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Skeletal Radiology III - #20240


General Trauma

Cervical Spine Trauma

Arthritis Jeopardy

Part 4 Board Review (pdf)

Skeletal Radiology 3 Introduction (pdf)

Cervical spine trauma (pdf)

Thoracic and lumbar trauma (pdf)

Extremity trauma

Pelvic and hip trauma (pdf)

Knee trauma (pdf)

Ankle and foot trauma (pdf)

Shoulder trauma (pdf)

Wrist and hand trauma (pdf)

Arthritis

Intro/Degenerative Joint Disease (pdf)

Inflammatory Arthritis (pdf)

Metabolic Arthritis (pdf)

 

 
Renée M. DeVries, DC, DACBR
2.5
45
2.0
1.0
Radiographic interpretation of skeletal trauma using a regional approach. Presentation of degenerative, inflammatory, and metabolic arthritides. Correlation of radiographic findings with those from patient history and physical examination and lab. Discussion of various concerns regarding case management.
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Course Objectives
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  1. Understand the roles of plain-film radiography and advanced diagnostic imaging in the evaluation of musculoskeletal trauma.
  2. Recognize and describe various traumatic lesions of the spine, pelvis and extremities.
  3. Understand the significance of these lesions in the context of case management, including recognition of contraindications to spinal manipulation, indications for additional diagnostic imaging and indications for referral for other work-up or treatment.
  4. Understand, anticipate and recognize various complications of musculoskeletal trauma.
  5. Understand the roles of history, clinical examination, laboratory evaluation and diagnostic imaging in the evaluation of arthropathies and related disorders.
  6. Recognize and describe various arthritides and associated disorders, including recognizing and naming selected specific radiographic signs of abnormality.
  7. Classify the various arthropathies and related disorders as degenerative, inflammatory, metabolic or idiopathic.
  8. Understand the clinical significance of these various classifications and the specific conditions discussed. Recognize contraindications to manipulative therapy and indications for referral for advanced diagnostic imaging or other assessment or treatment.

Materials
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A. Required Text(s):
  1. Marchiori, DM, Clinical Imaging With Skeletal Chest and Abdomen Pattern Differentials, Mosby 1999.
    OR
  2. Yochum TR & Rowe LJ, Essentials of Skeletal Radiology, 2nd ed.,Williams & Wilkins, 1995.

B. Recommended Text(s):
  1. Keats T., Atlas of Normal Roentgen Variants.

C. Required Materials for Lab:
  1. Radiographs in Radiological Learning Lab (RLL) and on University Website.
  2. Library Resources.
Assignments
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  1. Reading handout materials and applicable textbook material.
  2. Lecture and lab material
Attendance
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Your attendance is expected at all class sessions.
Grading Criteria
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The final grade is calculated on the basis of scores on two major examinations (midterm and final), each with written and lab components. These are cumulative and comprehensive. Material from Skeletal Radiology I and II and non-radiology courses at NWCC may be included, but emphasis on both the midterm and final will be on "new" material. For example, the final will emphasize material from the second half of course, but questions from all course work previously covered, including the first half of Skeletal Radiology III may be included.

Guaranteed grades are as follows:

A = 90-100%
B = 80-89%
C = 70-79%
D = 60-69%
F = 60%
Course Competencies
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-

COGNITIVE DOMAIN


Students will be able to construct and follow a rational diagnostic process in evaluating plain film radiographs demonstrating the following signs:

  1. Altered osseous alignment
  2. Altered joint spaces
  3. Altered soft tissues
  4. Altered osseous integrity
  5. Erosions of bone
  6. Sclerosis of bone
  7. Osteopenia
  8. Fractures
  9. Subluxations and dislocations
  10. Instability
  11. Spondylolysis and spondylolisthesis
  12. Fracture complications
  13. Sprain/Strain of selected joints
  14. Named traumatic lesions
  15. Physeal injuries
  16. Signs of healing of fracture
  17. Signs of degenerative arthritis
  18. Signs of inflammatory arthritis
  19. Signs of metabolic arthritis
  20. Signs of connective tissue diseases

 



Conditions:
Students will be able to recognize on plain film radiographs the following conditions and to make clinical decisions based upon findings related to these conditions: (See key at end of table for description of codes)
Clinical Condition

Etiol. & Epidem.

