Question 1

A radiograph of a plantodorsal (axial) projection of the calcaneus reveals foreshortening.The technologist used 60 kV, 6 mAs, 40-inch (102-cm) SID, and a 25° cephalad CR angle from the long axis of the foot.Which of the following modifications will produce a more diagnostic image of the calcaneus?

Accepted Answer

Increasing the CR angulation will help to elongate the calcaneus and reduce foreshortening in the image.

Question 2

Which one of the following projections will best demonstrate signs of Osgood-Schlatter disease?

Accepted Answer

Osgood-Schlatter disease primarily affects the tibial tuberosity, and the best views to demonstrate signs of this condition are the anteroposterior (AP) and lateral views of the knee. These projections allow for clear visualization of the tibial tuberosity where changes associated with Osgood-Schlatter disease occur.

Question 3

A patient comes to radiology with a clinical history of osteoarthritis of both knees.The referring physician wants a projection to evaluate the damage to the articular facets.Which of the following projections will provide the best image of this region of the knee?

Accepted Answer

The PA axial weight-bearing bilateral knee projection (Rosenberg method) is specifically designed to evaluate joint spaces and is particularly useful for assessing conditions like osteoarthritis in the knees. This method provides a clear view of the articular facets and the space between them, which is crucial for evaluating the extent of osteoarthritis damage.

Question 4

A radiograph of an AP oblique foot with medial rotation demonstrates considerable superimposition of the third through fifth metatarsals.How must the original position be changed to eliminate this problem?

Accepted Answer

Decreasing the obliquity of the foot will separate the metatarsals and reduce superimposition, making sure that the area of interest is well demonstrated.

Question 5

Which of the following imaging modalities and/or procedures will provide the best assessment for osteomyelitis of the foot?

Accepted Answer

Nuclear medicine imaging, specifically bone scan using technetium-99m (Tc-99m) labeled radiopharmaceuticals such as methylene diphosphonate (MDP) or hydroxymethylene diphosphonate (HDP), is the most sensitive and specific imaging modality for detecting osteomyelitis in the foot. It can detect early changes of osteomyelitis before they become apparent on other imaging modalities such as X-ray, CT, or MRI. Other imaging modalities may be used to confirm or further evaluate the extent of the disease, but bone scanning is the primary choice for initial screening and diagnosis.

Question 6

A patient comes to the radiology department for a knee study with special interest in the region of the proximal tibiofibular joint and the lateral condyle of the tibia.Which of the following positioning routines should the technologist obtain?

Accepted Answer

The medial oblique knee position best demonstrates the proximal tibiofibular joint and the lateral condyle of the tibia.

Question 7

For the AP weight-bearing knee projection on an average patient, the CR should be:

Accepted Answer

The AP weight-bearing knee projection on an average patient should be taken with the CR perpendicular to the image receptor. There is no need to adjust the angulation or increase the SID for this projection.

Question 8

A patient comes to radiology with an infection involving the sesamoid bones of the foot.Beyond the routine foot projections, which one of the following projections can be performed to best demonstrate these structures?

Accepted Answer

The tangential projection is specifically designed to best demonstrate the sesamoid bones of the foot, providing a clear view of these small structures by angling the X-ray beam tangentially to their location.

Question 9

A radiograph of an AP mortise projection of the ankle reveals that the lateral malleolus is slightly superimposed over the talus and the lateral joint space is not open.What is most likely cause for this radiographic outcome?

Accepted Answer

The lateral malleolus being superimposed over the talus and the lateral joint space not being open is indicative of insufficient medial rotation of the foot and ankle. This means that the foot and ankle were not rotated enough towards the center of the body when the radiograph was taken.

Question 10

A patient enters the ED with an injury near the base of the first and second metatarsals.The basic foot projections are inconclusive on demonstrating a fracture to the medial cuneiform.Which of the following projections would best demonstrate this bone?

Accepted Answer

The answer of A patient enters the ED with an...

Question 11

A patient comes to radiology with a history of chondromalacia of the patella.The orthopedic surgeon is concerned about possible loose bodies within the patellofemoral joint space.She wants the best projection to demonstrate this joint space.What projection should be performed?

