a rotator cuff tear may include: A. B. C. D. A hatchet defect A decreased acromiohumeral space (<7mm) An increased acromiohumeral space (>5mm) A “hanging shoulder” or “drooping shoulder” A decreased acromiohumeral space (<7mm) A fracture which disrupts the bone between the inferior orbital fissure and the lateral maxillary wall and also sjatters the ethmoid bone is classified as: A. B. C. D. An orbital blowout fracture A LeFort I fracture A LeFort II fracture A LeFort III fracture A LeFort II fracture The most common lumbar fracture is: A. A burst fracture B. A fracture of the transverse process of L4 or L5 C. A Chance fracture D. A compression fracture A compression fracture Fracture healing involves three major phases which are: A. B. C. D. The circulatory (inflammatory phase), the reparative (metabolic) phase, and the remodeling (mechanical) phase. The circulatory (inflammatory) phase, the vascular phase, and the remodeling (mechanical) phase. The vascular phase, the metabolic phase, and the reparative phase. The vascular phase, the reparative (metabolic) phase, and the primary callus phase. The circulatory (inflammatory phase), the reparative (metabolic) phase, and the remodeling (mechanical) phase. Fergusons view, or Hibbs projection helpful in directing L5 pars defects and anterolisthesis is: A. B. C. D. A cross-table lateral projection. An upright lateral projection. A “tilt-up” upright AP projection. A weight bearing oblique projection A “tilt-up” upright AP projection. Another term for stress fracture is: A. B. C. D. Fatigue fracture Pseudofracture Occult fracture Increment fracture Fatigue fracture Risk of nonunion or avascular necrosis is grestest when: A. A fracture of the proximal femur occurs in an elderly female. B. A proximal femure fracture is subtrochanteric C. A proximal femur fracture is intracapsular D. A proximal femur fracture is intertrochanteric proximal femur fracture is intracapsular When an AP radiograph of the knee shows the full fibula head overlapping very little with the tibial condyle one may suspect a diagnosis of: A. Distal tibiofibular diastatic fracture B. Anterolateral proximal tibiofibular dislocation C. Posteromedial proximal tibiofibular dislocation D. Distal fibular malleolar fracture Anterolateral proximal tibiofibular dislocation A dancers fracture must be differentiated from: A. A longitudinally oriented juvenille apophysis B. A horizontally juvenile apophysis C. A transversly oriented juvenile apophysis D. A jones fracture A longitudinally oriented juvenille apophysis Little leaguers elbow may involve: A. B. C. D. Lateral epicondyle avulsion Bilateral epicondyle avulsion Medial epicondyle avulsion Triceps tendon rupture Medial epicondyle avulsion “luxatio erecta” is a synonym for: A. B. C. D. Posterior GH joint dislocation Inferior GH joint dislocation Anterior GH joint dislocation Sprengels deformity Inferior GH joint dislocation Mandibular fracture is best demonstrated radiographically by: A. An overpenetrated Towne’s projection B. A lateral projection with the injured side adjacent to the film C. A lateral projection with the uninjured side adjacent to the film D. A Caldwell projection An overpenetrated Towne’s projection Adequate radiographic imaging of the upper thoracic vertebrae may require: A. B. C. D. An apical lordotic projection A swimmers lateral projection Filtration of the thoracolumbar region Left and right oblique projections A swimmers lateral projection During the vascular phase of fractue healing: A. A vascular spindle forms in the area of hyperemia around the injury B. A mesenchymal blastema is created by granulation tissue around the injury C. The hematoma around the injury is replaced by granulation tissue D. Cartilage and osteoid are formed or deposited within the healing callus A vascular spindle forms in the area of hyperemia around the injury A “bowline of Brailsford” on a frontal projection is indicative of: A. B. C. D. Advanced DJD SPO Spondylolisthesis of L5 on S1 Facet imbrication Spondylolisthesis of L5 on S1 Pathologic fractures often appear: A. Unusually jagged B. Smooth, disrupting the bone in a straight transverse line C. In a spiral pattern with a white line of impaction D. Comminuted with excessive fragmentation Smooth, disrupting the bone in a straight transverse line An “open book” or “sprung” pelvis is best described as: A. A symphysis pubis diastasis B. Diastasis of the symphysis pubis and one or both of the SIJ’s. C. Fracture/dislocation of one or both ilia D. The lateral displacement of one or both ilia, with bilateral fractures of the pubic rami Diastasis of the symphysis pubis and one or both of the SIJ’s. Transverse (or slightly oblique) patellar fractures: A. Are the most common patellar fractures B. Are seen less often than stellate patellar fractures C. Are less common than vertical patellar fractures D. Are the least common patellar fracture Are the most common patellar fractures Lisfrancs injury involves: A. B. C. D. Multiple proximal metatarsal fractures Foot dislocation without fracture Ankle dislocation without fracture Tarsometatarsal fracture dislocation Tarsometatarsal fracture dislocation The position of the humeral head after a proximal humeral shaft fracture may be affected by any of the following muscles except: A. B. C. D. The RC muscles Deltoid muscle Triceps muscle Pectoralis major muscle Triceps muscle The most common location of the humeral head after an anterior GH dislocation is: A. B. C. D. An intrathoracic position A subclavicular position A subglenoid position A subcoracoid position A subcoracoid position Up to 80% of skull fractures are: A. B. C. D. Depressed fractures In the base of the skull Linear fractures Incomplete fractures Linear fractures Nuclear bone scan is a useful imaging modality for trauma patients because of its: A. High specifity for occult fracture B. High sensitivity for occult fracture C. High specificity for non fracture articular damage D. High sensitivity for non fracture articular damage High sensitivity for occult fracture The hematoma at a fracture site: A. Is essential for proper callus formation B. Should be resorbed within 10 days C. May delay healing healing if it is allowed to remain at the site D. Is normally resorbed during the cellular phase of healing Is essential for proper callus formation Factors that may predispose a patient to the development of a degenerative spindylolithesis include all the following except: A. Female gender B. Hyperlordosis with an unstable lumbosacral joint C. Sacralisation of the L5 D. Facet joint arthrosis Hyperlordosis with an unstable lumbosacral joint When it occurs in the spine, the injury that is called an impaction fracture in the apendicular skeleton is called: A. B. C. D. Torus fracture Teardrop fracture Compression fracture Limbus bone Compression fracture A “tug lesion” (iliac avulsion fracture): A. B. C. D. Is usually a pathologic avulsion fracture caused by osteochondroma at the ASIS Is usually a pathologic avulsion of the rectus femoris from the AIIS Is often caused by repetitive stress causing avulsion of the sartorius from the ASIS or avulsion of the rectus femoris from the AIIS Is most commonly an avulsion of osteoporotic bone in a geriatric patient Is often caused by repetitive stress causing avulsion of the sartorius from the ASIS or avulsion of the rectus femoris from the AIIS An avulsion of the lateral tibial condyle by the TFL (iliotibial band) tendon is termed: A. B. C. D. Segond’s fracture Cotton’s fracture Pott’s fracture Dupuytren’s fracture Segond’s fracture Ankle fractures include all of the following except: A. B. C. D. Tillaux’s fracture Maisonneuves fracture Jones fracture Dupuytrens fracture Jones fracture When the surgical neck of the humerus is fractured the shaft is ussually displaced : A. B. C. D. Posteriorly Superiorly Anterolaterally Anteromedially Anteromedially A bankart lesion is: A. B. C. D. An avulsion of the inferior glenoid rim at the insertion of the triceps An avulsion of the superior glenoid rim at the insertion of the suprspinatus A “chip fracture” of the humeral head caused during an anterior humeral dislocation An impaction fracture of the humeral head acquired during the posterior humeral dislocation An avulsion of the inferior glenoid rim at the insertion of the triceps On x-ray a “growing fracture” in the skull may be an indication of: A. B. C. D. Subdural hematoma A leptomeningeal cyst Arachnoiditis Cerebral hemorrohage A leptomeningeal cyst Nonunion of the secondary growth centre for the spinous process must be differentiated from: A. B. C. D. A clay shovelors fracture A teardrop fracture An articular pillar fracture An chance fracture A clay shovelors fracture The inflammatory (circulatory) phase of fracture repair: A. May last as long as 60 days B. Has four sub-phases each of which may last as long as 10 days C. Involve necrosis, hematoma formatio, vascular spindle formation and primary callus formation D. Is the second phase of repair Involve necrosis, hematoma formatio, vascular spindle formation and primary callus formation Some of the classifications of spondylolisthesis are: A. B. C. D. Dysplastic, degenerative or traumatic Congenital, degenerative or infectious Dysplastic ithmic or infectious Infectious, dysplastic or pathologic Dysplastic, degenerative or traumatic An avulsion fracture is the term used to describe: A. The bending of a soft bone with no cortical disruption B. Cortical disruption only on the convex side of the injured bone C. A cortical bone torn away by tractional force of the ligament or tendon D. A bone fragment driven into another portion of the bone A cortical bone torn away by tractional force of the ligament or tendon A bucket handle pelvic fracture is caused by: A. Excessive weight bearing in a geriatric or osteoporotic patient B. An impact contralateral to the actual fracture C. Traumatic compresive force as in a fall from great height D. Traumatic impact from behind and above An impact contralateral to the actual fracture With traumatic hyperextension of the knee: A. The posterior cruciate ligament may avulse the medial tibial plateau B. The posterior cruciate ligament may avulse the lateral tibial plateau C. The anterior cruciate ligament may avulse the anterior tibial spine D. The anterior cruciate ligament may avulse the medial tibial plateau The anterior cruciate ligament may avulse the anterior tibial spine A distal fibular fracture with rupture of the distal tibiofibular ligamentbut no malleolar fracture is: A. B. C. D. A Colles fracture A Potts fracture A Dupuytrens fracture A bumper fracture A Potts fracture Significant displacement (>1cm) of the free fragment in a flap fracture indicates: A. B. C. D. Probable ankle instability Probable patellar tendon rupture Probable significant RC rupture Probable atlantoaxial instability Probable significant RC rupture The most common fracture of the clavicle is: A. A middle clavicle fracture B. A medial clavicle fracture C. A fracture of the distal third of the clavicle D. An avulsion fracture at the insertion of the AC ligament A middle clavicle fracture The optimal imaging modality for demonstrating skull fractures is: A. B. C. D. CT MRI Plain films tomography CT Acute anterior cervical syndrome (immediate complete paralysis, loss of pain and temperature) is associated with: A. B. C. D. A teardrop fracture A burst fracture A jefferson fracture A type 2 odontoid fracture A teardrop fracture The salter-harris type V fracture is: A. A pathologic fracture seen with rickets B. An oblique fracture requiring open reduction C. The most commonly seen salter-harris fracture D. An impaction fracture of the physis An impaction fracture of the physis Pars defects in newborns: A. Are seen more frequently seen in native american infants than in other populations B. Have never been reported C. Are asymptomatic and are incedental findings on x-rays taken for other purposes D. Occur only in approximately 1% of x-rayed infants Have never been reported A comminuted fracture involves: A. A bone separted into two fragments B. A bone separated by more than two fragments C. Disruption of the skin over the fracture D. Disruption of the bone on the convex surface of the injury only A bone separated by more than two fragments The posterolateral impaction fracture often occurring with anterior GH dislocation is best demonstrated radiographically with: A. B. C. D. An internal rotation AP shoulder projection An external rotation AP shoulder projection An axillary view A weighted external rotation AP shoulder view An internal rotation AP shoulder projection Cotton’s fracture is: A. A fracture of the medial malleolus distal to the talar plafond B. A fracture of the proximal fibula C. A “B-B fracture” involving both tibia and fibula D. A fracture of the tibial shaft with distal fibulotibial diastasis A fracture of the tibial shaft with distal fibulo-tibial diastasis A “bumper-fracture” is: A. B. C. D. A fracture of the tibial plateau A fracture of the proximal fibula A “B-B” fracture involving tibia and fibula A fracture of the tibial shaft with distal fibulo-tibial diastasis A fracture of the tibial plateau A malgaigne fracture is: A. B. C. D. A pelvic fracture An elbow fracture A fracture/dislocation of the distal radius An ankle fracture A pelvic fracture Spondylolysis has a higher incidence among: A. B. C. D. White north americans Native amerians Black north americans Northern europeans Native amerians The Mach band is: A. A shadow on the AP open mouth film caused by a non union if a type 3 ondontoid fracture B. A shadow on the AP open mouth film caused by the tongue C. A shadow on the AP open mouth fikm caused by the dentocentral synchondrosis D. A shadow on the AP open mouth film caused by the posterior arch of the atlas A shadow on the AP open mouth film caused by the posterior arch of the atlas Factors in the development of osteonecrosis after fracture include all of the following except: A. Vascularity of the bone at the fracture site B. Appropriate early treatment of the injury C. Extent of soft tissue damage at the fracture site D. Site of the fracture itself Extent of soft tissue damage at the fracture site Adequate radiologic evaluation for acromioclavicular separation requries: A. Overpenetrated AP views of the shoulder with external and internal rotation B. Bilateral non-weighted and weighted (patient holding 10-15 pound weights) AP views C. Bilateral internally and externally rotated AP views D. Underpenetrated AP view with 15 degree cephalad tube tilt Bilateral non-weighted and weighted (patient holding 10-15 pound weights) AP views The “Thurston-Holland sing” is: A. A humeral head fragment often seen with GH dislocations B. A glenoid rim lesion seen with posterior GH dislocation C. An indication of a good prognsosis after a talar fracture D. A metaphyseal fragment seen with a salterharris type II fracture A metaphyseal fragment seen with a salter-harris type II fracture When the ulnar styloid fractures as the distal ulnar dislocates the result is called: A. B. C. D. A chauffers fracture A hutchinsons fracture A bartons fracture A moores fracture A moores fracture The Neer classification considers fractures: A. B. C. D. Of the proximal humeral shaft Of the femoral head and neck Of the humeral head and neck Of the radial head Of the humeral head and neck The ligament most often ruptured in ankle injuries is the: A. B. C. D. Deltoid ligament Tibiofibular ligament Medial collateral ligament Lateral collateral ligament Lateral collateral ligament The most common hip dislocation leaves the femoral head in: A. B. C. D. An anterior superior position An anteromedial position A superior posterior position An inferolateral position A superior posterior position Whenever there is a pelvic or sacral fracture: A. There is a high probability of nonunion