Skeletal and joint anatomy on imaging

63 Gulf Prometric Radiographer (DHA, DOH, MOH, SCFHS, QCHP) practice questions on Skeletal and joint anatomy on imaging, part of Radiographic Anatomy. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

1. Question 1 · Medium

   A child falls from a swing and the forearm radiograph shows the cortex broken on one side, while the opposite cortex is only bent. This fracture is called:

   1. AAvulsion fracture
   2. BComminuted fracture
   3. CGreenstick fracture
   4. DSpiral fracture

   Show answerHide answer

   Answer: C · Greenstick fracture

   Children's bones are softer and more elastic, so a force may break one cortex and bend the other, and this incomplete break is called a greenstick fracture. The periosteum stays largely intact and healing is usually quick.

   • A: An avulsion fracture is a fragment pulled off by a tendon or ligament.
   • B: A comminuted fracture has more than two fragments.
   • D: A spiral fracture is a twisting break that circles the shaft.

   Remember this

   A greenstick fracture breaks one cortex and bends the other, in children.

2. Question 2 · Hard

   A displaced femoral neck fracture carries a high risk of avascular necrosis of the femoral head primarily because it:

   1. ATears the retinacular vessels from the circumflex artery
   2. BDamages the obturator nerve supplying the hip joint
   3. CInjures the sciatic nerve running behind the hip
   4. DDisrupts the ligamentum teres artery, the main supply

   Show answerHide answer

   Answer: A · Tears the retinacular vessels from the circumflex artery

   The femoral head's main blood supply in adults comes from retinacular vessels, which arise from the medial circumflex femoral artery and run along the neck to the head. A displaced intracapsular fracture tears them, and the artery of the ligamentum teres is small in adults.

   • B: Nerve injury does not cause avascular necrosis.
   • C: The sciatic nerve is not the blood supply.
   • D: The artery in the ligamentum teres is a minor supply in adults.

   Remember this

   Displaced femoral neck fractures risk avascular necrosis by tearing the retinacular branches of the medial circumflex artery.

3. Question 3 · Medium

   On a true lateral ankle radiograph, which relationship between the fibula and the tibia confirms correct positioning?

   1. AThe fibula lies completely clear of the tibia
   2. BThe fibula lies directly in line with the tibial centre
   3. CThe fibula overlaps the anterior half of the tibia
   4. DThe distal fibula overlaps the posterior half of the tibia

   Show answerHide answer

   Answer: D · The distal fibula overlaps the posterior half of the tibia

   In a true lateral the fibula lies behind the tibia, so its distal end overlaps the posterior half of the tibia and the talar domes superimpose. If it falls in front of this, the ankle was rotated, and the view must be repeated.

   • A: A fibula clear of the tibia shows an oblique, not lateral, ankle.
   • B: A fibula in line with the tibial centre is not a landmark for a true lateral.
   • C: Overlap of the anterior half means the leg was rotated in the opposite direction.

   Remember this

   In a true lateral ankle the distal fibula overlaps the posterior half of the tibia.

4. Question 4 · Medium

   The sacroiliac joint is formed between the sacrum and the:

   1. AIlium
   2. BIschium
   3. CPubis
   4. DCoccyx

   Show answerHide answer

   Answer: A · Ilium

   The auricular surfaces of the sacrum and the ilium form the sacroiliac joint, which is synovial in its lower part and fibrous above. It transmits weight from the spine to the pelvis and is shown best on an AP axial or oblique view.

   • B: The ischium forms the lower, posterior pelvis and not this joint.
   • C: The pubis forms the symphysis anteriorly.
   • D: The coccyx articulates with the sacrum at the sacrococcygeal joint.

   Remember this

   The sacroiliac joint lies between the sacrum and the ilium.

5. Question 5 · Easy

   Which carpal bone is the most commonly fractured?

   1. AScaphoid
   2. BLunate
   3. CHamate
   4. DPisiform

   Show answerHide answer

   Answer: A · Scaphoid

   The scaphoid is the most commonly fractured carpal bone, usually after a fall on the outstretched hand. Its retrograde blood supply makes the proximal pole prone to avascular necrosis, and initial radiographs can look normal.

   • B: The lunate is less commonly fractured.
   • C: The hamate is fractured less often, usually at the hook.
   • D: The pisiform is rarely fractured.

   Remember this

   The scaphoid is the commonest carpal fracture and has a risk of avascular necrosis.

6. Question 6 · Hard

   A 7-year-old has an elbow injury. The radiograph shows an ossification centre in the joint space, but there is none in the usual place of the medial epicondyle. What does this suggest?

   1. AA fracture of the lateral condyle
   2. BAn avulsed medial epicondyle trapped in the joint
   3. CA normal trochlear centre, and no abnormality
   4. DAbsence of the capitellum

   Answer and explanation in LearnFree account

7. Question 7 · Medium

   The level of the iliac crests on a surface or AP lumbar image corresponds to the:

   1. AL1 vertebral level
   2. BS3 vertebral level
   3. CL4 to L5 vertebral level
   4. DT10 vertebral level

   Answer and explanation in LearnFree account

8. Question 8 · Hard

   A forearm radiograph shows an angulated fracture of the proximal ulnar shaft. Which associated injury must be excluded on the elbow views?

