Knee Anatomy and Radiography Quiz

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Questions and Answers

What is the primary function of the menisci in the knee?

To connect bones directly

To facilitate blood flow

To increase the range of motion

To act as shock absorbers (correct)

Which ligament is also known as the medial collateral ligament (MCL)?

Tibial collateral ligament (correct)

Posterior cruciate ligament

Anterior cruciate ligament

Fibular collateral ligament

Which ligament controls the backward movement of the tibia?

Lateral collateral ligament

Fibular collateral ligament

Posterior cruciate ligament (correct)

Anterior cruciate ligament

What type of injury is most commonly associated with the medial collateral ligament (MCL)?

Blow to the medial side of the knee Signup and view all the answers

Which of the following describes the positioning of cruciate ligaments in the knee?

Crossing each other in an 'X' shape Signup and view all the answers

What can be a reason for performing knee x-rays?

Investigating effusions or ligament injuries Signup and view all the answers

What is the primary role of collateral ligaments in the knee?

Control sideways movement of the knee Signup and view all the answers

Which imaging method is commonly used before MRI or arthroscopy for assessing bony injury in the knee?

Plain film imaging Signup and view all the answers

What is the recommended degree of knee flexion for standard lateral knee radiography?

30 degrees Signup and view all the answers

What angulation is typically required for short patients with a wide pelvis during knee radiography?

7 to 10 degrees Signup and view all the answers

Which of the following statements contributes to accurate lateral knee positioning?

Epicondyles should be positioned perpendicular to the image receptor. Signup and view all the answers

What happens if the knee is flexed more than 30 degrees during the lateral projection?

Compression of soft tissue structures Signup and view all the answers

What is the primary criterion for determining if the knee is positioned in a true lateral view?

Superimposition of the epicondyles Signup and view all the answers

For long male patients with a narrow pelvis, what is the recommended tube angulation?

5 degrees Signup and view all the answers

What is the consequence of improperly positioning the knee in lateral view?

Loss of diagnostic information Signup and view all the answers

Why should the CR be directed 5 to 7 degrees cephalad during a lateral knee projection?

To align with the joint space Signup and view all the answers

What is the required position of the patient for a standard AP projection?

Supine with the leg fully extended Signup and view all the answers

Which technical factor should be used for the SID in radiographic projections?

100 cm Signup and view all the answers

When considering the positioning of the patient for the AP projection, what indicates that the image is not properly aligned?

The fibula head is entirely superimposed Signup and view all the answers

For a patient with a prosthesis, what is the minimum image receptor size recommended?

24 × 30 cm Signup and view all the answers

What is the correct CR placement for an AP projection?

1.25 cm distal to the apex of the patella Signup and view all the answers

Which projection requires the knee to be flexed at 20° to 30°?

Lateral projection Signup and view all the answers

What does Internal Derangement Knee (IDK) primarily describe?

Multiple types of knee joint injuries Signup and view all the answers

A patient with larger thighs requires the central ray to be directed at what angle for an AP projection?

3° to 5° cephalad angle Signup and view all the answers

The kVp range recommended for knee projections is:

60-70 Signup and view all the answers

What is lipohemarthrosis?

Leakage of blood and fat from the medullary cavity in the bone Signup and view all the answers

Which imaging technique is essential to detect lipohemarthrosis after an acute injury?

Horizontal beam lateral Signup and view all the answers

In the context of fractures, what type of fracture is a supracondylar fracture?

Fracture of the distal femur, potentially involving the knee joint Signup and view all the answers

Which condition is associated with osteochondritis dissecans?

Bone death due to lack of blood flow under joint cartilage Signup and view all the answers

What is a common consequence of a tibial plateau fracture?

Development of lipohemarthrosis Signup and view all the answers

Which of the following is NOT a technical consideration to detect lipohemarthrosis?

Use of contrast agents during imaging Signup and view all the answers

What type of injury commonly leads to acute knee trauma?

Direct trauma leading to fractures Signup and view all the answers

What is the main clinical rationale for performing knee radiography?

To evaluate bone alignment and integrity Signup and view all the answers

Which of the following bones is NOT part of the knee joint?

Humerus Signup and view all the answers

Which method is primarily used for the routine projection of the knee joint?

Standard radiographic positioning Signup and view all the answers

What type of joint is primarily regarded as the knee joint?

Femorotibial joint Signup and view all the answers

How many bones are involved in the knee joint?

four Signup and view all the answers

Which projection technique is important for standard knee radiography?

Basic/standard positioning Signup and view all the answers

In knee anatomy, the joint primarily responsible for hinge movement is which?