B. There is a high probability of subsequent avascular necrosis C. There is a high probability associated injury to pelvic organs D. There is a high probability of reflex sympathetic dystrophy syndrome There is a high probability associated injury to pelvic organs A Chance fracture: A. Almost always involves neurologic deficit B. Most commonly is seen at L4 or L5 C. Specifically involves horizontal splitting of the spinous process, pedicle, and posterior body to the superior endplate D. Involves the cleaving of an entire lumbar vertebra on a coronal plane Specifically involves horizontal splitting of the spinous process, pedicle, and posterior body to the superior endplate The hangmans fracture is the result of: A. B. C. D. Traumatic compression Traumatic hyperflexion Traumatic hyperextension Traumatic distraction Traumatic hyperextension Post traumatic osteolysis is a complication that is likely to be seen after fracture of the: A. B. C. D. Tarsal navicular Calcaneus Distal clavicle acromion Distal clavicle Fracture of the distal clavicle may be followed by: A. Stress hypertrophy of the acromion B. Posttraumatic osteolysis of the distal clavicle C. Stress hypertrophy of the distal clavicle D. Stress hypertrophy of the coracoid process Posttraumatic osteolysis of the distal clavicle The most frequently seen type of Salter-Harris fracture is: A. B. C. D. Type I Type II Type IV Type V Type II In the common childhood injury known as “toddler elbow”: A. Forceful supination of the forearm dislocates the radial head B. Pronation coupled with hyperextensionof the elbow dislocates the radial head C. The annular ligament becomes entrapped in the radioulnar joint D. The annular ligament becomes entrapped in the radiohumeral joint The annular ligament becomes entrapped in the radiohumeral joint A “head-splitting fracture” refers to: A. B. C. D. A LeFort type III fracture A cranial diastasis A comminution of the humeral head An impaction fracture of the radial head A comminution of the humeral head When an ankle fracture exists, ligament ruptures should be ruled out by: A. Stress studies comparing the ankles bilaterally B. Stress studies looking for >6 degrees combined lateral and medial tilt C. Stress studies looking for >6 degrees in either lateral or medial joint tilt D. Stress studies looking for any joint space >3mm Stress studies comparing the ankles bilaterally A normal Kleins line should: A. Intersect the superolateral acetabular margin B. Intersect the fovea crepitus centralis C. Intersect the femoral head D. Pass tangential to the superolateral margin of the femoral head Intersect the femoral head The most commonly seen sacral fracture is: A. A transverse fracture at the third or fourth sacral tubercle level B. A vertical sacral fracture C. An avulsion of the sacral promontory D. A horizontal fracture at the level of the second sacral tubercle A transverse fracture at the third or fourth sacral tubercle level Traumatic fracture of the lumbar pars interarticularis: A. Is the third most common occult fracture B. Is extremely rare and results only from violent hyperextension C. Is the second most common cause of a ‘pars defect’ D. Is most likely to occur at L1 as opposed to a stress fracture of the pars which occurs at L4 or L5 Is extremely rare and results only from violent hyperextension A “guillotine” effect may be produced on the cervical spinal cord when there is: A. B. C. D. A congenital block vertebrae A ruptured transverse ligament SBO of the atlas and axis A persistent ossiculum terminale of the axis A ruptured transverse ligament The fracture most frequently associated with fat embolism formation is a fracture of: A. B. C. D. The pelvis The spine The femur The tibia The femur The bone most frequently fractured in the birth process is: A. B. C. D. The maternal coccyx The infant acromion The infant clavicle The maternal ischial spine The infant clavicle Good apposition of a fracture refers to: A. Almost complete surface contact of fractured fragments B. Lack of angulation between fractured fragments C. Optimal alignment of fractured fragments D. Little or no rotation of the distal fragment around its long axis Almost complete surface contact of fractured fragments The Galeazzi (or Piedmont) fracture is a serious injury because: A. It often results in permanent neurologic damage B. It usually results in rupture of the radial artery C. It is subject to non union and redislocation despite surgical reduction D. It usually results in Sudecks atrophy It is subject to non union and redislocation despite surgical reduction All of the following must be assessed in the evaluation of AC joint injury except: A. B. C. D. Coracoclavicular distance Anterior GH joint space AC joint space AC joint alingnment Anterior GH joint space The optimal imaging modality for demonstration of damage to the knee ligaments or meniscus is: A. B. C. D. MRI CT Arthrography scintigraphy MRI An optimal radiologic study for evaluating slipped femoral capital epiphysis should include: A. AP and “frog-leg” hip views of the involved sides B. Bilateral AP and “frog leg” hip views C. Bilateral AP and overpenetrated lateral hip views D. Bilateral AP hip views with internal and external rotation of the thigh Bilateral AP and “frog leg” hip views Conservative treatment of a patient with spondylolisthesis has a poor prognosis if: A. There are bilateral pars defects B. There is a unilateral pars defects C. Flexion and extension lateral lumbar films indicate instability at the level of the lesion D. The patient is <20 yo. Flexion and extension lateral lumbar films indicate instability at the level of the lesion Cauda equina injury is most likely to result from: A. B. C. D. A thoracolumbar compression fracture A lumbar “burst” fracture A Chance fracture A lumbar transverse process fracture A lumbar “burst” fracture Significant trauma to the cervical spine involves neurologic damage in approx: A. B. C. D. 10-14% of cases 40% of cases 4% of cases 60-70% of cases 40% of cases Following a fracture, x-ray indication of claustridium perfringens infection may show as: A. Thin linear parallel lucent streaks within muscle planes B. Lucent “bubbles” around the newly formed callus C. Lucent “bubbles” just below the skin contour D. Lucent streaks between the periosteum and cortical surface Thin linear parallel lucent streaks within muscle planes A “golfers fracture” involves: A. The tip of the SP usually C6 and T2 B. A stress fracture of the proximal lateral metatarsals C. Fracture of the lateral rib margins D. Fracture of the ulnar styloid Fracture of the lateral rib margins A spiral fracture is distinguished by: A. Sharply pointed ends of the fracture fragments B. An angled fracture line with blunt fracture ends C. A “bulge” in the bone on the concave side of the injury D. A spiral shaped avulsed bone fragment Sharply pointed ends of the fracture fragments A comminuted radial head fracture coupled with distal radioulnar dislocation is called a(n): A. B. C. D. “baby car” fracture Galeazzi fracture Essex-Lopresti fracture Monteggia fracture Essex-Lopresti fracture Glenoid labral tears are called: A. B. C. D. Bankart lesions Rim signs SITS lesion SLAP lesion SLAP lesion Pelligrini-Stieda disease is defined as: A. Ununited avulsions at the lateral femoral condyle B. Medial collateral ligametn calcifications at the distal femur caused by previous avulsions C. Ununited avulsions of the medial tibial plateau D. Calcifications in the lateral collateral ligament; possibly caused by previous ligament damage Medial collateral ligametn calcifications at the distal femur caused by previous avulsions Slipped Femora Capital Epiphysis (SFCE) is: A. Now known to be genetically mediated B. Now recognized as a pathologic fracture C. Actually a Salter-Harris type 1 stress fracture D. Almost always preceeded by significant trauma Actually a Salter-Harris type 1 stress fracture The Meyerding classification system grades spindulolisthersis displacement: A. By 10% increments, based on lateral projections B. By 25% increments, based on lateral projections C. By 10% increments, based on anterior oblique projections D. By 25% increments, based on anterior oblique projections By 25% increments, based on lateral projections A linear zone of impaction below a vertebral body endplate denotes: A. B. C. D. An old healed fracture A recent fracture A period of growth arrest Pagets disease A recent fracture Spinal fractures are most common in the: A. B. C. D. Lumbar spine Thoracic spine Cervical and thoracolumbar areas Mid-cervical spine Cervical and thoracolumbar areas Muscle damage adjacent to a fracture site: A. May be surgically repaired B. Has no effect on the healing of the fracture itself C. Appears to enhance fracture healing D. Appears to be detrimental to fracture healing Appears to enhance fracture healing The “costal-hook sign” may indicate the presence of: A. B. C. D. Costochondral calcifications Atelectasis Bronchogenic carcinoma A flail segment A flail segment MRI is the only imaging modality that is capable of displaying: A. B. C. D. An occult fracture A bone bruise A stress fracture A torus fracture A bone bruise Wolff’s law, which applies in fracture healing, states that: A. Callus forms only when the hematoma is undisturbed B. Stress will retard the formation of the callus C. Stress will speed the formation of the callus D. Bone is deposited in stressed areas and removed from non-stressed areas Bone is deposited in stressed areas and removed from non-stressed areas CHAPTER 5 An “Andersson lesion” is: A. A pathologic fracture through a long bone B. A pseudoarthrosis caused by a pathologic fracture through a previously ankylosed joint C. An ankylosed spinal motion segment D. A cavitation between the spine and the anterior longitudinal ligament. A. B) A pseudoarthrosis caused by a pathologic fracture through a previously ankylosed joint A striking difference between the pathologic process of rheumatoid arthritis and psoriatic arthritis is that the latter does not involve: A. B. C. D. Pannus Periarticular osteoporosis Narrowing of the joint space Cortical margin erosions A. B) Periarticular osteoporosis The onset of systemic lupus erythematosus most frequently occurs in: A. B. C. D. Males above 50 years of age Females above 40 yrs of age Males between 10 and 40 yrs of age Females between 10 and 40 yrs of age A. D) Females between 10 and 40 yrs of age The Lesch-Nyhan syndrome is a rare hereditary clinical syndrome associated with: A. B. C. D. Rheumatoid arthritis Ochronosis Wilsons disease hyperuricemia A. D) hyperuricemia Scleroderma has potentially serious effects on all the following except: A. B. C. D. The heart The kidneys The lungs The Gastrointestinal tract A. B) The kidneys Forestier’s disease commonly involves calcification and ossification of: A. B. C. D. The posterior longitudinal ligament The anterior longitudinal ligament The ligamentum flavum The nuchal ligament A. B) The anterior longitudinal ligament Sjogren’s syndrome commonly seen with various connective tissue disorders involves: A. Excessive tearing and serous mucous production B. Vasculitis C. Scleromalacia perforans D. Generalized drying of mucous membranes A. D) Generalized drying of mucous membranes Coxarthrosis is a term used to describe: A. Advanced degenerative joint disease of the hip B. Surgical fixation of the hip C. Early degeneration of the acetabular joint D. Formation of an auxiliary acetabular joint because of congenital dislocation A. Advanced degenerative joint disease of the hip In the hands the x-ray appearance of ‘dot-rash’ cortical interruptions is characteristic of: A. B. C. D. Gout Psoriasis Pseudgout Rheumatoid arthritis A. Rheumatoid arthritis Synoviochondrometaplasia is: A. B. C. D. An inflammatory arthritide A degenerative arthritide A metabolic arthritide A tumor like or neoplastic lesion A. B) A degenerative arthritide The subjective signs if ankylosing spondylitis are frequently aggravated by: A. B. C. D. Moderate activity A posture of slight spinal Alcohol consumption Caffeine consumption A. C) Alcohol consumption Psoriatic arthropathy most commonly affects the joints of the: A. B. C. D. Hands and feet Lumbosacral spine Thoracolumbar spine Cervicothoracic spine A. Hands and feet The arthritis associated wit Reiter’s syndrome is: A. Relentlessly progressive B. Usually self limiting, but prone to recurrence and may leave residual joint damage C. Limited by steroid treatments, and seldom recurs D. Apt to recur but seldom results in residual joint damage A. B) Usually self limiting, but prone to recurrence and may leave residual joint damage Most frequently gout develops in: A. B. C. D. Post menopausal woman on diuretics Males between 20 and 40 year of age Males between 40 and 60 years of age Men or woman older than 60 yrs A. C) Males between 40 and 60 years of age CREST syndrome is associated with: A. Premature closure of the iliac crest physis B. Scleroderma C. Raynaud’s phenomenon D. Thibierge-Weissenbach syndrome A. B) Scleroderma Diabetes mellitus has a recognized correlation with: A. B. C. D. Ankylosing spondylitis Reiter’s syndrome Osteitis pubis DISH A. D) DISH A better prognosis is indicated when rheumatoid arthritis: A. Is asymmetric and its onset is in later years B. Is symmetric in distribution C. Is clinically recognized before age 30 D. Involves subcutaneous nodules A. Is asymmetric and its onset is in later years Radiologic indications of sacroiliac degenerative joint disease: A. Usually include sclerosis of the sacral joint surface B. Usually involve changes in the lower two thirds of the joint C. Usually include a vacuum cleft D. Usually involve changes in the upper third of the joint A. B) Usually involve changes in the lower two thirds of the joint Rheumatoid arthritis in the hands often: A. Spares the distal interphalangeal joints B. Spares the second and third metacarpophalangeal joints C. Spares the first ray D. Spares the proximal interphalangeal joints A. Spares the distal interphalangeal joints Degenerative arthritides include all of the following except: A. Erosive osteoarthritis B. Diffuse idiopathic skeletal hyperostosis (DISH) C. Neuropathic arthropathy D. Osteitis condensans ilii A. D) Osteitis condensans ilii An arthritis showing a clear predilection for the axial skeleton in young males is: A. B. C. D. Seropositive JRA Classic systemic Stills disease Marie Strumpell’s disease Pseudogout A. C) Marie Strumpell’s disease In the spine x-ray findings may be identical in cases of ankylosing spondylitis and: A. B. C. D. Ochronosis Rheumatoid arthritis Neurotrophic arthropathy Enteropathic arthropathy A. D) Enteropathic arthropathy Reiter’s syndrome has clear associations with: A. B. C. D. Crohn’s disease Regional enteritis Ulcerative colitis Dysentery caused by salmonella A. D) Dysentery caused by salmonella The term podagra associated with gout refers to: A. The belief that poison fell ‘drop by drop’ into the joint B. The chalky urate deposits in joints C. A predilection for the foot D. hyperuricaemia A. C) A predilection for the foot The diagnosis of idiopathic chondrolysis of the hip should be strongly suspected when there is: A. A young woman with prolific osteophytic growth at the acetabular joint B. A patient in the 5th decade with osteoarthritis of the hip C. An asymptomatic young woman with protrusio acetabuli D. A young man with a limp and knee pain A. C) An asymptomatic young woman with protrusio acetabuli The vacuum cleft indicates degenerative joint disease only when it is seen: A. B. C. D. In the hip In the shoulder In the spine In the knee A. C) In the spine Rheumatoid arthritis generally spares A. B. C. D. The cervical spine The lumbar spine The shoulder joints The carpal joints A. B) The lumbar spine Lower costovertebral or costotransverse involvement in osteoarthritis may result