Question 1

A study of a prosthetic hip demonstrates that the end of the prosthesis is cut off on the AP projection,but the entire device is demonstrated on the lateral projection.What should the technologist do next?

Accepted Answer

Since the entire device is visible on the lateral projection, it is clear that the issue is with the positioning of the hip for the AP projection. Therefore, repeating the AP projection only would be the most logical next step to ensure proper visualization of the entire prosthesis. It is not necessary to repeat both projections or seek the opinion of another technologist or radiologist at this point.

Question 2

Which of the following lateral hip projections cannot be performed on a trauma patient with a possible hip fracture?

Accepted Answer

The modified Cleaves method involves placing the affected leg in abduction and external rotation, which can be painful and potentially harmful for a trauma patient with a possible hip fracture. The other three options can be performed with the patient lying on their side with minimal or no movement of the affected hip.

Question 3

A radiograph of an AP pelvis demonstrates that the right obturator foramen is foreshortened but the left foramen is open.Which one of the following positioning errors is present on this radiograph?

Accepted Answer

The answer of A radiograph of an AP pelvis demonstrates...

Question 4

MATCHING
Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.)
-Fractures that occur in adolescent athletes who experience sudden,forceful,or unbalanced contraction of the tendinous and muscular attachments on the bony pelvis.

Accepted Answer

Avulsion fractures occur when a sudden, forceful, or unbalanced contraction of muscles leads to the tearing away of a piece of bone where a tendon or ligament attaches. This type of injury is common in adolescent athletes due to the high levels of physical activity and the stress placed on the growing bones and their attachments.

Question 5

MATCHING
Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.)
-A fracture resulting from a severe blow to one side of the pelvis

Accepted Answer

A pelvic ring fracture is a fracture resulting from a severe blow to one side of the pelvis.

Answer: A
 Metastatic carcinoma refers to the spread of cancer from a primary organ to the bone, causing bone destruction and pain.

Answer: C
 Congenital dislocation of the hip refers to a condition where the femoral head is not properly aligned with the acetabulum, leading to joint instability and potential dislocation.

Answer: D
 Chondrosarcoma is a type of bone cancer that arises from cartilage cells.

Answer: F
 Osteoarthritis is a degenerative joint disease characterized by the breakdown of cartilage and bone remodeling, often resulting in pain, stiffness, and limited mobility.

Answer: G
 An avulsion fracture is a type of fracture where a small piece of bone is torn away from the main bone, typically as a result of a tendon or ligament pulling excessively on the bone.

Question 6

A patient enters the ER with a possible pelvic ring fracture due to a MVA.The initial pelvis projections do not reveal any fracture or dislocation,but the ER physician is concerned about a possible right acetabular fracture.Which of the following projections will best demonstrate the right acetabulum?

Accepted Answer

The Judet method, or posterior oblique pelvis projection, is specifically designed to demonstrate the acetabulum and is ideal for identifying acetabular fractures.

Question 7

MATCHING
Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.)
-A degenerative joint disease

Accepted Answer

Osteoarthritis is a degenerative joint disease.

Answer: D
 Chondrosarcoma is a malignant tumor of cartilage tissue.

Answer: B
 Ankylosing spondylitis is a chronic inflammatory disease affecting the spine and sacroiliac joints.

Answer: C
 Congenital dislocation of hip is a developmental disorder where the femoral head is partially or completely out of the acetabulum.

Answer: A
 Metastatic carcinoma is a cancer that has spread from its primary site to other parts of the body.

Answer: E
 Pelvic ring fracture is a disruption of the bony structure of the pelvis due to high-energy trauma.

Answer: G
 Avulsion fracture is a type of fracture where a ligament or tendon is pulled off a piece of bone.

Question 8

A patient comes to the ER with a possible pelvic ring fracture.The initial AP pelvis projection is inconclusive.What other projection can be taken to assist with the diagnosis?

Accepted Answer

The AP axial inlet projection provides a view of the pelvic ring and can help in assessing the extent and nature of a pelvic ring fracture.

Question 9

MATCHING
Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.)
-A disease producing extensive calcification of the longitudinal ligament of the spinal column

Accepted Answer

Ankylosing spondylitis is a disease that results in excessive calcification of the longitudinal ligament of the spinal column, leading to fusion of the vertebral bodies.