   1. ALunate dislocation at the wrist
   2. BPosterior dislocation of the shoulder
   3. CScaphoid waist fracture at the wrist
   4. DRadial head dislocation at the elbow

   Answer and explanation in LearnFree account

9. Question 9 · Medium

   A fracture through the base of the fifth metatarsal at the junction of the metaphysis and diaphysis, about 1.5 cm from the tuberosity tip, is called a:

   1. AJones fracture
   2. BLisfranc fracture
   3. CPott fracture
   4. DMarch fracture

   Answer and explanation in LearnFree account

10. Question 10 · Hard

    In a child's wrist injury, the fracture line crosses the metaphysis, the physis and the epiphysis, entering the joint. Which Salter-Harris type is this?

    1. AType III
    2. BType IV
    3. CType V
    4. DType II

    Answer and explanation in LearnFree account

11. Question 11 · Medium

    In a child's elbow, which secondary ossification centre appears first?

    1. AThe medial epicondyle
    2. BThe capitellum
    3. CThe olecranon
    4. DThe radial head

    Answer and explanation in LearnFree account

12. Question 12 · Medium

    A child falls onto the elbow, and the lateral radiograph shows a raised, sail-shaped posterior fat pad but no visible fracture line. This suggests:

    1. AEarly osteomyelitis of the distal humerus
    2. BEffusion with an occult intra-articular fracture
    3. CA normal variant that needs no action
    4. DA simple collateral ligament sprain with no effusion

    Answer and explanation in LearnFree account

13. Question 13 · Medium

    Which ossification centre of the paediatric elbow normally appears next after the medial (internal) epicondyle, at about 7 years?

    1. ACoronoid
    2. BLateral epicondyle
    3. CTrochlea
    4. DOlecranon

    Answer and explanation in LearnFree account

14. Question 14 · Medium

    A boy of 8 has a clavicle fracture after a bicycle fall. At which part of the clavicle does a fracture most commonly occur?

    1. AThe middle third of the shaft
    2. BThe lateral third near the acromion
    3. CThe sternoclavicular joint surface
    4. DThe medial third near the sternum

    Answer and explanation in LearnFree account

15. Question 15 · Medium

    On a true lateral elbow of a 7-year-old after a fall, the anterior humeral line passes through the front of the capitellum instead of its middle third. What does this suggest?

    1. AA dislocation of the radial head
    2. BA fracture of the olecranon process
    3. CA normal finding at this age
    4. DA supracondylar fracture with posterior displacement

    Answer and explanation in LearnFree account

16. Question 16 · Medium

    Which group of ribs is classed as false ribs?

    1. ARibs 1 to 10
    2. BRibs 1 to 7
    3. CRibs 8 to 12
    4. DRibs 11 and 12 only

    Answer and explanation in LearnFree account

17. Question 17 · Medium

    A Colles fracture is a fracture of the distal radius with:

    1. AIntra-articular fracture of the scaphoid
    2. BVolar displacement of the distal fragment
    3. CDorsal displacement and angulation of the distal fragment
    4. DIsolated fracture of the radial styloid with ulnar dislocation

    Answer and explanation in LearnFree account

18. Question 18 · Medium

    Under the Weber classification, a Weber B ankle fracture of the fibula is located:

    1. ABelow the syndesmosis
    2. BAbove the syndesmosis, high in the fibula
    3. CIn the medial malleolus
    4. DAt the level of the tibiofibular syndesmosis

    Answer and explanation in LearnFree account

19. Question 19 · Medium

    A 9-year-old boy's wrist radiograph shows a fracture line through the physis that also exits through a triangle of metaphysis. What is the Salter-Harris type?

    1. AType III
    2. BType II
    3. CType V
    4. DType I

    Answer and explanation in LearnFree account

20. Question 20 · Medium

    A lateral knee radiograph is routinely taken with the knee flexed about 20 to 30 degrees. What is the main reason?

    1. ATo open the intercondylar notch fully for a tunnel view
    2. BTo lock the patella firmly against the femoral groove
    3. CTo bring the fibular head into profile behind the tibia
    4. DTo relax the quadriceps and show the joint space

    Answer and explanation in LearnFree account

21. Question 21 · Medium

    The most common type of physeal (growth plate) fracture in children is Salter-Harris type:

    1. AII
    2. BV
    3. CI
    4. DIII

    Answer and explanation in LearnFree account

22. Question 22 · Medium

    On an AP pelvis of a toddler, Hilgenreiner's and Perkin's lines are drawn. Where should the normal femoral head ossification centre lie?

    1. AIn the upper outer quadrant
    2. BIn the lower outer quadrant
    3. CAbove Hilgenreiner's line
    4. DIn the lower inner quadrant

    Answer and explanation in LearnFree account

23. Question 23 · Hard

    On a lateral knee radiograph, the patellar tendon measures 54 mm and the greatest diagonal length of the patella is 36 mm. What does the Insall-Salvati ratio show?

    1. AA normal patellar height
    2. BPatellar tendon rupture only
    3. CPatella baja
    4. DPatella alta

    Answer and explanation in LearnFree account

24. Question 24 · Easy

    A fracture of the radial shaft with dislocation of the distal radioulnar joint is called a:

    1. ABarton fracture
    2. BMonteggia fracture
    3. CGaleazzi fracture
    4. DSmith fracture

    Answer and explanation in LearnFree account

25. Question 25 · Medium

    A knee radiograph of a newborn shows an ossified centre in the distal femur. This finding is consistent with a baby born at about:

    1. A6 months after birth
    2. B36 to 40 weeks of gestation
    3. C28 weeks of gestation
    4. D2 years after birth

    Answer and explanation in LearnFree account