in: A. Gastrointestinal disease B. Maigne’s syndrome which stimulates gastrointestinal disease C. Roberts syndrome which involves pain referred to the lower lumbar spine D. Roberts syndrome which stimulates gastrointestinal disease A. D) Roberts syndrome which stimulates gastrointestinal disease Articular lesions typical of rheumatoid arthritis result in the radiographic appearance called: A. B. C. D. Mouse ears sign Overhanging margin sign Gull wing sign Rat bite erosions A. D) Rat bite erosions Inflammatory processes may lead to ossification of spinal ligaments causing the development of: A. B. C. D. Osteophytes Spondylophytes Syndesmophytes Periostitis A. C) Syndesmophytes X-ray signs of juvenile rheumatoid arthritis in the hands commonly include: A. Ballooning of the distal interphalangeal joints B. Interphalangeal ankylosis C. Arachnodactyly D. Multiple altered digit lengths A. B) Interphalangeal ankylosis Enteropathic arthritis in the peripheral skeleton usually does not affect: A. B. C. D. The hips The elbows The knees The wrists A. A) The hips Reiter’s syndrome has been observed to have: A. B. C. D. A 50:1 male predilection A 2:1 male predilection A 2:1 female predilection A 25:1 male predilection A. A) A 50:1 male predilection The theory of pathogenesis of hypertrophic osteoarthropathy that is most widely accepted involves: A. B. C. D. An increased peripheral blood flow (humeral theory) A decreased peripheral blood flow (humeral theory) Autonomic reflex vasodilation (neurogenic theory) Visceral lesion produces a substance that increases peripheral blood flow (endocrine theory) A. C) Autonomic reflex vasodilation (neurogenic theory) Chondrolysis of the hip is most commonly: A. B. C. D. Idiopathic Secondary to slipped femoral capital epiphysis Secondary to septic or rheumatoid arthritis Secondary to immobilization as with paraplegia A. B) Secondary to slipped femoral capital epiphysis Among the universal radiologic signs that characterize degenerative joint diseases are: A. Inflammation and periarticular periositis B. Symmetry of distribution and uniform loss of joint space C. Eburnation and geodes D. Syndesmophytes and subchondral sclerosis A. C) Eburnation and geodes Synoviochondrometaplasia is: A. B. C. D. A malignant neoplastic process A metabolic process An ischemic necrosis A benign arthropathy A. D) A benign arthropathy An intercalary bone is: A. Calcification of the anterior annulus B. Calcification of the posterior nucleus pulposus C. Calcification of the posterior longitudinal ligament D. Calcification of the nuchal ligament A. A) Calcification of the anterior annulus The inflammatory spondyloarthropathies: A. Frequently result in atlantoaxial hypomobility B. May result in the complete dissolution of the odontoid process C. May affect the synovium between the anterior tubercle and the posterior odontoid D. May result in ossification of the transverse ligament A. B) May result in the complete dissolution of the odontoid process An enthesis is: A. B. C. D. Is essentially immobile joint An inflammation of the periosteum A slightly movable joint The periarticular site of tendon or ligament insertion into bone A. D) The periarticular site of tendon or ligament insertion into bone Still’s disease is: A. A variant of ankylosing spondylitis B. A seronegative chronic arthritis seen in pediatric patients C. A transient monoarticular arthritis D. A metabolic arthritis A. B) A seronegative chronic arthritis seen in pediatric patients Seronegative arthritides include all of the following except: A. B. C. D. Enteropathic arthropathy Neurotrophic arthopathy Reiter’s syndrome Ankylosing spondylitis A. B) Neurotrophic arthopathy Marginal syndesmophytes: A. Are typical of psoriatic arthritis B. Are thin vertical ossification of the inner annular fibers C. Are characteristic of ankylosing spondylitis and of enteropathic arthropathy D. Are usually unilateral originating from peripheral body endplate junctions A. C) Are characteristic of ankylosing spondylitis and of enteropathic arthropathy Hypertrophic osteoarthropathy (HAO) appears to develop most commonly as a sequel to: A. B. C. D. Renal failure Myocardial infarction Bronchogenic carcinoma Cholecystitis A. C) Bronchogenic carcinoma An arthritide that occurs in consequence of rheumatic fever is: A. B. C. D. Rheumatic arthritis Stills disease Jaccoud’s syndrome Reiter’s syndrome A. C) Jaccoud’s syndrome Erosive OA may involve: A. B. C. D. Positive rheumatoid factor Positive HLA-B27 Periarticular osteoporosis The base of the thumb A. D) The base of the thumb Spinal involvement in neurotrophic arthropathy is most often associated with: A. B. C. D. Spina bifida Leprosy Syphilis Syringomyelia A. C) Syphilis Among the most common spinal sites for degenerative arthritis are: A. B. C. D. C1-C2 L1-L3 C7-T1 C5-C7 A. D) C5-C7 Rheumatoid may result in: A. Bony ankylosis of synovial joints B. Bony ankylosis of fibrocartilaginous joints C. Carrot stick fractures in the lower cervical spine D. Ossification of the posterior longitudinal ligament A. Bony ankylosis of synovial joints A synarthrosis is: A. B. C. D. A slightly movable joint A cartilaginous joint A freely movable joint An essentially immobile fibrous joint A. D) An essentially immobile fibrous joint Theories regarding the etiology of osteitis pubis include all of the following except: A. Vascular etiology involving venous stasis, engorgement and local osteoporosis B. Microfractures caused by unaccustomed vectors of stress C. Low-grade infection after childbirth or pelvic surgery D. Sudeck’s atrophy variant A. B) Microfractures caused by unaccustomed vectors of stress The “Bywaters-Dixon” syndesmophyte, a variety of non-marginal syndesmophyte may be described as: A. A complete syndesmophyte attached to the mid body of two contiguous vertebrae B. A teardrop syndesmophyte contiguous with a mid vertebral body and tapering distally C. A bagpipe syndesmophyte with a bulky base attached to the mid body of a vertebra D. A floating syndesmophyte bridging the disc space but not ossifying at the vertebral body A. D) A floating syndesmophyte bridging the disc space but not ossifying at the vertebral body A vertebral appearance associated with ankylosing spondylitis is: A. B. C. D. Sail vertebrae Fish vertebrae Barrel vertebrae Spool shaped vertebrae A. C) Barrel vertebrae The fat pad sign at the elbow is: A. Specific to occult fracture of the elbow B. A reliable indicator of elbow involvement in osteoarthritis C. Present in up to 90% of cases involving rheumatoid arthritis at the elbow D. A late indication of elbow pathology A. C) Present in up to 90% of cases involving rheumatoid arthritis at the elbow As rheumatoid athritis progresses, pannus: A. B. C. D. Creates extensive periostitis Is resorbed Undergoes fibrosis Undergoes liquefaction A. C) Undergoes fibrosis The eponym for neurotrophic arthropathy is: A. B. C. D. Charcot’s joints Newman’s joints Volkmann’s joints Lisfranc’s joints A. Charcot’s joints Osseous nodules at the proximal interphalangeal joints are: A. Heberden’s nodes indicative of OA B. Bouchard’s nodes indicative of OA C. Haygarth’s nodes indicative of arthritis deformans D. Heberden’s nodes indicative of gout A. B) Bouchard’s nodes indicative of OA With systemic lupus erythematosus, osteoporosis is: A. First seen in the lumbar spine B. A rare occurrence C. Severe and conducive to pathologic fracture in long bones D. Mild and seldom symptomatic A. C) Severe and conducive to pathologic fracture in long bones A young adult male with signs of inflammatory arthritis may be suspected to have: A. B. C. D. Gout Rheumatoid arthritis Ankylosing spondylitis Synoviochondrometaplasia A. C) Ankylosing spondylitis Globus hystericus is a symptom that may accompany: A. Ochronosis B. Wilson’s disease C. Hydroxyapatite deposition disease in the cervical spine D. Bronze diabetes A. C) Hydroxyapatite deposition disease in the cervical spine Conditions similar to osteitis condensans illi may develop at: A. The pubic symphysis and medial clavicle B. The pubic symphysis and the distal clavicle C. The distal clavicle symphysis and the ischial tuberosities D. The pubic symphysis and the ischial tuberosities A. The pubic symphysis and medial clavicle In the thoracic and lumbar spine psoriatic arthritis is likely to manifest with: A. Fine marginal syndesmophytes B. Coarse asymmetric non-marginal syndesmophytes C. Coarse symmetrical marginal syndesmophytes D. Coarse asymmetric osteophytes A. B) Coarse asymmetric non-marginal syndesmophytes In ankylosing spondylitis: A. The posterior longitudinal ligament ossifies B. The outer annulus and the tissue beneath the anterior longitudinal ligament ossify C. The outer fibers of the anterior longitudinal ligament ossify D. Both the inner and outer fibers of the anterior longitudinal ligament ossify A. B) The outer annulus and the tissue beneath the anterior longitudinal ligament ossify Otto’s pelvis is: A. B. C. D. Malum coxa senilis Associated with paget’s disease Protrusio acetabulae Ischemic necrosis of the femoral head A. C) Protrusio acetabulae Pannus is: A. B. C. D. Vascular granulation tissue An inflammatory exudate An erosion of subchondral bone Inflamed collagen tissue A. Vascular granulation tissue Ossification of the posterior longitudinal ligament may result in: A. Demyelination of the posterior and lateral white columns of the spinal cord B. Flattening of the anterior margins of the spinal cord C. Erb’s palsy D. Brachial plexus lesions A. Demyelination of the posterior and lateral white columns of the spinal cord OA in the shoulder complex most often involves: A. B. C. D. The acromioclavicular joint The posterosuperior glenohumeral joint The anterosuperior glenohumeral joint The sternoclavicular joint A. The acromioclavicular joint An x-ray sign that is distinctly characteristic of lupus erythematosus is: A. Subchondral bone cysts B. Asymmetric loss of joint space C. Reversible, symmetric, bilateral deformities D. Fluffy periostitis A. C) Reversible, symmetric, bilateral deformities The intervertebral disc is considered: A. B. C. D. An amphiarthrosis A synarthrosis A diarthrosis None of the above, it is a unique joint A. An amphiarthrosis A male patient with diabetes, cirrhosis of the liver and a bronze color to his skin is likely to have a diagnosis of: A. B. C. D. Wilson’s disease CPPD Ochronosis Hemachromatosis A. D) Hemachromatosis An arthropathy with a 9:1 female predominance and predilection for multiparous women is: A. B. C. D. Systemic lupus erythematosus Erosive osteoarthritis Scleroderma Osteitis condensans ilii A. D) Osteitis condensans ilii Sacroiliac involvement in psoriatic patients: A. B. C. D. Is rare, occurring in less than 10% of cases Is most commonly unilateral Is most commonly bilateral and asymmetric Is most commonly bilateral and symmetric A. C) Is most commonly bilateral and asymmetric Radiographic indications of ankylosing spondylitis involving the sacroiliac joints include all the following except: A. Syndesmophytes B. Subtle widening of the SIJ space early in the disease C. Star sign D. Ghost joint A. Syndesmophytes Inflammatory arthritis may be indicated by radiographic evidence of: A. Posterolateral migration of the femoral head B. Medial migration of the femoral head C. Axial migration of the femoral head D. Anteromedial migration of the femoral head A. C) Axial migration of the femoral head Rheumatoid arthritis involves the cervical spine in: A. B. C. D. Less than 10% of cases Approximately 50% of the cases Approximately 80% of the cases 100% of the cases A. C) Approximately 80% of the cases Ossification of the posterior longitudinal ligament has been observed to have a predilection for: A. B. C. D. Eskimos Native Americans African Americans Japanese A. D) Japanese The movie sign is: A. Radiologic evidence of upper cervical hypermobility in extension B. Neurological evidence of brachial plexus lesions caused by pressure on the medial arm C. Laboratory evidence of a clotting disorder D. Clinical evidence of OA of the knee A. D) Clinical evidence of OA of the knee Conditions known to be associated with systemic lupus erythematosus include: A. Raynaud’s phenomenon and alopecia B. Reflex sympathetic dystrophy and raynaud’s phenomenon C. Renal failure and reflex sympathetic dystrophy D. Cholecystitis and renal failure A. Raynaud’s phenomenon and alopecia The bare area refers to: A. The articulating surfaces of bone where there is no periosteum B. The intracapsular surfaces of the bone where there is no periosteum C. The intracapsular surface of bone where there is no hyaline membrane D. The periphery of the articular surface where there is no articular cartilage A. D) The periphery of the articular surface where there is no articular cartilage The most common clinical presentation of CPPD involves: A. B. C. D. Bilateral symmetric arthritis in peripheral joints, with knee and elbow contractures seen as a chronic condition with progressively severe acute episodes A relatively pain free instability of peripheral joints A chronic progressively severe peripheral arthritis with no acute episodes A self limiting peripheral arthritis affecting the distal lower extremities A. Bilateral symmetric arthritis in peripheral joints, with knee and elbow contractures seen as a chronic condition with progressively severe acute episodes Calcinosis cutis is the term for: A. Subcutaneous calcifications B. Sheet like calcifications that appear along myofascial planes C. Punctate calcifications in the myofascial tissue of the hands D. Punctate calcifications within the joint capsules of the fingers A. Subcutaneous calcifications Lesions of psoriatic arthritis are known to occur: A. In a ray pattern B. Most commonly in the metacarpophalangeal joints and wrists C. In a symmetric distribution D. Rarely in the interphalangeal joints A. In a ray pattern Enthesopathy at the insertion sites of the annular fibers may result in: A. Romanus lesions B. A shiny corner sign C. A radiographic appearance of rosary beads D. Andersson lesions A. Romanus lesions The summation effect is caused by A. Increasing thoracic kyphosis seen with advanced osteoporosis B. Cervical disc diminution, osteolysis, and invagination seen with RA C. Increasing low back rigidity seen with osteophytes and lumbar disc dimunition in DJD D. Increasing rigidity seen with ankylosing spondylitis as the process progresses A. B) Cervical disc diminution, osteolysis, and invagination seen with RA Keratoconjunctivitis sicca is: A. B. C. D. Dry eyes (lacrimal gland atrophy) An allergic inflammation of the sclera A chronic low grade infection of the eyes Idiopathic excessive production of tears and serous mucus A. Dry eyes (lacrimal gland atrophy) Carrot stick fractures caused by AS which may cause serious neurologic complications are most common at: A. B. C. D. C5-C7 T4-T6 T10-L2 L4-S1 A. C5-C7 Chondromalacia patella is most common: A. B. C. D. In adolescents In osteoporotic females In geriatric patients In marathon runners or broad jumpers A. In adolescents All of the following statements about systemic lupus erythematosus are true except: A. It apparently involves significant immunologic abnormalities B. It shows a clear female predilection C. Almost all SLE patients exhibit the classic pattern of malar erythema D. It frequently involves the urinary, cardiopulmonary, nervous and musculoskeletal systems and the intergument A. C) Almost all SLE patients exhibit the classic pattern of malar erythema Synovial joints include A. A fibrous capsule, synovium and hyaline cartilage B. Fibrocartilaginous tissue with some hyaline cartilage C. Synovium and fibrocartilage D. Synovium and fibrocartilage with some hyaline cartilage A. A fibrous capsule, synovium and hyaline cartilage Common factors that exacerbate gouty arthritis include: A. B. C. D. Green leafy vegetables