Answer: A
 Metastatic carcinoma is a cancer that spreads to the bone and can cause extensive bone destruction and pathological fractures.

Answer: C
 Congenital dislocation of the hip is a condition where the head of the femur is dislocated from its normal position in the acetabulum.

Answer: D
 Chondrosarcoma is a type of bone cancer that arises from cartilage cells and can cause destruction of the bone.

Answer: F
 Osteoarthritis is a degenerative joint disease that leads to wear and tear on the cartilage, resulting in pain and stiffness in the affected joint.

Answer: G
 An avulsion fracture occurs when a small piece of bone is pulled off from its attachment to a tendon or ligament due to a sudden and forceful contraction of the muscle. A pelvic ring fracture is a break in the bone surrounding the pelvis.

Question 10

MATCHING
Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.)
-Now referred to as "developmental dysplasia of the hip"

Accepted Answer

"Developmental dysplasia of the hip" is now the preferred term for congenital dislocation of the hip.

Answer: F
 Osteoarthritis is a degenerative joint disease characterized by cartilage breakdown and bone remodeling.

Answer: B
 Ankylosing spondylitis is a chronic inflammatory disorder that primarily affects the spine and sacroiliac joints.

Answer: E
 Pelvic ring fracture is a fracture that involves one or more of the bones of the pelvic ring (i.e. the sacrum, coccyx, and two hip bones).

Answer: A
 Metastatic carcinoma is cancer that has spread from its site of origin to other parts of the body, including bones.

Answer: G
 An avulsion fracture occurs when a small piece of bone is pulled away from the main bone by a tendon or ligament.

Answer: D
 Chondrosarcoma is a malignant tumor that arises from cartilage cells.

Question 11

During a repeat study of the AP axial (Taylor)outlet projection,both obturator foramina are symmetric but foreshortened.Which of the following positioning modifications must be performed to correct this error?

Accepted Answer

Increasing the cephalic CR angulation will help to elongate the obturator foramina, correcting the foreshortening observed in the image.

Question 12

A patient comes to radiology with a request for a right hip study.He is from an extended care facility and is confused about the cause of the injury.The technologist takes an AP pelvis,and when the lateral frog-leg projection is attempted,the patient complains loudly about the pain in his affected hip.What should the technologist do to complete the study?

Accepted Answer

The axiolateral (inferosuperior) projection can be used as an alternative to the lateral frog-leg projection when the patient is unable to tolerate the discomfort involved. This means the technologist can still obtain an image of the hip without causing undue pain to the patient. Option A is not recommended as it may cause unnecessary pain to the patient, while option B would leave out useful and necessary diagnostic information. Option D is not a standard projection for a hip study.

Question 13

Which of the following projections requires that the IR be tilted 15° from the vertical plane?

Accepted Answer

The modified axiolateral projection (Clements-Nakayama method) requires that the IR be tilted 15° from the vertical plane to ensure that the central ray is targeted accurately at the joint space of interest. The other projections listed do not require this degree of tilt for the IR.

Question 14

MATCHING
Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.)
-Malignancy spread to bone via the circulatory,lymphatic systems,or direct invasion

Accepted Answer

Metastatic carcinoma refers to the spread of cancer cells from their original site to the bone via the circulatory, lymphatic systems or direct invasion.

Answer: D
 Chondrosarcoma is a type of bone cancer that arises from cartilage cells and can lead to the destruction of bones.

Answer: G
 Avulsion fracture is a type of bone fracture where a small fragment of bone attached to a tendon or ligament gets pulled away from the main bone due to sudden excessive force or trauma.

Question 15

A patient enters the ER with possible bilateral fractured hips.Which of the following routines should be performed?

Accepted Answer

The modified axiolateral (Clements-Nakayama method) projection is the best choice for visualizing possible bilateral hip fractures. This projection is typically used when a patient cannot lie flat on their back, which may be the case if hip fractures are suspected. The AP pelvis is also necessary to assess the overall pelvic region.

Question 16

MATCHING
Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.)
-A malignant tumor of the cartilage

Accepted Answer

Chondrosarcoma is a malignant tumor of the cartilage.

Answer: A
 Metastatic carcinoma refers to a cancer that has spread from another part of the body to a different site.

Answer: F
 Osteoarthritis is a degenerative joint disease, resulting in the breakdown of joint cartilage and underlying bone.