Accepted Answer

The Merchant method is the best choice for demonstrating the patellofemoral joint space as it involves a tangential projection of the joint space in a weight-bearing position, allowing for the detection of loose bodies. The other options (Camp-Coventry method, Settegast method, and AP axial projection) do not specifically target the patellofemoral joint space and are not as effective in detecting loose bodies.

Question 12

The radiographic hallmark of Reiter's syndrome seen in young men is:

Accepted Answer

The radiographic hallmark of Reiter's syndrome in young men is erosion of the Achilles tendon insertion, which is caused by the inflammatory process that occurs in the affected joint. The other choices are not specific to Reiter's syndrome.

Question 13

A patient comes to radiology with a history of chondromalacia of the patella.Her physician orders a projection of the patellofemoral joint space.Due to advanced emphysema, the patient cannot lie recumbent for this projection.Which of the following projections would be best for this patient?

Accepted Answer

The superoinferior sitting tangential method-Hobbs modification would be the best option for the patient with advanced emphysema who cannot lie recumbent. This projection is taken with the patient seated and the x-ray beam directed at a 10-15 degree angle toward the patella, allowing for the joint space to be visualized without requiring the patient to lie down. The other options (tangential projections - Settegast or Merchant methods and AP axial projection - Béclere method) all require the patient to lie recumbent and would not be suitable for this individual.

Question 14

A patient comes to radiology with a clinical history of a Lisfranc joint injury.Which of the following projections would best demonstrate this condition?

Accepted Answer

A Lisfranc joint injury typically involves the midfoot region, specifically the articulation between the metatarsals and tarsals. Weight-bearing foot series is the best choice as it includes oblique projections that allow for visualization of this area. The other options focus on different joints and/or areas of the lower extremity.

Question 15

A patient enters radiology with a possible ligament tear to the lateral aspect of the ankle.Initial ankle radiographs are negative for fracture or dislocation.Because the clinic is in a rural setting, the patient cannot have an MRI performed to evaluate the ligaments of the ankle.Which of the following techniques may provide an assessment of the soft tissue structures of the ankle?

Accepted Answer

AP stress positions can be used to assess the integrity of the ligaments by applying stress to the ankle and observing for abnormal movement or alignment, which can indicate a ligament tear when MRI is not available.

Question 16

A patient enters the emergency department (ED) with a possible transverse fracture of the patella.Which of the following routines would safely provide the best images of the patella?

Accepted Answer

A transverse fracture of the patella requires minimal movement to avoid further injury. An AP and horizontal beam lateral with no knee flexion will provide clear images while maintaining the knee in a safe, stable position.

Question 17

For the AP weight-bearing feet projection, the CR should be:

Accepted Answer

For the AP weight-bearing feet projection, the central ray (CR) should be angled 15° posteriorly to properly visualize the joint spaces and the arches of the feet.

Question 18

A geriatric patient comes to the radiology department for a study of the knee.The patient is unsteady and unsure of himself.Which intercondylar fossa projection would provide the best results without risk of injury to the patient?

Accepted Answer

The Camp-Coventry method is considered the safest option for unsteady and unsure geriatric patients. It is a weight-bearing projection that does not require any movement from the patient, reducing the risk of injury or falls. The other options (Holmblad, Hughston, and Rosenberg methods) all require some level of patient movement and may not be suitable for an unsteady patient.

Question 19

A patient comes to radiology for an evaluation of the longitudinal arch of the foot.Which of the following projections would provide the best information about the arch?

Accepted Answer

AP and lateral weight-bearing projections of the foot are specifically designed to evaluate the structure and function of the foot's arches under load, providing the most relevant information about the longitudinal arch.

Question 20

A radiograph of a PA axial projection for the intercondylar fossa (Camp-Coventry method) does not demonstrate the fossa well.It is foreshortened.The following positioning factors were used: patient prone, knee flexed 40° to 45°, CR angled to be perpendicular to the femur, 40-inch SID, and no rotation of the lower limb.Based on the factors used, what changes need to be made to produce a more diagnostic image?

Accepted Answer

The central ray (CR) should be perpendicular to the lower leg, not the femur, to properly visualize the intercondylar fossa in the Camp-Coventry method.

Quiz 6: Lower Limb