and yoghurt Milk and citrus fruits Aspirin and diuretics Apples oranges and bananas A. C) Aspirin and diuretics Vitiligo, telangiectasia and mauskopff are all features associated with: A. B. C. D. Scleroderma Systemic lupus erythematosus Stills disease hemochromatosis A. Scleroderma An important clinical consideration associated with patients with psoriatic arthritis is: A. B. C. D. Severe early osteoporosis High likelihood of ottos pelvis Likelihood of cauda equina syndrome Likelihood of atlantoaxial instability A. D) Likelihood of atlantoaxial instability In a patient with ankylosing spondylitis, posterior vertebral body scalloping may indicate: A. Malignant degeneration B. Concurrent hodgkins disease C. Early posterior longitudinal ligament involvement D. Dural ectasia with arachnoid diverticula A. D) Dural ectasia with arachnoid diverticula The terry thomas sign is radiologic evidence of: A. B. C. D. Midcarpal ankylosis Lunate luxation Multiple carpal erosions Scapulolunate separation A. D) Scapulolunate separation Feltys syndrome is defined as RA with: A. B. C. D. Raynaud’s syndrome Leukopenia and splenomegaly Cardiac lesions CNS lesions A. B) Leukopenia and splenomegaly Diffuse idiopathic skeletal hyperstosis shows a clear predilection for: A. B. C. D. Males over 40yo Adolescent males Adolescent females Middle-aged females A. Males over 40yo OA at the knee most often affects: A. B. C. D. The patellofemoral joint The medial femorotibial joint The proximal tibiofibular joint The lateral femorotibial joint A. B) The medial femorotibial joint The most common radiographic sign of reiters syndrome in the knee is: A. The development of a fabella B. The development of Pelligrini stieda calcification C. Swelling caused by intraarticular effusion D. Periostitis at the proximal tibial metaphysis A. C) Swelling caused by intraarticular effusion Poorly defined erosions of bone and osteopenic subarticular bone are characteristic of x-ray findings in: A. B. C. D. Metabolic arthritides Crystalline arthritides Inflammatory arthritides Degenerative arthritides A. C) Inflammatory arthritides Waldenstroms sign is: A. B. C. D. Femoral head anterosuperior migration with decreased superior and medial joint space Femoral head posterosuperior migration with decreased superior and medial joint space Femoral head anterosuperior migration with decreased superior and increased medial joint space Femoral head posterosuperior migration with decreased superior and medial joint space A. C) Femoral head anterosuperior migration with decreased superior and increased medial joint space Chapter 6 Questions A periosteal reactino of “tripmmed winskers”- very thin fairly short spicules of reactive new bone is most typical of: a) b) c) d) Parosteal sarcoma Central osteoscarcoma Ewing’s sarcoma Chondrosarcoma c) Ewings sarcoma In male patients, the primary source of skeletal metastasis is a primary tumor of the A) B) C) D) Colon Kidney Lung prostate d) prostate The patognomonic lesion seen in the metastasis of neuroblastoma to the skull is a) Widening of the skull sutures b) Multiple, diffuse, symmetric lucencies c) Soft tissue mass with sunburst spiculation of the skull tables d) Scalloped geographic lesions in the calvarium Soft tissue mass with sunburst spiculation of the skull tables Pagets disease may be radiographically distinguised from fibrous dysplasia because Paget’s will commonly have: a) A hazy, “ground glass” appearance b) Pseudofractures c) Bowing deformities in the long tubular bones d) Subarticular long bone lesions Subarticular long bone lesions The typical radiologic appearance of perosteal chondroma includes a classic triad of: a) Endosteal scalloping, eccentric expansion of the bone and a calcified cartilaginous matrix b) Cortical scalloping, overhanging bony edges and a calcified cartilaginous matrix c) A distinct soft tissue mass, mortical scalloping and a calcified, cartilaginous matrix. d) Eccentric bone expansion, a distinct soft tissue mass, and a calcified cartilaginous matrix Cortical scalloping, overhanging bony edges and a calcified cartilaginous matrix Clinically, aneurysmal bone cysts: a) Are usually silent, and are incidental findings on xrys taken for other reasons b) Are discovered only when there is pathologic fracture c) Are characterized by acture onset of local pain, which rapidly increases in severity Are characterized by acture onset of local pain, which rapidly increases in severity The triad of abnormal growths seen in almost half of the cases of Gardner’s syndrome consists of: a) Café au lait spots, soft tissue fibromas, and multiple osteomas. b) Café au lait spots, colonic polyps and mustiple osteomas c) Soft tissue fibromas, multiple osteomas and colonic polyps d) Colonic polyps, soft tissue fibromas and Soft tissue fibromas, multiple osteomas and colonic polyps Osteosarcoma shows a clear predilection for: a) b) c) d) Females of childbearing age Males >50 years of age Females <25 years of age Males <25 years of age Males <25 years of age A coat hanger exostosis projecting away from a joint describes: a) b) c) d) Sessile osteochondroma A pedunculated osteochondroma Trevors disease A large traction spur Sessile osteochondroma The 4th most common primary malignant bone tumore, ewings sarcoma, constitues approx: A) 20% of all biopsied primary malignant bone B) 15% C) 11% D) 7% 7% The most common malignant skeltal tumor is : a) b) c) d) Osteosarcoma Metastasis Multiple myloma chondrosarcoma Metastasis Neuroblastoma is: a) The 2nd most common childhood abdominal neoplasm b) The most common abdominal neoplasm in children <5years of age c) An abdominal neoplasm commonly seen in multiparous females d) The second most common abdominal The 2nd most common childhood abdominal neoplasm The most common clinical feature of spinal invovlemtn in neurofibromatosis is: a) A short segment kyphoscoliosis in the lower thoracic spine b) A long C curve thoracolumbar scoliosis c) An acute reversal of the cervical lordosis d) An acute reversal of the lumbar lordosis A short segment kyphoscoliosis in the lower thoracic spine The characteristic subarticular lucency in a tubular bone that is characteristic of Paget’s disease is a) b) c) d) A punched out lesion A “blade of grass” defect A shepherd’s crook defect A saber shin defect A “blade of grass” defect A purely lucent bone lesion in the hand causes the physican to consider all of the following excpt: a) b) c) d) Osteoma Simple bone cyst Soliatry enchondroma osteoblastoma Osteoma Aneurysmal bone cyst is a) b) c) d) A non neoplastic lesion A cartilaginous neoplsm A collagenous neoplsm A fibrous neoplasm A non neoplastic lesion Sinusitis, exophtalmos, headaches, visual disturbance and blaance problems are possible signs of a) b) c) d) Hemangioma Aneurysmal bone cyst Osteoid osteoma osteoma osteoma The second most common primary malignant bone tumor is a) b) c) d) Ewing’s sarcoma Plasmacytoma Chondrosarcoma osteosarcoma osteosarcoma A subungual exostosis is a) A lesion in the great toe, seen with tophaceous gout. b) A type of osteochondroma at the distal end of the terminal phalanx of the toe c) A thickening of the tissue beneat the nail of the great toe seen with psoriatic arthritis d) A nodule beneat the nail fo the great toe A type of osteochondroma at the distal end of the terminal phalanx of the toe Non Hodgkin’s lymphoma, myeloma and Ewings sarcoma are all: a) Primary malignancies affecting adolescent patients b) Round cell tumors c) Osteosarcomas d) Possible products of degeneration of Paget’s disease Round cell tumors A painful, lytic, expansile lesion in the mandible, with periosteal new bone response is most likely to be a) b) c) d) Fibrous dysplasia Giant cell tumor Aneurysmal bone cyst adamantinoma adamantinoma In differntiating multiple myeloma from lytic metatstasis to the skull a helpful feature is a) Multiple myeloma lesions tend to become confluent, geographic lesions b) Multiple myeloma lesions tend to be of varied sizes c) Lytic metastatic lesions tend to be of varied sizes and multiple myeloma lesions are more uniform d) Lytic metastatic lesions are more apt to be round, and multiple myloma lesions more Lytic metastatic lesions tend to be of varied sizes and multiple myeloma lesions are more uniform Optic nerve neurofibroma may result in: a) b) c) d) Irreversible blindness Scotoma and transient blindness Plusating exophthalmos Dislocation of the eyeball Scotoma and transient blindness During the lytitc phase of Paget’s disease, spinal x rays may show: a) b) c) d) Squared off picture frame vertebrae Enlarged ivory vertebrae Vertebra plana Rugger jersey vertebrae Vertebra plana Solitary enchondroma: a) Is equally likely to be either lucent or to have stippled or punctate calcifications b) May occasionally contain a fleck of calcification, but as usually purely lucent c) Is usually filled with flocculent calcification d) Is densely sclerotic Is equally likely to be either lucent or to have stippled or punctate calcifications The “fallen fragment” of hinged fragment” sings are characteristic of the radiographic appearance of: a) Pathologic fracture of hemangioma in lumbar vertebra b) A charrot stic fracture c) Pathologic fracture with fibrous dysplasia d) Pathologic fracture of a simple bone cyst SBC Pathologic fracture of a simple bone cyst SBC Osteoma shows a predilection for: a) b) c) d) Geriatric males Pediatric males Pediatric females Adult females Adult females The radiologic appearance of a solitary plasmacytoma is most often: a) A vertebra plana or “silver dollar vertebra” b) An ovoid, sclerotic medullary lesion with a lucent nidus c) An expansile, lucent geographic lesion with soap bubble internal architecture d) A lucent geographic lesion with punctate An expansile, lucent geographic lesion with soap bubble internal architecture Osteochondromas are most commonly found in: a) b) c) d) The mandible and sacrum The spine The long tubular bones The small tubular bones of the hands and feet The long tubular bones The most common primary malignant bone tumor of the hand is: a) b) c) d) Central ostosarcoma Parosteal sarcoma Fibrosarcoma chondrosarcoma chondrosarcoma The only primary malignant tumor in direct anatomic relation ship with a joint surface is a) b) c) d) A malignant GCT A synovioma A chordoma plasmcytoma A synovioma The list of differential diagnoses for osteoblastic metastasis should include all of the following exept: a) Fibrous dysplasia b) Paget’s disease c) Brown tumors of the hyperparathyroidism d) Chronic osteomelitis Brown tumors of the hyperparathyroidism Diagnosis of neurofibromatosis requires at least six café au lait spots because: a) Fibrous dysplasia also presents with café au lait spots b) At least 15% of the normal population have one or two café au lait spots c) At least 25% of the normal population have three or four café au lait spots d) Patients with fibrous dysplasia may have At least 15% of the normal population have one or two café au lait spots Both “osteoporosis cicumscripta” and “cottonwool appearance” describe the radiographic appearance of the skull in cases of a) b) c) d) Lytic metastatic disease Fibrous dysplasia Multiple myeloma Paget’s disease Paget’s disease The most common bening bone tumor of the hand is a) b) c) d) A bone island An ostochondroma A solitary enchondroma Fibrous dysplasia A solitary enchondroma The incidence of pthologic fracture with a simple bone cyst is a) b) c) d) Less than 10% Almost 33% Over 65% Over 90% Over 65% Hemangioma in the skull: a) Erodes the outer table, extending outward beyond normal bone contour. b) Preserves the outer table, but erases the inner table of the skull c) Erodes the innner and outer skull tables, with dense radiating spiculae d) Expands the outer table, projecting Erodes the outer table, extending outward beyond normal bone contour. “Raindrop skull” describes: a) Occasional lytic lesions of varying size in the skull, with clear sclerotic margins. b) The signs of hyperparathroidism in the skull c) Early lytic metastatic disease in the dkull, with geographic lucencies and small lytic lesions d) Widespread, uniformly sized oval lucencies with no reactive sclerosis, typical of multiple myeloma in the skull Widespread, uniformly sized oval lucencies with no reactive sclerosis, typical of multiple myeloma in the skull The most common benign bone neoplasm is: a) b) c) d) Hemangioma Nonossifying fibroma Ostochondroma Fibrous cortical defect Ostochondroma Intramedullary tumors are those which occur: a) b) c) d) In the epidural tissues In the leptomeninges In spinal nerve roots Within the substance of the SPC Within the substance of the SPC “Ree Sternberg cells” are found in histologic examination of: a) b) c) d) Non-Hodgkins lymphoma of bone Plasmacytoma Hodgkins lymphma of bone adamantinoma Hodgkins lymphma of bone Tumors that occasional metastasize to the distal extremities are usually from: a) b) c) d) GIT Lung breast or kidney Skin lesions (melanoma) Prostate, uterus or ovaries Lung breast or kidney The clinical form of neurofibromatosis known as von Reklinghausens is apt to include a) b) c) d) Acoustic nerve tumors Large, “coast of maine” café au lait spots Small “coast of maine” café au lait spots Small, “coast of California” café au lait spots and bone changes Small, “coast of California” café au lait spots and bone changes In addition to bowing deformities and bone density changes, radiologic signs of Paget’s disease inclde all of the following except: a) b) c) d) Pseudofractures Cortical thickening Bone expansion Thinning of stress bearing trabeculae Thinning of stress bearing trabeculae The histologic appearance of an osteoid osteoma may be nearly identical to: a) b) c) d) An osteoscarcoma An ostoma An osteoblastoma An osteochondroma An osteoblastoma Treatment for a simple bone cyst SBC is usually a) Wide en bloc excision b) Curettage with irradiation c) Curettage with cauterization and bone chip packing d) Not necessary since they are self limiting and resolve in 2-5 years Curettage with cauterization and bone chip packing The radiologic appearance of hemangioma in the spine is most typically a) b) c) d) A sandwich vertebra A corduroy cloth, or striated vertebra A rugger jersey vertebra A picture frame vertebra A corduroy cloth, or striated vertebra Extramedullary plasmacytomas, often seen in patients with multiple myeloma, are locally invasive tumors that erode adjacent bone, and most often occur in: a) b) c) d) The chest wall The reteroperitoneum The pelvic basin The nasopharynx The nasopharynx An exostosis with a hyaline lined cartilage cap projecting from a cortical surface is a) b) c) d) A traction osteophyte An osteochondroma An ostoeblastoma A chondroblastoma An osteochondroma The café au lait spots of fibrous dysplasia: a) b) c) d) Are larege with smooth margins Are small and have smooth margins Are large with jagged irregular margins Are small lightly pigmented and have jagged irregular margins Are large with jagged irregular margins The “blind vertebra” is an x ray sign representing: a) A horzontally “split” vertebra, as in a seat belt (chance) fracture b) Unilateral lytic destrictuion fo the cortical margin of a pedicle. c) Bilateral loss of the cortical margins of the pedicles d) A congential agenesis of a pedicle Bilateral loss of the cortical margins of the pedicles Hodgkins lymphoma is most often seen in: a) b) c) d) two age groups 15-34 and over 60 Children under 15 Children between 5 and 10 Adults between 35 and 60 two age groups 15-34 and over 60 Chondrosarcoma represents: a) 27% of all primary malignant bone tumors b) 20% of all primary malignant bone tumors c) 10% of all primary malignant bone tumors d) 7% of all primary malignant bone tumors 10% of all primary malignant bone tumors Multiple Myeloma may be detectd by a) b) c) d) A “hot” bone scan at the lesion sites Serum