Answer: C
 Congenital dislocation of hip is a condition where the hip joint is improperly formed at birth.

Answer: G
 Avulsion fracture refers to a small piece of bone breaking off where a tendon or ligament attaches to the bone.

Answer: E
 Pelvic ring fracture refers to a break in the bony structure of the pelvis that surrounds the hip joint.

Question 17

A patient enters the ER with a possible separation of the symphysis pubis caused by trauma.The AP pelvis projection is inconclusive for determining the extent of the injury.What other projection can be taken to evaluate this region without excessive movement of the patient?

Accepted Answer

The AP axial (Taylor) outlet projection is specifically designed to evaluate the pubic and ischial rami, as well as the symphysis pubis, making it suitable for assessing separation in this region.

Question 18

A radiograph of an AP axial (Taylor)"outlet" projection reveals that the obturator foramina are not symmetric.What type of positioning problem is present on this radiograph?

Accepted Answer

The AP axial (Taylor) "outlet" projection is designed to demonstrate the pubic and ischial bones, as well as the obturator foramina. If the obturator foramina are not symmetrically demonstrated, it indicates a rotation of the pelvis, which is a common positioning problem with this projection. Tilting of the pelvis and off-center CR can also contribute to an asymmetric appearance, but rotation is the most likely cause. Fracture of the pubis or ischium would be visible as a bony abnormality rather than a positional problem.

Question 19

How much CR angle,from the horizontal,is required for the modified axiolateral (Clements-Nakayama)projection?

Accepted Answer

The modified axiolateral (Clements-Nakayama) projection requires a CR angle of 15° to 20° from the horizontal to properly visualize the hip joint and femoral neck.

Question 20

Which of the following imaging modalities will best detect early signs of bone infection of the pelvis?

Accepted Answer

Nuclear medicine imaging, specifically using a bone scan or radiolabeled leukocyte imaging, is the most sensitive modality for detecting early signs of bone infection (osteomyelitis) in the pelvis. Radiography and CT may not show apparent changes until the infection has progressed, while MRI may not be as specific for osteomyelitis and can be limited by metal artifacts in some cases.

Quiz 7: Femur and Pelvic Girdle

A study of a prosthetic hip demonstrates that the end of the prosthesis is cut off on the AP projection,but the entire device is demonstrated on the lateral projection.What should the technologist do next?

Which of the following lateral hip projections cannot be performed on a trauma patient with a possible hip fracture?

A radiograph of an AP pelvis demonstrates that the right obturator foramen is foreshortened but the left foramen is open.Which one of the following positioning errors is present on this radiograph?

MATCHING Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.) -Fractures that occur in adolescent athletes who experience sudden,forceful,or unbalanced contraction of the tendinous and muscular attachments on the bony pelvis.

MATCHING Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.) -A fracture resulting from a severe blow to one side of the pelvis

MATCHING Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.) -A degenerative joint disease

A patient comes to the ER with a possible pelvic ring fracture.The initial AP pelvis projection is inconclusive.What other projection can be taken to assist with the diagnosis?

MATCHING Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.) -A disease producing extensive calcification of the longitudinal ligament of the spinal column

MATCHING Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.) -Now referred to as "developmental dysplasia of the hip"

During a repeat study of the AP axial (Taylor) outlet projection,both obturator foramina are symmetric but foreshortened.Which of the following positioning modifications must be performed to correct this error?

Which of the following projections requires that the IR be tilted 15° from the vertical plane?

MATCHING Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.) -Malignancy spread to bone via the circulatory,lymphatic systems,or direct invasion

A patient enters the ER with possible bilateral fractured hips.Which of the following routines should be performed?

MATCHING Match the correct disease or condition with the corresponding pathologic description.(Use each choice only once.) -A malignant tumor of the cartilage

A patient enters the ER with a possible separation of the symphysis pubis caused by trauma.The AP pelvis projection is inconclusive for determining the extent of the injury.What other projection can be taken to evaluate this region without excessive movement of the patient?

A radiograph of an AP axial (Taylor) "outlet" projection reveals that the obturator foramina are not symmetric.What type of positioning problem is present on this radiograph?

How much CR angle,from the horizontal,is required for the modified axiolateral (Clements-Nakayama) projection?

Which of the following imaging modalities will best detect early signs of bone infection of the pelvis?