 Patho-
physiology

Nat. History & Course

 Exam and Diagnosis Treatment & Management
Atlanto-axial subluxation 2 0 0 1,6 6
Atlanto-axial rotary fixation 2 0 0 1,6 1,6
C1 posterior arch fracture 2 0 0 1,2,6 1,6
Jefferson fracture 2 0 0 1,6 6
Lateral mass fracture 1 0 0 6 -
C1 transverse process fracture 1 0 2 1,6 6
Odontoid fracture 2 0 2 1,6 6
Body fracture of C2 1 0 0 6 6
Hangman's fracture 2 0 2 6 6
C2 spinous process fracture 0 0 0 6 -
Margin fracture of C3-7 bodies 2 0 1 6 6
C3-7 burst fracture 2 0 2 6 6
Uncinate process fracture 1 0 0 6 -
Lateral wedge fracture, C3-7 1 0 0 6 -
Posterior arch fracture, C3-7 2 0 1 1,6 6
Pedicle fracture, C3-7 1 0 0 - -
Lamina fracture, C3-7 2 0 0 6 6
Spinous process fracture, C3-7 2 0 1 6 -
Transverse process fracture, C3-7 2 0 0 6 -
Hyperextension sprain, c-spine 2 2 1 6 1,6
Hyperflexion sprain, c-spine 2 2 1 6 6
Bilateral facet dislocation 2 2 0 6 6
Hyperflexion fracture/dislocation 2 0 0 6 6
Thoracic compression fracture 3 2 3 1,6 1,6
Traumatic Schmorl's nodes 3 2 1 6 -
Limbus bones 2 2 0 6 -
Seat-belt fractures 2 0 2 6 6
Rib fractures 2 0 1 6 1,6
Sternal fractures 1 0 0 1,6 -
Facet fracture, lumbar spine 2 0 1 6 -
Lumbar transverse process fracture 2 0 2 1,5,6 6
Lumbar spinous process fracture 1 0 0 6 -
Lumbar vertebral body fracture 2 0 0 6 -
Sacral fracture 2 0 0 1,6 6
Subluxation of sacrococcygeal jt. 1 0 0 - -
Coccyx fracture 1 0 0 6 -
Iliac wing fracture 2 0 0 6 -
Pelvic ring fracture 2 0 2 6 6
Acetabular fracture 2 0 0 6 -
Pelvic avulsion fracture 2 0 2 1,6 6
Hip fractures 3 0 2 1,6 6
Distal femoral fractures 2 0 2 6 6
Hip dislocations 2 0 2 6 6
Slipped femoral capital epiphysis 3 2 2 6 6
Tibial plateau fracture 2 2 2 6 -
Osteochondral fracture of femoral condyle 2 2 2 6 6
Proximal fibular fracture 2 0 0 6 6
Patellar fracture 2 0 0 6 6
Avulsion of tibial spine 1 0 0 6 -
Trampoline fracture 2 0 0 6 -
Avulsion of tibial tuberosity 2 0 0 6 6
Segond's fracture 2 0 0 6 6
Patellar dislocation 2 0 0 6 6
Dislocation of proximal tib-fib jt. 1 0 0 - -
Dislocation of femoral-tibial jt. 1 0 0 - -
Boot-top fracture 2 0 0 6 6
Toddler fracture 2 0 0 6 6
Malleolar fractures 2 0 0 6 6
Osteochondral fractures of the talus 2 0 2 6 6
Fracture of posterior process, talus 2 0 2 6 -
Calcaneal fracture 2 0 0 1,6 -
Stress fracture of calcaneus 2 0 1 6 -
Ankle sprain 2 1 2 1,6 -
Navicular fracture 2 0 0 6 -
5th metatarsal fracture 2 0 2 1,6 6
LisFranc fracture 2 0 2 6 6
Chopart's fracture 2 0 0 6 -
Stress fracture of the foot 2 0 2 6 6
Sesamoid fracture 2 0 2 6 6
Clavicle fracture 2 0 2 6 6
Surgical neck fracture of the humerus 2 0 0 6 6
Flap fracture of the humerus 2 0 0 6 6
Scapular fracture 2 0 0 1,6 6
Coracoid fracture 1 0 0 - -
Acromion fracture 2 0 0 6 -
Shoulder dislocation 3 0 3 6 6
Acromioclavicular sprain 2 0 2 6 -
Radial head fracture 2 0 2 6 -
Radial neck fracture 2 0 2 6 -
Supracondylar fracture 2 0 0 6 -
Radial head subluxation/dislocation 2 0 2 1,2,3 1,6
"Little leaguer's" elbow 2 0 0 6 -
Osteochondral fracture of capitellum 2 0 0 6 -
Galeazzi fracture/dislocation 2 0 0 6 -
Monteggia fracture/dislocation 2 0 0 6 -
"Nightstick" fracture of the ulna 2 0 0 6 -
Scaphoid fracture 2 0 2 1,2,3,6 6
Triquetral fracture 2 0 2 1,2,6 6
Lunate dislocation 2 0 0 6 -
Perilunate dislocations 2 0 0 6 -
Colle's fracture 2 0 0 2,6 6
Smith's fracture 2 0 0 2,6 6
Ulnar styloid process fracture 2 0 2 2,6 -
Torus fracture 2 0 2 2,6 6
Boxer's fracture of metacarpal 2 0 0 2,6 6
Bennett's fracture 1 0 0 6 6
Rolando's fracture 1 0 0 6 6
Phalangeal fractures 2 0 2 2,6 6
Gamekeeper's thumb 2 0 2 2,6 6
Metacarpal-phalangeal dislocation 1 0 2 6 -
Physeal (Salter-Harris) fractures 3 0 3 6 6
Non-accidental injury of childhood 2 0 0 6 -
Stress fractures 3 3 3 2,6 6
Fracture healing - 3 - 6 -
Spondylolisthesis 3 3 3 1,2,3,6 -
Degenerative joint disease 3 3 3 1,2,6 -
Erosive osteoarthritis 2 2 2 1,2,5,6 -
Diffuse Idiopathic Skeletal Hyperostosis 2 2 2 1,2,5,6 -
Ossification of the posterior longitudinal ligament 2 2 2 1,2,6 6
Rheumatoid arthritis 3 3 3 1,2,5,6 6
Juvenile chronic arthritis 2 2 2 1,2,5,6 6
Ankylosing spondylitis 3 3 3 1,2,5,6 1,6
Enteropathic arthritis 2 2 2 1,2,5,6 -
Psoriatic arthritis 3 3 3 1,2,5,6 6
Reiter's syndrome 2 2 2 1,2,5,6 6
Osteiitis condensans ilii 2 2 2 1,2,5,6 1,6
Osteiitis pubis 2 2 2 1,2,6 6
Systemic Lupus Erythematosis 2 2 2 1,2,5,6,7 -
Scleroderma 2 2 2 1,2,6 -
Gout 2 2 2 1,2,6 6
Calcium Pyrophosphate Crystal Deposition Disease (CPPD) 3 3 3 1,2,6,7 6
Calcium Hydroxyapetite Crystal Deposition Disease (HADD) 2 2 2 1,2,6 2,6
Neuropathic Arthropathy 2 2 2 1,2,5,6 -
Synovial Chondrometaplasia 2 2 2 1,2,6 -