hypocalcemia Bence jones proteinuria Increased serum phosphorus Bence jones proteinuria The relationship between an FCD and an NOF is a) The fibrous coritcal defect probably represents early identification of non ossifying fibroma. b) The non ossifying fibroma probably represent early identification of a fibrous cortical defect c) The fibrous cortical defect may resolve but I slikely to predispose the bone to formation of a non ossifying fibroma d) The non ossifying fibroma may predispose the The fibrous coritcal defect probably represents early identification of non ossifying fibroma. A bening ostoblastic neoplams that is seen roe often in the spine than in the appendicular skeleton is: a) b) c) d) An ostoid ostoma An osteoma A bone island An osteoblastoma An osteoblastoma Commonly seen radiologic signs of malignant degeration in pagetic bone include all of the following except: a) Cannonball metastasis to the lung b) Onion skin or laminated periosteal response c) Oval lucent lesions seen agains a background of pagetic d) Pathologic fracture Onion skin or laminated periosteal response Although hemangioma is a bening lesion it may cause symptoms due to: a) b) c) d) Periostitis Bone expansion Cord compression Basilar invagination Cord compression Approximately half the patients with neurofibromatosis develop osseous lesions, most commonly in the: a) b) c) d) Skull or facial bones Spine Chest wall pelvis Spine The smoky opacity of polyostotic fibrous dysplasia lesion: a) Is set off from normal bone by thick ring of sclerosis b) Is set apart from normal bone by an egg shell margin c) Blends imperceptibly into normal bone d) Is set off from normal bone by a hazy sclerotic zone of transition Is set off from normal bone by thick ring of sclerosis Metastatic tumores are more likely than primary tumors to have a) b) c) d) Periosteal response Soft tissue mass Polyostotic expression Expansile lesions Polyostotic expression Reticulum cell sarcoma is also known as: a) b) c) d) Hodgkins disease Non Hodgkins lymphoma Ewings sarcoma Synovial sarcoma Non Hodgkins lymphoma Parosteal sarcoma a) Is a highly aggressive lesion of the spine b) Is one of the few primary malignancies with a strong predilection for the hands c) Is a rapidly fatal sarcoma, occurring primarily in pediatric patients. d) Is usually a slow growing malignancy found in middle aged adults Is usually a slow growing malignancy found in middle aged adults The 5 year survival rate for patients with a malignant GCT is a) b) c) d) >80% >50% >20% <10% <10% The non ossifying fibroma and fibrous cortical defect are both: a) Caused by cartilaginous remnants in the metaphysis after the physis closes b) Examples of cartilaginous tumors c) Examples of fibrous xanthoma of bone d) Benign tumors with a high likelihood of malignant degneration Examples of fibrous xanthoma of bone On plain film, the ostoid osteoma is seen as: a) A sclerotic nidus within a less dense area of reactive sclerosis b) An area of reactive sclerosis containing a lucent nidus c) A uniformly dense, sclerotic lesion with an ill defined border d) A lucent lesions with a small central An area of reactive sclerosis containing a lucent nidus Cardiac failure I sa possible complication of Paget’s disease because: a) Increased serum calcium results in calcification of the coronary arteries b) Pagetic bone has 20 times the normal vascularity and causes high output cardiac failure c) Increasing size of the sternum may cause cardiac tamponade d) Anemia because of loss of bone marrow Pagetic bone has 20 times the normal vascularity and causes high output cardiac failure In the spine the most common benign bone tumor is: a) b) c) d) Osteochondroma Aneurysmal bone cyst Hemangioma Osteoid osteoma Hemangioma Skull lesions commonly occurring with neurofibromatosis include all the following except: a) Bare orbit with pulsating exphthalmos b) Growing fracture, as sutrual margins are eroded c) Asterion defect adjacent to the lambdoidal suture d) Macroencephaly (macrocranium) Growing fracture, as sutrual margins are eroded The most common bneing rib lesion is a) b) c) d) Monostotic fibrous dysplasia Bone island Solitary enchondroma chondroblastoma Monostotic fibrous dysplasia A serious limitation of plain film radiography when ruling out skeletal metatstasis is that a) It can’t detect bone density loss <6065% b) It can’t detect bone density loss <5560% c) It can’t detect bone density loss <5055% d) It can’t detect bone density loss <30- It can’t detect bone density loss <3050% A lesion that is known to cross discs and spread into contiguous vertebral bodies is a) b) c) d) Osteosarcoma Chordoma Ewings sarcoma Adamantinoma Chordoma The “cumulus cloud appearance” on xray describes a) The mottled, permeative lesion with a poor zone of transition, seen in about 25% of central osteosarcoma b) The dense, ivory lesion with rough lobulated margin seen in about 50% of cnetral osteosarcoma c) The fluffy periostitis caused by early cortical disruption by an aggressive malignancy d) The lobulated soft tissue mass that forms The dense, ivory lesion with rough lobulated margin seen in about 50% of cnetral osteosarcoma GCT in the spine a) Are generally in the neural arch of throacic vertebra b) Are rare, but most commonly occur in the thoracic vertebral bodies c) Are rare, but most often occur in lumbar or cervical vertebrae d) Are commonly seen in the thoracolumbar a) Are rare, but most often occur in lumbar or cervical vertebrae Chondromyxoid fibromas appear on plain film as: a) Opaque, oval, eccentric lesions creating endosteal scalloping b) Lucent, eccentric, sometimes, “soap-bubbled” oval lesions with scalloped sclerotic margins. c) Lucent, eccentric oval lesions with fluffy or punctate calcifications and hazy margins d) Lucent, eccentric expansile lesions with thin egg shell margins Lucent, eccentric, sometimes, “soapbubbled” oval lesions with scalloped sclerotic margins. After excision of an osteoid osteoma, the lesion may recur unless a) The entire nidus has been removed b) The entire area of reactive sclerosis has been removed c) The site is irradiated after excision d) The excision is performed when the lesion is metabolically inactive The entire nidus has been removed Osseous inducd basilar artery syndrome, with vertigo, headaches and spinal cord ischemia, may be symptomatic of: a) b) c) d) Multiple myeloma Ostomalacia Idiopathic osteoporosis Paget’s disease Paget’s disease Hereditary multiple exostosis may result in a “byonet hand” deformity in which: a) The ulna is shortened and bows outwards b) The ulna is shortened and radius bows outward c) The radius is shortened and the ulna bows outward d) The radius is shortened and bows The ulna is shortened and radius bows outward Benign polyostotic tumorlike lesions suggest consideration of seven bone disorders “TRY” 7, including all of the following except: a) b) c) d) Fibrous dysplasia Neurofibromatosis Fibrous xanthoma Ollier’s disease Fibrous xanthoma Cerubism is fibrous dysplasia of the jaws that: a) Regresses spontaneously during pubery b) Accompanies sever metal retardation c) Includes endocrine abnormalities that significantly shorten the life span d) Becomes apparent during puberty Regresses spontaneously during pubery With most metastic bone disease, nuclear bone scan will show “hot spots” where there is: a) b) c) d) A minimum of 30% bone destruction As little as 3-5% bone destruction A minimum of 15% bone destruction As little as 1% bone destruction As little as 3-5% bone destruction Chordoma is a primary malignant bone tumor that is usually spread by a) b) c) d) Hematogenous routes Lymphogenous routes Direct extension Mechanical spread by instruments or gloves during surgical procedures Direct extension Tumor thrombus is: a) External compression by a tumor, causing deep venus thrombosis b) Hematogenous spread of primary tumor fragments c) Pressure on the SPC lesion d) Stroke like symptoms caused by tumor emboli External compression by a tumor, causing deep venus thrombosis GCT are: a) Neoplams formed from connective tissue in the bone marrow. b) Non-neoplastic cycsts in the epiphysis c) Neoplams formed in the epiphysis before closure of the physis d) Malignant tumors of the epiphysis of pediatric patients Neoplasms formed from connective tissue in the bone marrow. Buttressing by periosteal new bone is a feature common to: a) Periosteal chondroma and aneurysmal bone cyst b) Osteoblastoma and osteochondroma c) Osteochondroma and solitary enchondroma d) Condroblastoma and osteochondroma Periosteal chondroma and aneurysmal bone cyst Osteoid osteoma can be differentiated from a bone island because the fomer: a) Protrudes from the bone surface and is found mostly in the skull b) Is usually polyostotic and is usually painful c) Has a central nidus within a sclerotic area and is usually painful d) Is usually lucent and is often found in the Has a central nidus within a sclerotic area and is usually painful Osteitis deformans may be a painless condition but may be discovered because of: a) b) c) d) Associated respiratory symptoms Associated renal symptoms Increasing hat or shoe size Increasingly rigid back with loss of lordotic lumbar curve Increasing hat or shoe size Trevor’s disease strongly resembles an osteochondroma, except that: a) b) c) d) It has no cartilage cap It occurs at the eiphysis It points toward the joint It has no pedunculated stalk It occurs at the eiphysis The thin, irregular, scalloped and attenuated ribs seen in neurofibromatosis are described as having: a) b) c) d) A paddle rib appearance Bifrucated appearance Indurated appearance Twisted ribbon appearance Twisted ribbon appearance The monostotic for of fibrous dysplasia: a) Does not transform the polyostotic form b) Occasionally progresses to the polyostotic form c) Frequently progresses to the polyostotic form d) Invariable, relentlessly progresses to the polyostotic form Does not transform the polyostotic form Blow out lesions in the bony pelvis are likely to represent skeletal metastases from: a) b) c) d) Prostate Kidney and thyroid Lungs Breast Kidney and thyroid In patients over 60 fibrosarcoma is most frequently found: a) b) c) d) Ilium Spine Facial bones femus Ilium The treatment of choice for primary central osteosarcoma (before metastasis) is: a) Irradiation b) Chemotherapy c) Wide en bloc excision followed by irradiation d) amputation amputation Aneurysmal bone cysts in long bones: a) May extend into subarticular bone after closure of the physis b) Typically extend across the open growth plate into the epiphysis c) Are typically central lesions, symmetrically expanding the metaphysis until the cortex ruptures d) Are typically eccentric thinninga nd expanding the cortex and creating an “onion skin” May extend into subarticular bone after closure of the physis Chondroblastoma is most often located a) In the medullary cavity of the epiphyseal region of a long tubular bone b) In the medullary cavity of the metaphysis of a long tubular bone c) In the cortex of a metaphysis of a long tubular bone d) In the cortex of the epiphyseal region In the medullary cavity of the epiphyseal region of a long tubular bone Bone islands do not occur a) b) c) d) In pediatric patients In the ribs Distal to eh knees or elbow In the skull In the skull Pagets disease is a polyostotic disorder that affects any bone, bu ti s least often found in a) b) c) d) Atlas and axis Fibula Clavicle carpus Fibula Ostochondroma in a long bone occurs at the a) b) c) d) Epiphysis Physis Metaphysis diaphysis Metaphysis Osteomas originate in: a) b) c) d) Cortical bone Cancellous bone Both cortical and Cancellous bone periosteum Both cortical and Cancellous bone Chapter 7 When radiologic findings in a child between 2 and 5 years old include lucent submetaphyseal bands, the DDx should include (among other things): A. Thalassemia, hemophilia and lymphocytic leukemia B. Leukemia, syphilis and hemophilia C. Hemophilia, neuroblastoma and leukemia D. Lymphocytic leukemia, scurvy and neuroblastoma Lymphocytic leukemia, scurvy and neuroblastoma Gout, pancreatitis, hemoglobinopathy, collagen diseases, caisson disease, gauchers disease alcoholism, trauma and treatment with corticosteroids or radiation may all predispose a patient to: A. B. C. D. Hyperparathyroidism Renal osteodystrophy Osteonecrosis Hypophosphatasis Osteonecrosis A male patient, aged 7, reports pain in the anteromedial knee and vague groin pain. This is a typical presentation for: A. B. C. D. Thalassemia Leukemia Osgood-Schlatter’s disease Leff-Calve-Perthes disease Leff-Calve-Perthes disease Blount's disease is most commonly seen in: A. B. C. D. Infants, 1-3 years old Children 3-7 years old Adolescents 8-15 years old Adolescents and young adults 15-20 years old Infants, 1-3 years old Scheuermann's disease is believed to affect: A. Up to 8% of the general population between 13-17 years old B. Up to 25% of the population <15yo C. Up to 5% of the general population <15yo D. Up to 3% of the general population 13-17 years old Up to 8% of the general population between 13-17 years old “Megacondyle” seen in tubercular arthritis is more commonly an x-ray sign of: A. B. C. D. Suppurative osteomyelitis Leukemia or sickle cell anemia Stills disease or hemophilia Thalassemia or hypervitaminosis A Stills disease or hemophilia The most commonly seen radiologic sign of acquired syphilis is: A. Saber shin appearance due to cortical thickening B. Proliferative periostitis (solid or laminated and sometimes lace like) C. ??p471q7 D. Medullary lytic lesions caused by pressure erosion of gummata Proliferative periostitis (solid or laminated and sometimes lace like) Tom Smith’s arthritis is: A. A variety of spinal osteomyelitis B. Septic arthritis in joints which the metaphysis is within the joint capsule C. A variety of septic arthritis in the spine D. A variety of non-suppurative discitis Septic arthritis in joints which the metaphysis is within the joint capsule The effects of sickle cell anemia in the skull are radiographically demonstrated only: A. In the occiput B. In the frontal bone C. Below the external occipital protuberance D. Above the internal occipital protuberance Above the internal occipital protuberance A chronic low-grade diffuse non-purulent osteomyelitis, Garres sclerosing osteomyelitis is seen on x-ray as: A. A lytic destructive lesion with a sequestrum B. A lytic destructive lesion with no sequestrum C. Cortical disruption with minimal reactive new bone formation D. Exuberant cortical fusiform bone thickening with significant reactive new bone formation Exuberant cortical fusiform bone thickening with significant reactive new bone formation The ballooned epiphysis (megacondyle) and attenuated squared inferior pole of the patella in a young patient are common characteristics of: A. Sickle cell anemia and thalassemia major B. Thalassemia major and hemophilia C. Juvenile rheumatoid arthritis (JRA) and hemophilia D. Childhood leukemia and hemophilia Juvenile rheumatoid arthritis (JRA) and hemophilia A “chain” of dense round or oval well marginated opacities on an x-ray located along the upper margin of the superior pubic ramus is most likely to be: A. B. C. D. Undissolved calcium tablets Phleboliths Arteriosclerosis in the internal iliac artery A calcified chain of lymph nodes Phleboliths Bilateral involvement of Legg-CalvePerthes disease: A. B. C. D. Rarely occurs in females Rarely occurs in males Does not occur Occurs in most cases Rarely occurs in females Osteochondritis dissecans at the talus most commonly involves: A. B. C. D. The talar neck The talonavicular articulation ??p471 q14 ?? Answer is D Osgood-Schlatter's disease is: A. Vascular necrosis of the tibial tuberosity B. Avulsion fracture of the tibial tuberosity C. Mycotic osteomyelitis at the tibial tuberosity D. Tendinitis at the tibial insertion of the