Femorotibial joint Signup and view all the answers

Which of these anatomical points would be involved in a routine knee radiography?

Distal femur and patella Signup and view all the answers

What is the correct angulation of the CR for the PA axial weight-bearing bilateral knee projection using the Rosenberg Method?

10° only caudad Signup and view all the answers

In which position should the patient be for the PA axial weight-bearing projection of the knees?

Erect with knees flexed 45° Signup and view all the answers

Who should apply joint stress for knee stress projections?

The radiologist or orthopedic surgeon Signup and view all the answers

What condition is indicated by using a bilateral knee weight-bearing projection?

Cartilage degeneration Signup and view all the answers

What is typically evaluated using stress projections of the knee?

Joint integrity Signup and view all the answers

Which view is used to assess the left knee in a patient with osteopenia?

AP medial oblique view Signup and view all the answers

Which of the following conditions would a bilateral knee weight-bearing projection help assess?

Osteoarthritis Signup and view all the answers

What should patient positioning ensure during the knee radiographic projections?

Optimal visibility of joint spaces Signup and view all the answers

Study Notes

Knee Radiography Lecture Notes

The lecture covers radiographic anatomy and positioning of the knee joint.
Learning objectives include identifying reasons for knee radiography, listing routine projections, and describing positioning methods.
Required readings include specific chapters and pages from textbooks by Bontrager and Lampignano and McQuillen Martensen. Additional reading is recommended for specific knee projections.
The knee joint is composed of four bones: femur, tibia, fibula, and patella.
Anatomical details include the popliteal surface, patellar surface, medial and lateral epicondyles, medial and lateral condyles, and the intercondylar fossa.
The knee joint is primarily the femorotibial joint (FTJ), a synovial hinge joint. The patellofemoral joint (PFJ) is a modified hinge joint.
Cruciate ligaments (ACL and PCL) and collateral ligaments (MCL and LCL) control knee movement.
Reasons for knee x-rays include injury or trauma to soft tissues (sprains, strains, tears, effusions), bones (fractures, dislocations), and diseases (acquired or congenital).
A horizontal beam lateral is essential for detecting lipohemarthrosis which is blood and fat leakage in a suprapatellar pouch.
Possible fractures due to trauma or pathological reasons include supracondylar fractures of the distal femur, lateral tibial condyle fractures, and tibial plateau fractures.
Other conditions include osteochondritis dessicans, chondromalacia patellae, and conditions like synovial chondromatosis or osteochondromatosis.
Osgood-Schlatter's disease is inflammation of the bone and cartilage at the tibial tuberosity, commonly appearing in boys aged 10 to 15.
Technical considerations include the use of 100cm SID, small focal spot, kVp range 60-70, and short exposure time .
Basic views include AP and lateral projections. Additional views include intercondylar fossa, tangential projection of the patella, and stress views.
If implants exist, the full length of the implant must be shown in the image.
Patient preparation involves appropriate positioning, pain management, and potential use of a trolley for less mobile patients. Patients may need assistance getting onto the x-ray table, and should be provided with a gown and gonadal shielding.
Specific positioning details are included for the AP and lateral projections of the knee, as well as directions on how to determine proper positioning of the knee.
For the AP, the patient should be supine with the leg extended, the cassette centered over the apex of the patella. The femoral epicondyles should be parallel to the film plane, and the femorotibial joint space should be open. Internal rotation of 3-5 degrees may be necessary if required to obtain appropriate superposition. In patients with thin thighs, a caudal angulation is required; in patients with larger thighs, cephalad positioning is required.
For the lateral knee view, the patient should be turned to the affected side, the knee flexed between 20–30 degrees, cassette centred over the knee, and Central Ray directed 2.5cm distal to medial condyle and 5–7 degrees cephalad.

Supplementary Projections/Additional Projections/Additional radiographic projections

Oblique projections highlight the patella.
Weightbearing projections, both AP and PA axial (Rosenberg Method).

Activity 1: Clinical Rationale Discussion Point

Two critical technical considerations for detecting lipohaemoarthrosis include the horizontal beam method and accurate exposure.

Activity 2: Radiographic Projections of the Knee

Determining the correct CR angulation for the PA axial weightbearing projection (Rosenberg Method) is needed.

References

The presentation provides a list of relevant references.

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Description

Test your knowledge on knee anatomy, including ligaments, menisci, and imaging techniques. This quiz covers the functions of various knee components, common injuries, and optimal radiographic positioning. Perfect for students in medical imaging or anatomy courses.