Elaboration of Coding Definitions Regarding the Conditions

The following codes refer to the depth of coverage for Etiology and Epidemiology, Pathophysiology, and Natural History and Course:

0 No coverage or content

1 Introduction, without test items

2 Moderate class discussion and/or handout material, with test items

3 Extensive discussion and/or handout material, with test items

For Exam and Diagnosis, the fillowing numbers indicate which aspects of exam and diagnosis of each condition are taught in this course:

  1. Presenting symptoms: Presenting symptoms related to conditions are discussed.
  2. History findings: Relevant personal and family history are discussed.
  3. Exam findings: General physical exam findings are discussed.
  4. Chiro. findings: Posture, subluxation, muscle tone and length, trigger points.
  5. Lab findings: Blood, urine, CSF...
  6. Imaging findings: Plain films, CT, MRI...
  7. Special test findings: eg. sweat test for cystic fibrosis, spirometry for asthma.

For Treatment/ Management, the following numbers indicate which aspects of treatment and management of each condition are taught in this course:

  1. Chiropractic: Adjustments, soft tissue techniques
  2. PT: Physical therapy modalities of all types
  3. Nutrition/ Suppl: Diet and supplement recommendations
  4. Exercise: Stretching, strengthening, aerobic exercise recommendations
  5. Lifesyle Mgmt: Stress reduction, smoking cessation, allergen avoidance ...
  6. Medical: Drugs, antibiotics, surgical procedures, radiotherapy ...
  7. Other: Acupressure/puncture, massage, homeopathic or herbal treatments ...
  8. Guidelines: If published, do you refer to them regarding this condition?


PSYCHOMOTOR DOMAIN


Students will be able to conduct an appropriate assessment of imaging studies to seek and detect signs of trauma and arthritis.

In addition, students will observe and analyze images as a first step in processing information. This involves detection and discernment of findings prior to discrimination of normal, versus abnormal findings and differential diagnosis.

AFFECTIVE DOMAIN


Students will demonstrate integrity, sensitivity, respect, courtesy, compassion and professionalism at all times, both in lectures and labs.
Weekly Calendar of Learning Objectives
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Week Dates Topics/Learning objectives
Week 1 1-4-07 Introduction: Imaging of skeletal trauma -Spinal trauma
Week 2 1-11-07 Spinal trauma
Week 3 1-18-07 Spinal trauma
Week 4 1-25-07 Pelvic and Extremity trauma
Week 5 2-1-07 No Class - Homecoming
Week 6 2-8-07 Extremity trauma
Week 7 2-15-07 MIDTERM EXAMS
Week 8 2-22-07

Spondylolisthesis and Introduction to Arthropathies & Degenerative arthropathies
Week 9 3-1-07

Degenerative arthropathies and related disorders
Week 10 3-8-07

Inflammatory arthropathies and related disorders
Week 11 3-15-07 Metabolic (Crystal-induced) arthropathies and related disorders
Week 12 3-22-07 Miscellaneous arthropathies
Week 13 3-29-07 Catch up and/or review
Week 14 4-5-07 FINAL EXAMS - Written & Practical
Week 15 4-12-07 FINAL EXAMS - Written & Practical
Please Note
This schedule of lecture and lab topics and quizzes and exams may be changed during the course of the trimester as circumstances require. Whenever possible, such changes will be announced in class before the date and time in question. You are responsible for anything that transpires during lectures and labs, even when you are unable to attend. In the event that you miss a class session, make sure you check with a classmate about any announcements or schedule changes which may have been made. Makeup exams are allowed only according to the policies described in the current student handbook, which is available in the Student Affairs office.
Maintained by Northwestern College of Chiropractic
Last updated: 30 March, 2007
 

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