patellar tendon Tendinitis at the tibial insertion of the patellar tendon Tubercular arthritis causes a constellation of typical radiographic signs known as: A. B. C. D. The 1-2-3 sign “Phemisters triad” “TRY-7” “The 6 Ds” “Phemisters triad” Bilateral saber shin bowing is a radiological sign characteristic of: A. The metaphysitis phase of congenital syphilis B. Paget's disease C. Tubercular osteitis D. The osteitis phase of congenital syphilis The osteitis phase of congenital syphilis A toddler who becomes uncharacteristically irritable, runs a low grade fever and refuses to walk stand or sit down should be examined to rule out: A. B. C. D. Wilms tumor Leukemia Congenital syphilis Childhood inflammatory discitis Childhood inflammatory discitis Radiologically the effects of sickle cell anemia on the small tubular bones of the hands and the feet may simulate: A. B. C. D. Osteomyelitis Hypertrophic arthropathy Neurotrophic arthropathy Tom smith arthritis Osteomyelitis Skeletally Brodies abscess shows a predilection for: A. B. C. D. The radius The fibula The femur The tibia The tibia Long standing hemophilic arthropathy produce affects that stimulate: A. B. C. D. Neurotrophic arthropathy Rheumatoid arthropathy Psoriatic arthropathy Septic arthritis Neurotrophic arthropathy Low back pain that is exacerbated by lying supine indicates the presence of: A. B. C. D. Myelofibrosis Leukemia Abdominal aortic aneurysm Metastatic bone disease Abdominal aortic aneurysm The peak incidence of Legg-CalvePerthes disease occurs in the age group: A. B. C. D. 1-5 yrs 5-7 yrs 12-15 yrs 14-18 yrs 5-7 yrs The radiographic appearance of osteochondritis dissecans may include any of the following features except: A. A concave defect in the mother bone and a thin arc like lucent cleft between the mother bone and the displaced fragments B. A dense elliptical opacity representing a sequestrated necrotic fragment C. A thin onion skin periosteal response D. A frayed irregular sclerotic concave border at the site of origin in the mother bone A thin onion skin periosteal response Panners disease occurring almost exclusively in 4 to 10 years old males is: A. B. C. D. Osteonecrosis of the calcaneus caused by repetitive trauma of running and jumping Osteonecrosis of the talus caused by repetitive trauma of running and jumping Osteonecrosis of the humeral capitellum caused by repetitive trauma of throwing or pitching Osteonecrosis of the lateral humeral condyle caused by repetitive trauma of throwing or pitching Osteonecrosis of the humeral capitellum caused by repetitive trauma of throwing or pitching Tubercular arthritis is usually: A. Polyarticular with symmetric distribution bilaterally B. Polyarticular with asymmetric bilateral distribution C. Polyarticular with monomelic distribution D. monoarticular monoarticular Wimbergers sign is: A. An increased distance between the medial margin of the femoral head and the lateral margin of Kohler's tear drop B. Symmetrical erosions of the medial surfaces of the proximal tibiae C. Broadened discolored appearance of the epiphyseal line in infants dying from hereditary syphilis D. Loss of the knee jerk in tabes dorsalis Symmetrical erosions of the medial surfaces of the proximal tibiae Epidural abscess is optimally imaged by: A. B. C. D. MRI Myelography Scintigraphy Contrast CT MRI Typical effects of sickle cell anemia on vertebral bodies include: A. B. C. D. Central body bulging (barrel shaped vertebra) corduroy cloth vertical striations die to accentuation of vertical trabeculae and thinning of the cortices Thinned prominent cortices anterior notching of the central vertebral bodies (enlarged anterior vascular notch) and generalized osteopenia Central endplate depressions (fish vertebrae) transient vertebral body collapse prominent osteoporosis Silver dollar vertebrae, thickened sclerotic cotices vertically striated vertebral bodies Central endplate depressions (fish vertebrae) transient vertebral body collapse prominent osteoporosis Brodies abscess always shows a predilection for: A. B. C. D. Adolescent females Young adult males Male children Obese females Male children The psuedotumors of hemophilia are caused by: A. Intraosseous hemorrhage acting as a space occupying lesion B. Sequestrated infectious foci C. Engorged and calcified lymph nodes D. Paraspinal abscesses Intraosseous hemorrhage acting as a space occupying lesion The most common site of aortic aneurysm is: A. B. C. D. In the ascending aorta Below the renal arteries In the aortic arch Between the diaphragm and the renal arteries Below the renal arteries Adult avascular necrosis (spontaneous osteonecrosis) at the mature femoral head is probably precipitated by occlusion of: A. The profunds femoris artery B. The foveal artery C. The lateral circumflex vessels from the profunda femoris D. The medial circumflex vessels from the profunda fermoris The lateral circumflex vessels from the profunda femoris The loose body typical of osteochondritis dissecans: A. Must be surgically removed B. May undergo malignant degeneration C. May be completely resorbed, may reattach or may become a joint mouse D. Continues to grow because its composed of viable bone May be completely resorbed, may reattach or may become a joint mouse Ischemic necrosis or a normal growth variation may be responsible for alterations at the tarsal navicular called: A. B. C. D. Hass’s disease Blount's disease Kohler's disease Kummels disease Kohler's disease In the earlier stages of Potts disease spinal films usually show: A. Mild to moderate loss of disc space and endplate disruption B. Anterior vertebral body gouge defects with little to no disc space loss C. Rarefaction of the entire vertebral body with little or no disc space loss D. Superoanterior vertebral body cortical disruption with a moderate disc space loss Anterior vertebral body gouge defects with little to no disc space loss VDRL is a screening test for: A. B. C. D. HIV infection Previous exposure to tuberculosis Active tuberculosis infection Syphilis Syphilis Spinal infection in children or adolescents in most likely to seed first: A. In the vertebral endplate B. In subperiosteal bone of the anterosuperior vertebral body C. In the intervertebral disc D. In subarachnoid vascular structures In the intervertebral disc Sickle cell anemia is: A. Always symptomatic but shortens the life span only in those who are homozygous for the trait B. Inevitably a life shortening condition although it is markedly more symptomatic in homozygous individuals C. Symptomatic only during a sickle cell crisis D. Asymptomatic except in homozygous individuals Asymptomatic except in homozygous individuals Brodies abscess is a localized form of: A. B. C. D. Suppurative osteomyelitis Septic arthritis Non-suppurative osteomyelitis Mycotic osteomyelitis Suppurative osteomyelitis Christmas disease is: A. A synonym for thalassemia minor B. A synonym for hemophilia B, lack of clotting factor IX C. A synonym for hemophilia A, lack of clotting factor VIII D. A synonym for thalassemia intermedia A synonym for hemophilia B, lack of clotting factor IX The aneurysm that shows a 3:1 predilection for women in patients younger than 50 is the: A. B. C. D. Aortic arch aneurysm Renal artery aneurysm Splenic artery aneurysm Carotid artery aneurysm Splenic artery aneurysm Three to twelve months after radiation therapy radiation necrosis may be visible on plain film as: A. Patchy sclerosis, moth-eaten destruction and periostitis B. Lytic medullary lesions with popcorn calcifications and thickened expanded cortices C. Lytic cortical lesions and widened medullary canals with thickened irregular trabecular patterns D. Licked candy stick resorption of the articular ends of boned and calcified articular cartilage Patchy sclerosis, moth-eaten destruction and periostitis Active individuals between 20 and 40 years of age are most likely to develop osteochondritis dissecans: A. B. C. D. At the knee At the shoulder At the talus At the elbow At the talus Kienbochs disease shows a predilection: A. B. C. D. For females (5:1) age 12-18 years For females (3:1) age 20-40 years For males (9:1) age 20-40 years For males (2:1) age 15-20 years For males (9:1) age 20-40 years A draining sinus from a psoas abscess may surface paraspinally in an inguinal area or near the lesser trochanter and is called: A. B. C. D. Empyema necessitatis Weaver’s bottom Pott’s puffy tumor Spina ventosa Empyema necessitatis Endarteritis obliterans is caused by: A. B. C. D. Actinomyces israelii Treponema pallidum Aspergillus Mycobacterium tuberculosis Treponema pallidum Depending on the site of infection the radiographic latent period for osteomyelitis may be: A. B. C. D. Up to 6 months 10-21 days Up to 7 days Up to 3 days 10-21 days Sickle cell anemia almost exclusively affects: A. Northern European and Scandinavian populations B. Central and South American populations C. Asian and Australasian populations D. Mediterranean and black populations Mediterranean and black populations The most common pathogen (90% of cases) causing osteomyelitis is: A. B. C. D. Diplococcus pneumoniae Klebsiella Streptococcus Staphylococcus aureus Staphylococcus aureus The patient population most frequently seen with osteochondritis dissecans at the knee is: A. B. C. D. Adolescent Geriatric Pediatric Middle-aged Adolescent Caisson’s disease affects the shoulders and hips bilaterally, appearing on plain film as: A. Medullary pseudotumors and soft tissue masses B. Endosteal scalloping of subarticular cortical bone C. Epiphyseal and metaphyseal/diaphyseal infarcts, and secondary degenerative joint disease D. Diffuse osteopenia, and softening of bone with bowing of weight-bearing bones Epiphyseal and metaphyseal/diaphyseal infarcts, and secondary degenerative joint disease The two most common causes of aneurysm are atherosclerosis and: A. B. C. D. Infection (mycotic aneurysm) Syphillis Arteritis diabetes Infection (mycotic aneurysm) “Rodent facies”, with upper incisors displaced forward, is characteristic of: A. B. C. D. Gargoylism Fetal alcohol syndrome Thalassemia Hurler’s syndrome Thalassemia Tubercular spondylitis may be differentiated radiographically from mycotic osteomyelitis because: A. TB does not exhibit calcification of paraverteral abscesses B. TB often causes vertebral collapse, which is not characteristic of mycotic osteomyelitis C. TB does not affect the IVDs D. TB does not involve prominent sclerosis, which is characteristic of mycotic infections TB often causes vertebral collapse, which is not characteristic of mycotic osteomyelitis Condyloma lata and alopecia areata are secondary clinically evident lesions of: A. B. C. D. Syphillis Tuberculosis Tuberous sclerosis Systemic lupus erythematosus Syphillis Pott’s disease is most commonly seen at: A. B. C. D. T1 and T2 T6-T8 L1 L4-S1 L1 Freiberg’s disease is epiphyseal osteonecrosis at: A. B. C. D. The humeral head The calcaneus The second or third metatarsal head The lunate The involucrum seen in osteomyelitis is: A. A collar of new bone walling off an infection B. A defect in the “wall” around the infection, allowing it to drain C. A necrotic bone fragment, isolated from normal bone D. An ulceration into a fibrous “wall” around an infection A collar of new bone walling off an infection Epiphyseal disorders that affect the spine include: A. Kummel’s disease and Scheuermann’s disease B. Diaz’s disease and Panner’s disease C. Mauclaire’s disease and Scheuermann’s disease D. Calve’s disease and Mauclaire’s disease Kummel’s disease and Scheuermann’s disease Osteochondritis dissecans: A. B. C. D. Is due to mycotic infection Is not associated with inflammation In an inflammatory arthritide Is most often caused by Staphylococcus aureus Is not associated with inflammation The site most commonly affected by spontaneous osteonecrosis of the knee (SONK) is: A. B. C. D. The medial tibial condyle The medial femoral condyle The lateral femoral condyle The superolateral pole of the patella The medial femoral condyle The third most frequently calcified abdominal artery is: A. B. C. D. The renal artery The splenic artery The hepatic artery The iliac artery The splenic artery The long bones of children with thalassemia display: A. Narrowed, undertubulated metaphyses, shortening, with growth arrest lines B. General osteopenia, narrowed metaphyses with thin cortices, and repeated pathologic fractures C. Shortening, with growth arrest lines, and Erlenmeyer flask deformity D. Erlenmeyer flask deformity, and elongation with thin cortices Shortening, with growth arrest lines, and Erlenmeyer flask deformity The most common site for mycotic osteomyelitis due to Actinomycosis is: A. The proximal femur B. L1, caused by hematogenous spread via Batson’s plexus C. The ribs and sternum, via lymphogenous spread D. The mandible, at the angle of the jaw The mandible, at the angle of the jaw Clutton’s joints and Hutchinson’s teeth are clinical indications of: A. B. C. D. Gargoylism Congenital syphilis Epiphyseal dysplasia multiplex Rickets Congenital syphilis Pott’s puffy tumor appears as: A. A “button sequestrum” with a fluctuant cold abscess in the scalp B. A lucent geographic lesion in the calvarium with an “eggshell” rim of sclerosis C. A moth-eaten calvarial lesion with a thick rind of sclerosis D. A cortical lesion in the outer table of the calvarium, with spiculated periosteal response A “button sequestrum” with a fluctuant cold abscess in the scalp Freiberg’s diease affects adolescents, with a: A. B. C. D. 5:1 male predilection 2:1 male predilection 2:1 female predilection 5:1 female predilection 5:1 female predilection Sequestra are: A. Collars of new bone walling off an infection B. Defects in the “wall” around the infection, allowing it to drain. C. Necrotic bone fragments isolated from normal bone D. Ulcerations into a fibrous “wall” around an infection Necrotic bone fragments isolated from normal bone A radiologic sign that suggests a favourable prognosis in Diaz’s disease is: A. B. C. D. Hawkins sign Wimberger’s sign Klein’s sign Rim’s sign Hawkins sign Scheuermann’s ossicle is a synonym for: A. B. C. D. An unfused spinous process A teardrop fracture A limbus bone A nuchal bone A limbus bone Longitudinal splitting of cortical bone is a feature of: A. Osteochondritis dissecans B. A medullary osteonecrotic infarct C. Hypertrophic pulmonary osteoarthropathy D. Metaphyseal/ diaphyseal cortical infarction Metaphyseal/ diaphyseal cortical infarction The “thumbnail sign” is a radiographic finding signifying: A. Chondrocalcinosis at the humeral head, with CPPD B. The cortical rim of an unfused apophysis, usually a spinous process C. A ring of calcification in the transverse aortic arch, with arteriosclerosis D. The small bulge of bone at the site of a torus (incomplete) fracture A ring of calcification in the transverse aortic arch, with arteriosclerosis “Fish vertebra” are characteristic of: A. Cushing’s syndrome, sickle-cell anaemia, and Gaucher’s disease B. Gaucher’s disease, Paget’s disease, and thalassemia C. Thalassemia, sickle-cell anemia, and Gaucher’s disease D. Congenital syphilis, Gaucher’s disease, and Cushing’s syndrome Thalassemia, sickle-cell anemia, and Gaucher’s disease “Desert rheumatism” with symptoms of conjunctivitis, arthritis, erythema nodosum, and respiratory infection, is: A. B. C. D. Histoplasmosis Maduromycosis Actinomycosis coccidioidomycosis coccidioidomycosis The most common skeletal site for acquired syphilitic osteomyelitis is: A. B. C. D. The metaphyses of long tubular bones The vertebral bodies The skull, clavicles, and tibiae The pelvic bones The skull, clavicles, and tibiae Tuberculous bursitis in subgluteal bursae is called: A. B. C. D. Cossack’s disease Weaver’s bottom Spina ventosa Pott’s puffy tumour Weaver’s bottom In addition to Waldenstrom’s sign, radiographic evidence of Legg-CalvePerthes disease may include: A. B. C. D. An abnormal Klein’s line A curvilinear “crescent sign” Fraying of the metaphyseal margin Medial and lateral buttressing on the femoral neck A curvilinear “crescent sign” Sub-articular bone is not vulnerable to hematogenous seeding of osteomyelitis: A. In neonates B. In children from about age 1 year until full growth is achieved C. In young and middle-aged adults D. In the geriatric population In children from about age 1 year until full growth is achieved Blount’s disease commonly has a radiographic appearance of: A. A fragmented tibial tuberosity B. A fragmented lateral tibial epiphysis C. A wedge-shaped, medial femoral epiphysis D. A wedge-shaped, sometimes fragmented medial tibial epiphysis A wedge-shaped, sometimes fragmented medial tibial epiphysis Theories for the mechanism causing Scheuermann’s disease include all of the following except: A. Avascular necrosis of the secondary ring epiphyses B. Vitamin or mineral deficiencies C. Traumatic disk etrusion with growth inhibition D. Slow-growing, benign lytic neoplasm Slow-growing, benign lytic neoplasm In epiphyseal osteonecrosis, a subchondral fracture, seen on plain film as a “rim sign” or “crescent sign”: A. Represents the compacted bone of an impaction fracture B. Represents an avulsion at the site of an enthesis C. Represents the separation of the articular cortex from underlying cancellous bone D. Represents the separation of the epiphysis from the physis Represents the separation of the articular cortex from underlying cancellous bone The differential considerations, when the radiologic appearance suggests myelofibrosis should include (among others): A. B. C. D. Multiple myeloma, Paget’s disease Osteopoikilosis, hemophilia Fluorosis, thalassemia Paget’s disease, blastic metastasis Paget’s disease, blastic metastasis Patients who have sickle-cell anemia are predisposed to Salmonella osteomyelitis with a unique distribution: A. B. C. D. In the “S” joints of the axial skeleton In the carpal and tarsal bones, exclusively In a bilateral, symmetric, diaphyseal pattern In metaphyses of the small tubular bones of hands and feet, with symmetric, bilateral distribution In a bilateral, symmetric, diaphyseal pattern A chronic, granulomatous fungal disease of the foot is: A. B. C. D. Actinomycosis Histoplasmosis Maduromycosis Coccidioidomycosis Maduromycosis A common sequela of syphilitic infection is: A. B. C. D. Fibrous ankylosis Empyema necessitatis Brodie’s abscess Neurotrophic arthropathy Neurotrophic arthropathy Tubercular infection in the spine (tubercular spondylitis) is called: A. B. C. D. Tom Smith’s arthritis Clutton’s joints Pott’s disease Maduromycosis Pott’s disease Early identification of Legg-CalvePerthes disease is best accomplished via: A. B. C. D. Plain film Ultrasonography Scintigraphy and MRI CT Scintigraphy and MRI The most common route of invasion for osteomyelitis is: A. Instrumentation (contaminated surgical sites) B. Puncture wounds or penetrating injuries (eg. Open fractures) C. Hematogenous spread of infection D. Contiguous spread of infection (from dental, cutaneous, or sinus infections) Hematogenous spread of infection The likely etiology of Blount’s disease is: A. Ischemic necrosis B. Normal growth variant C. Traumatic inhibition of growth plate development D. Chronic, low-grade infeciton at the growht plate Traumatic inhibition of growth plate development Scheuermann’s disease is treated with: A. Surgical insertion of Harrington rods B. Nutritional therapy, stretching, and specific exercises C. Bracing and restriction of weight-bearing stresses D. Massage, extension exercises, and light weight lifting Bracing and restriction of weightbearing stresses Radiologic manifestations of epiphyseal infarction include all of the following except: A. Solid or laminated periosteal new bone formation B. Articular cortical collapse in an angular defect or as a smooth undulation C. Fragmentation of the entire epiphyses D. Mottled bone caused by patchy sclerosis, thickened trabeculae, and subchondral cysts Solid or laminated periosteal new bone formation A clear association exists between chronic myelogenous leukemia and: A. B. C. D. Hemophilia Thalasseia Myelofibrosis Systemic lupus erythematosus Myelofibrosis X-ray signs in the long tubular bones that suggest a diagnosis of sickle-cell anemia include: A. “bone within a bone” appearance, frayed metaphyses, “blade of grass” appearance B. “asterisk sign” in the femoral head, “cupped metapyses” and “Codman’s triangle” of new bone C. Tibio-talar slant deformity, frayed metaphyses, and “crescent sign” in the femoral head D. “bone within a bone” appearance, “cupped metaphyses”, and “asterisk sign” in the femoral “bone within a bone” appearance, “cupped metaphyses”, and “asterisk sign” in the femoral head Metaphysitis is a characteristic of: A. Tuberculous osteitis, scurvy, leukemia, and sickle cell anemia B. Leukemia, sickle cell anemia, metastatic neuroblastoma, and metastatic carcinoma C. Leukemia, scurvy, congenital syphilis, and metastatic neuroblastoma D. Scurvy, leukemia, sickle cell anemia, and congenital syphilis Leukemia, scurvy, congenital syphilis, and metastatic neuroblastoma Patients with diagnosis of AIDS may have skeletal lesions due to: A. Osteomyelitis, non-Hodgkin’s lymphoma, or anemia (among others) B. The effects of the HIV infection itself C. Neuropathic arthropathy, if the disease is in late stages D. They do not develop skeletal lesions, but have soft tissue lesions instead Osteomyelitis, non-Hodgkin’s lymphoma, or anemia (among others) The earliest skeletal radiologic indication of septic arthritis is: A. Subarticular geodes B. Laminated periosteal response, with cortical disruption C. Metaphyseal “moth eaten” medullary lesions D. Loss of the subarticular white line (usually subchondral cortical bone) Loss of the subarticular white line (usually subchondral cortical bone) The hip movements which usually exacerbate the pain of Legg-CalvesPerthes disease are: A. B. C. D. Hip adduction and external rotation Hip extension and adduction Hip Abduction and Internal rotation Hip flexion and adduction Hip Abduction and Internal rotation Middle-aged male patients who develop suppurative osteomyelitis are most often affected: A. B. C. D. In the spine In the skull In the pelvis In the distal extremities, usually the tibia In the spine The joints vulnerable to “Tom Smith’s arthritis” are: A. The “S” joints of the axial skeleton B. “tightly packed” joints, such as the small joints of the hands and feet C. Slightly movable joints, such as the symphysis pubis D. The hip, knee, ankle, shoulder and elbow joints The hip, knee, ankle, shoulder and elbow joints CHAPTER 5 An “Andersson lesion” is: A. A pathologic fracture through a long bone B. A pseudoarthrosis caused by a pathologic fracture through a previously ankylosed joint C. An ankylosed spinal motion segment D. A cavitation between the spine and the anterior longitudinal ligament. A. B) A pseudoarthrosis caused by a pathologic fracture through a previously ankylosed joint A striking difference between the pathologic process of rheumatoid arthritis and psoriatic arthritis is that the latter does not involve: A. B. C. D. Pannus Periarticular osteoporosis Narrowing of the joint space Cortical margin erosions A. B) Periarticular osteoporosis The onset of systemic lupus erythematosus most frequently occurs in: A. B. C. D. Males above 50 years of age Females above 40 yrs of age Males between 10 and 40 yrs of age Females between 10 and 40 yrs of age A. D) Females between 10 and 40 yrs of age The Lesch-Nyhan syndrome is a rare hereditary clinical syndrome associated with: A. B. C. D. Rheumatoid arthritis Ochronosis Wilsons disease hyperuricemia A. D) hyperuricemia Scleroderma has potentially serious effects on all the following except: A. B. C. D. The heart The kidneys The lungs The Gastrointestinal tract A. B) The kidneys Forestier’s disease commonly involves calcification and ossification of: A. B. C. D. The posterior longitudinal ligament The anterior longitudinal ligament The ligamentum flavum The nuchal ligament A. B) The anterior longitudinal ligament Sjogren’s syndrome commonly seen with various connective tissue disorders involves: A. Excessive tearing and serous mucous production B. Vasculitis C. Scleromalacia perforans D. Generalized drying of mucous membranes A. D) Generalized drying of mucous membranes Coxarthrosis is a term used to describe: A. Advanced degenerative joint disease of the hip B. Surgical fixation of the hip C. Early degeneration of the acetabular joint D. Formation of an auxiliary acetabular joint because of congenital dislocation A. Advanced degenerative joint disease of the hip In the hands the x-ray appearance of ‘dot-rash’ cortical interruptions is characteristic of: A. B. C. D. Gout Psoriasis Pseudgout Rheumatoid arthritis A. Rheumatoid arthritis Synoviochondrometaplasia is: A. B. C. D. An inflammatory arthritide A degenerative arthritide A metabolic arthritide A tumor like or neoplastic lesion A. B) A degenerative arthritide The subjective signs if ankylosing spondylitis are frequently aggravated by: A. B. C. D. Moderate activity A posture of slight spinal Alcohol consumption Caffeine consumption A. C) Alcohol consumption Psoriatic arthropathy most commonly affects the joints of the: A. B. C. D. Hands and feet Lumbosacral spine Thoracolumbar spine Cervicothoracic spine A. Hands and feet The arthritis associated wit Reiter’s syndrome is: A. Relentlessly progressive B. Usually self limiting, but prone to recurrence and may leave residual joint damage C. Limited by steroid treatments, and seldom recurs D. Apt to recur but seldom results in residual joint damage A. B) Usually self limiting, but prone to recurrence and may leave residual joint damage Most frequently gout develops in: A. B. C. D. Post menopausal woman on diuretics Males between 20 and 40 year of age Males between 40 and 60 years of age Men or woman older than 60 yrs A. C) Males between 40 and 60 years of age CREST syndrome is associated with: A. Premature closure of the iliac crest physis B. Scleroderma C. Raynaud’s phenomenon D. Thibierge-Weissenbach syndrome A. B) Scleroderma Diabetes mellitus has a recognized correlation with: A. B. C. D. Ankylosing spondylitis Reiter’s syndrome Osteitis pubis DISH A. D) DISH A better prognosis is indicated when rheumatoid arthritis: A. Is asymmetric and its onset is in later years B. Is symmetric in distribution C. Is clinically recognized before age 30 D. Involves subcutaneous nodules A. Is asymmetric and its onset is in later years Radiologic indications of sacroiliac degenerative joint disease: A. Usually include sclerosis of the sacral joint surface B. Usually involve changes in the lower two thirds of the joint C. Usually include a vacuum cleft D. Usually involve changes in the upper third of the joint A. B) Usually involve changes in the lower two thirds of the joint Rheumatoid arthritis in the hands often: A. Spares the distal interphalangeal joints B. Spares the second and third metacarpophalangeal joints C. Spares the first ray D. Spares the proximal interphalangeal joints A. Spares the distal interphalangeal joints Degenerative arthritides include all of the following except: A. Erosive osteoarthritis B. Diffuse idiopathic skeletal hyperostosis (DISH) C. Neuropathic arthropathy D. Osteitis condensans ilii A. D) Osteitis condensans ilii An arthritis showing a clear predilection for the axial skeleton in young males is: A. B. C. D. Seropositive JRA Classic systemic Stills disease Marie Strumpell’s disease Pseudogout A. C) Marie Strumpell’s disease In the spine x-ray findings may be identical in cases of ankylosing spondylitis and: A. B. C. D. Ochronosis Rheumatoid arthritis Neurotrophic arthropathy Enteropathic arthropathy A. D) Enteropathic arthropathy Reiter’s syndrome has clear associations with: A. B. C. D. Crohn’s disease Regional enteritis Ulcerative colitis Dysentery caused by salmonella A. D) Dysentery caused by salmonella The term podagra associated with gout refers to: A. The belief that poison fell ‘drop by drop’ into the joint B. The chalky urate deposits in joints C. A predilection for the foot D. hyperuricaemia A. C) A predilection for the foot The diagnosis of idiopathic chondrolysis of the hip should be strongly suspected when there is: A. A young woman with prolific osteophytic growth at the acetabular joint B. A patient in the 5th decade with osteoarthritis of the hip C. An asymptomatic young woman with protrusio acetabuli D. A young man with a limp and knee pain A. C) An asymptomatic young woman with protrusio acetabuli The vacuum cleft indicates degenerative joint disease only when it is seen: A. B. C. D. In the hip In the shoulder In the spine In the knee A. C) In the spine Rheumatoid arthritis generally spares A. B. C. D. The cervical spine The lumbar spine The shoulder joints The carpal joints A. B) The lumbar spine Lower costovertebral or costotransverse involvement in osteoarthritis may result in: A. Gastrointestinal disease B. Maigne’s syndrome which stimulates gastrointestinal disease C. Roberts syndrome which involves pain referred to the lower lumbar spine D. Roberts syndrome which stimulates gastrointestinal disease A. D) Roberts syndrome which stimulates gastrointestinal disease Articular lesions typical of rheumatoid arthritis result in the radiographic appearance called: A. B. C. D. Mouse ears sign Overhanging margin sign Gull wing sign Rat bite erosions A. D) Rat bite erosions Inflammatory processes may lead to ossification of spinal ligaments causing the development of: A. B. C. D. Osteophytes Spondylophytes Syndesmophytes Periostitis A. C) Syndesmophytes X-ray signs of juvenile rheumatoid arthritis in the hands commonly include: A. Ballooning of the distal interphalangeal joints B. Interphalangeal ankylosis C. Arachnodactyly D. Multiple altered digit lengths A. B) Interphalangeal ankylosis Enteropathic arthritis in the peripheral skeleton usually does not affect: A. B. C. D. The hips The elbows The knees The wrists A. A) The hips Reiter’s syndrome has been observed to have: A. B. C. D. A 50:1 male predilection A 2:1 male predilection A 2:1 female predilection A 25:1 male predilection A. A) A 50:1 male predilection The theory of pathogenesis of hypertrophic osteoarthropathy that is most widely accepted involves: A. B. C. D. An increased peripheral blood flow (humeral theory) A decreased peripheral blood flow (humeral theory) Autonomic reflex vasodilation (neurogenic theory) Visceral lesion produces a substance that increases peripheral blood flow (endocrine theory) A. C) Autonomic reflex vasodilation (neurogenic theory) Chondrolysis of the hip is most commonly: A. B. C. D. Idiopathic Secondary to slipped femoral capital epiphysis Secondary to septic or rheumatoid arthritis Secondary to immobilization as with paraplegia A. B) Secondary to slipped femoral capital epiphysis Among the universal radiologic signs that characterize degenerative joint diseases are: A. Inflammation and periarticular periositis B. Symmetry of distribution and uniform loss of joint space C. Eburnation and geodes D. Syndesmophytes and subchondral sclerosis A. C) Eburnation and geodes Synoviochondrometaplasia is: A. B. C. D. A malignant neoplastic process A metabolic process An ischemic necrosis A benign arthropathy A. D) A benign arthropathy An intercalary bone is: A. Calcification of the anterior annulus B. Calcification of the posterior nucleus pulposus C. Calcification of the posterior longitudinal ligament D. Calcification of the nuchal ligament A. A) Calcification of the anterior annulus The inflammatory spondyloarthropathies: A. Frequently result in atlantoaxial hypomobility B. May result in the complete dissolution of the odontoid process C. May affect the synovium between the anterior tubercle and the posterior odontoid D. May result in ossification of the transverse ligament A. B) May result in the complete dissolution of the odontoid process An enthesis is: A. B. C. D. Is essentially immobile joint An inflammation of the periosteum A slightly movable joint The periarticular site of tendon or ligament insertion into bone A. D) The periarticular site of tendon or ligament insertion into bone Still’s disease is: A. A variant of ankylosing spondylitis B. A seronegative chronic arthritis seen in pediatric patients C. A transient monoarticular arthritis D. A metabolic arthritis A. B) A seronegative chronic arthritis seen in pediatric patients Seronegative arthritides include all of the following except: A. B. C. D. Enteropathic arthropathy Neurotrophic arthopathy Reiter’s syndrome Ankylosing spondylitis A. B) Neurotrophic arthopathy Marginal syndesmophytes: A. Are typical of psoriatic arthritis B. Are thin vertical ossification of the inner annular fibers C. Are characteristic of ankylosing spondylitis and of enteropathic arthropathy D. Are usually unilateral originating from peripheral body endplate junctions A. C) Are characteristic of ankylosing spondylitis and of enteropathic arthropathy Hypertrophic osteoarthropathy (HAO) appears to develop most commonly as a sequel to: A. B. C. D. Renal failure Myocardial infarction Bronchogenic carcinoma Cholecystitis A. C) Bronchogenic carcinoma An arthritide that occurs in consequence of rheumatic fever is: A. B. C. D. Rheumatic arthritis Stills disease Jaccoud’s syndrome Reiter’s syndrome A. C) Jaccoud’s syndrome Erosive OA may involve: A. B. C. D. Positive rheumatoid factor Positive HLA-B27 Periarticular osteoporosis The base of the thumb A. D) The base of the thumb Spinal involvement in neurotrophic arthropathy is most often associated with: A. B. C. D. Spina bifida Leprosy Syphilis Syringomyelia A. C) Syphilis Among the most common spinal sites for degenerative arthritis are: A. B. C. D. C1-C2 L1-L3 C7-T1 C5-C7 A. D) C5-C7 Rheumatoid may result in: A. Bony ankylosis of synovial joints B. Bony ankylosis of fibrocartilaginous joints C. Carrot stick fractures in the lower cervical spine D. Ossification of the posterior longitudinal ligament A. Bony ankylosis of synovial joints A synarthrosis is: A. B. C. D. A slightly movable joint A cartilaginous joint A freely movable joint An essentially immobile fibrous joint A. D) An essentially immobile fibrous joint Theories regarding the etiology of osteitis pubis include all of the following except: A. Vascular etiology involving venous stasis, engorgement and local osteoporosis B. Microfractures caused by unaccustomed vectors of stress C. Low-grade infection after childbirth or pelvic surgery D. Sudeck’s atrophy variant A. B) Microfractures caused by unaccustomed vectors of stress The “Bywaters-Dixon” syndesmophyte, a variety of non-marginal syndesmophyte may be described as: A. A complete syndesmophyte attached to the mid body of two contiguous vertebrae B. A teardrop syndesmophyte contiguous with a mid vertebral body and tapering distally C. A bagpipe syndesmophyte with a bulky base attached to the mid body of a vertebra D. A floating syndesmophyte bridging the disc space but not ossifying at the vertebral body A. D) A floating syndesmophyte bridging the disc space but not ossifying at the vertebral body A vertebral appearance associated with ankylosing spondylitis is: A. B. C. D. Sail vertebrae Fish vertebrae Barrel vertebrae Spool shaped vertebrae A. C) Barrel vertebrae The fat pad sign at the elbow is: A. Specific to occult fracture of the elbow B. A reliable indicator of elbow involvement in osteoarthritis C. Present in up to 90% of cases involving rheumatoid arthritis at the elbow D. A late indication of elbow pathology A. C) Present in up to 90% of cases involving rheumatoid arthritis at the elbow As rheumatoid athritis progresses, pannus: A. B. C. D. Creates extensive periostitis Is resorbed Undergoes fibrosis Undergoes liquefaction A. C) Undergoes fibrosis The eponym for neurotrophic arthropathy is: A. B. C. D. Charcot’s joints Newman’s joints Volkmann’s joints Lisfranc’s joints A. Charcot’s joints Osseous nodules at the proximal interphalangeal joints are: A. Heberden’s nodes indicative of OA B. Bouchard’s nodes indicative of OA C. Haygarth’s nodes indicative of arthritis deformans D. Heberden’s nodes indicative of gout A. B) Bouchard’s nodes indicative of OA With systemic lupus erythematosus, osteoporosis is: A. First seen in the lumbar spine B. A rare occurrence C. Severe and conducive to pathologic fracture in long bones D. Mild and seldom symptomatic A. C) Severe and conducive to pathologic fracture in long bones A young adult male with signs of inflammatory arthritis may be suspected to have: A. B. C. D. Gout Rheumatoid arthritis Ankylosing spondylitis Synoviochondrometaplasia A. C) Ankylosing spondylitis Globus hystericus is a symptom that may accompany: A. Ochronosis B. Wilson’s disease C. Hydroxyapatite deposition disease in the cervical spine D. Bronze diabetes A. C) Hydroxyapatite deposition disease in the cervical spine Conditions similar to osteitis condensans illi may develop at: A. The pubic symphysis and medial clavicle B. The pubic symphysis and the distal clavicle C. The distal clavicle symphysis and the ischial tuberosities D. The pubic symphysis and the ischial tuberosities A. The pubic symphysis and medial clavicle In the thoracic and lumbar spine psoriatic arthritis is likely to manifest with: A. Fine marginal syndesmophytes B. Coarse asymmetric non-marginal syndesmophytes C. Coarse symmetrical marginal syndesmophytes D. Coarse asymmetric osteophytes A. B) Coarse asymmetric non-marginal syndesmophytes In ankylosing spondylitis: A. The posterior longitudinal ligament ossifies B. The outer annulus and the tissue beneath the anterior longitudinal ligament ossify C. The outer fibers of the anterior longitudinal ligament ossify D. Both the inner and outer fibers of the anterior longitudinal ligament ossify A. B) The outer annulus and the tissue beneath the anterior longitudinal ligament ossify Otto’s pelvis is: A. B. C. D. Malum coxa senilis Associated with paget’s disease Protrusio acetabulae Ischemic necrosis of the femoral head A. C) Protrusio acetabulae Pannus is: A. B. C. D. Vascular granulation tissue An inflammatory exudate An erosion of subchondral bone Inflamed collagen tissue A. Vascular granulation tissue Ossification of the posterior longitudinal ligament may result in: A. Demyelination of the posterior and lateral white columns of the spinal cord B. Flattening of the anterior margins of the spinal cord C. Erb’s palsy D. Brachial plexus lesions A. Demyelination of the posterior and lateral white columns of the spinal cord OA in the shoulder complex most often involves: A. B. C. D. The acromioclavicular joint The posterosuperior glenohumeral joint The anterosuperior glenohumeral joint The sternoclavicular joint A. The acromioclavicular joint An x-ray sign that is distinctly characteristic of lupus erythematosus is: A. Subchondral bone cysts B. Asymmetric loss of joint space C. Reversible, symmetric, bilateral deformities D. Fluffy periostitis A. C) Reversible, symmetric, bilateral deformities The intervertebral disc is considered: A. B. C. D. An amphiarthrosis A synarthrosis A diarthrosis None of the above, it is a unique joint A. An amphiarthrosis A male patient with diabetes, cirrhosis of the liver and a bronze color to his skin is likely to have a diagnosis of: A. B. C. D. Wilson’s disease CPPD Ochronosis Hemachromatosis A. D) Hemachromatosis An arthropathy with a 9:1 female predominance and predilection for multiparous women is: A. B. C. D. Systemic lupus erythematosus Erosive osteoarthritis Scleroderma Osteitis condensans ilii A. D) Osteitis condensans ilii Sacroiliac involvement in psoriatic patients: A. B. C. D. Is rare, occurring in less than 10% of cases Is most commonly unilateral Is most commonly bilateral and asymmetric Is most commonly bilateral and symmetric A. C) Is most commonly bilateral and asymmetric Radiographic indications of ankylosing spondylitis involving the sacroiliac joints include all the following except: A. Syndesmophytes B. Subtle widening of the SIJ space early in the disease C. Star sign D. Ghost joint A. Syndesmophytes Inflammatory arthritis may be indicated by radiographic evidence of: A. Posterolateral migration of the femoral head B. Medial migration of the femoral head C. Axial migration of the femoral head D. Anteromedial migration of the femoral head A. C) Axial migration of the femoral head Rheumatoid arthritis involves the cervical spine in: A. B. C. D. Less than 10% of cases Approximately 50% of the cases Approximately 80% of the cases 100% of the cases A. C) Approximately 80% of the cases Ossification of the posterior longitudinal ligament has been observed to have a predilection for: A. B. C. D. Eskimos Native Americans African Americans Japanese A. D) Japanese The movie sign is: A. Radiologic evidence of upper cervical hypermobility in extension B. Neurological evidence of brachial plexus lesions caused by pressure on the medial arm C. Laboratory evidence of a clotting disorder D. Clinical evidence of OA of the knee A. D) Clinical evidence of OA of the knee Conditions known to be associated with systemic lupus erythematosus include: A. Raynaud’s phenomenon and alopecia B. Reflex sympathetic dystrophy and raynaud’s phenomenon C. Renal failure and reflex sympathetic dystrophy D. Cholecystitis and renal failure A. Raynaud’s phenomenon and alopecia The bare area refers to: A. The articulating surfaces of bone where there is no periosteum B. The intracapsular surfaces of the bone where there is no periosteum C. The intracapsular surface of bone where there is no hyaline membrane D. The periphery of the articular surface where there is no articular cartilage A. D) The periphery of the articular surface where there is no articular cartilage The most common clinical presentation of CPPD involves: A. B. C. D. Bilateral symmetric arthritis in peripheral joints, with knee and elbow contractures seen as a chronic condition with progressively severe acute episodes A relatively pain free instability of peripheral joints A chronic progressively severe peripheral arthritis with no acute episodes A self limiting peripheral arthritis affecting the distal lower extremities A. Bilateral symmetric arthritis in peripheral joints, with knee and elbow contractures seen as a chronic condition with progressively severe acute episodes Calcinosis cutis is the term for: A. Subcutaneous calcifications B. Sheet like calcifications that appear along myofascial planes C. Punctate calcifications in the myofascial tissue of the hands D. Punctate calcifications within the joint capsules of the fingers A. Subcutaneous calcifications Lesions of psoriatic arthritis are known to occur: A. In a ray pattern B. Most commonly in the metacarpophalangeal joints and wrists C. In a symmetric distribution D. Rarely in the interphalangeal joints A. In a ray pattern Enthesopathy at the insertion sites of the annular fibers may result in: A. Romanus lesions B. A shiny corner sign C. A radiographic appearance of rosary beads D. Andersson lesions A. Romanus lesions The summation effect is caused by A. Increasing thoracic kyphosis seen with advanced osteoporosis B. Cervical disc diminution, osteolysis, and invagination seen with RA C. Increasing low back rigidity seen with osteophytes and lumbar disc dimunition in DJD D. Increasing rigidity seen with ankylosing spondylitis as the process progresses A. B) Cervical disc diminution, osteolysis, and invagination seen with RA Keratoconjunctivitis sicca is: A. B. C. D. Dry eyes (lacrimal gland atrophy) An allergic inflammation of the sclera A chronic low grade infection of the eyes Idiopathic excessive production of tears and serous mucus A. Dry eyes (lacrimal gland atrophy) Carrot stick fractures caused by AS which may cause serious neurologic complications are most common at: A. B. C. D. C5-C7 T4-T6 T10-L2 L4-S1 A. C5-C7 Chondromalacia patella is most common: A. B. C. D. In adolescents In osteoporotic females In geriatric patients In marathon runners or broad jumpers A. In adolescents All of the following statements about systemic lupus erythematosus are true except: A. It apparently involves significant immunologic abnormalities B. It shows a clear female predilection C. Almost all SLE patients exhibit the classic pattern of malar erythema D. It frequently involves the urinary, cardiopulmonary, nervous and musculoskeletal systems and the intergument A. C) Almost all SLE patients exhibit the classic pattern of malar erythema Synovial joints include A. A fibrous capsule, synovium and hyaline cartilage B. Fibrocartilaginous tissue with some hyaline cartilage C. Synovium and fibrocartilage D. Synovium and fibrocartilage with some hyaline cartilage A. A fibrous capsule, synovium and hyaline cartilage Common factors that exacerbate gouty arthritis include: A. B. C. D. Green leafy vegetables and yoghurt Milk and citrus fruits Aspirin and diuretics Apples oranges and bananas A. C) Aspirin and diuretics Vitiligo, telangiectasia and mauskopff are all features associated with: A. B. C. D. Scleroderma Systemic lupus erythematosus Stills disease hemochromatosis A. Scleroderma An important clinical consideration associated with patients with psoriatic arthritis is: A. B. C. D. Severe early osteoporosis High likelihood of ottos pelvis Likelihood of cauda equina syndrome Likelihood of atlantoaxial instability A. D) Likelihood of atlantoaxial instability In a patient with ankylosing spondylitis, posterior vertebral body scalloping may indicate: A. Malignant degeneration B. Concurrent hodgkins disease C. Early posterior longitudinal ligament involvement D. Dural ectasia with arachnoid diverticula A. D) Dural ectasia with arachnoid diverticula The terry thomas sign is radiologic evidence of: A. B. C. D. Midcarpal ankylosis Lunate luxation Multiple carpal erosions Scapulolunate separation A. D) Scapulolunate separation Feltys syndrome is defined as RA with: A. B. C. D. Raynaud’s syndrome Leukopenia and splenomegaly Cardiac lesions CNS lesions A. B) Leukopenia and splenomegaly Diffuse idiopathic skeletal hyperstosis shows a clear predilection for: A. B. C. D. Males over 40yo Adolescent males Adolescent females Middle-aged females A. Males over 40yo OA at the knee most often affects: A. B. C. D. The patellofemoral joint The medial femorotibial joint The proximal tibiofibular joint The lateral femorotibial joint A. B) The medial femorotibial joint The most common radiographic sign of reiters syndrome in the knee is: A. The development of a fabella B. The development of Pelligrini stieda calcification C. Swelling caused by intraarticular effusion D. Periostitis at the proximal tibial metaphysis A. C) Swelling caused by intraarticular effusion Poorly defined erosions of bone and osteopenic subarticular bone are characteristic of x-ray findings in: A. B. C. D. Metabolic arthritides Crystalline arthritides Inflammatory arthritides Degenerative arthritides A. C) Inflammatory arthritides Waldenstroms sign is: A. B. C. D. Femoral head anterosuperior migration with decreased superior and medial joint space Femoral head posterosuperior migration with decreased superior and medial joint space Femoral head anterosuperior migration with decreased superior and increased medial joint space Femoral head posterosuperior migration with decreased superior and medial joint space A. C) Femoral head anterosuperior migration with decreased superior and increased medial joint space ...
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This note was uploaded on 07/15/2011 for the course ECO 2023 taught by Professor Mr.raza during the Summer '10 term at FAU.

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