Show
Citation, DOI & article dataCitation: Gaillard, F., Knipe, H. Osgood-Schlatter disease. Reference article, Radiopaedia.org. (accessed on 09 Oct 2022) https://doi.org/10.53347/rID-1786 Osgood-Schlatter disease, also known as apophysitis of the tibial tubercle, is a chronic fatigue injury due to repeated microtrauma at the patellar tendon insertion onto the tibial tuberosity, usually affecting boys between ages 10-15 years. On this page:Unresolved Osgood-Schlatter disease is the term given to clinical and radiological findings that persist into adulthood 10. Osgood-Schlatter disease is seen in active adolescents, especially those who jump and kick. It is bilateral in 25-50% of patients 1-3. The typical age of onset in females may be slightly earlier (boys 10-15 years; girls 8-12 years) 8. Clinically, patients present with pain and swelling over the tibial tuberosity exacerbated with exercise. Plain radiographSoft tissue swelling with loss of the sharp margins of the patellar tendon is the earliest sign in the acute phase; thus, a compatible history is also essential in making the diagnosis. Bone fragmentation at the tibial tuberosity may be evident 3 to 4 weeks after the onset. It is important not to equate isolated 'fragmentation' of the apophysis with OSD, as there may well be secondary ossification centers. UltrasoundUltrasound examination of the patellar tendon can depict the same anatomic abnormalities as can plain radiographs, CT scans, and magnetic resonance images. The sonographic appearances of Osgood-Schlatter disease include 3:
MRIMRI, as expected, is more sensitive and specific, and will demonstrate:
Treatment and prognosisTreatment is usually conservative and involves rest, ice, activity modification (decreasing activities that stress the insertion, especially jumping and lunging sports), and quadriceps and hamstring strengthening exercises. Analgesia and padding to prevent pressure on the tibial tuberosity are also useful. Only rarely are therapeutic casts required 4,5. The condition usually spontaneously resolves once the physis closes. In rare cases, surgical excision of the bone fragment(s) and/or free cartilaginous material may give good results in skeletally mature patients who remain symptomatic despite conservative measures 10. Adults with findings of prior Osgood-Schlatter disease are more likely to have patella alta and are at a higher risk of patellofemoral maltracking with subsequent chondrosis, and transient patellar dislocation 11. History and etymologyIt is named after American orthopedic surgeon Robert B Osgood (1873-1956)and Swiss professor of surgery Carl Schlatter (1864-1934). Imaging differential considerations include:
Related articles: Knee pathologyPromoted articles (advertising)the number of bones in the phalanges (Fingers and thumb) A radiograph of an AP projection of the foot reveals that the metatarsophalangeal joints are not open and the metatarsals are somewhat foreshortened. What positioning error was ivolved, and what modification should ne made to improve this image on he repeat exposure? CR is not angle properly: CR should be perpendicular to the metatarsals The number of bones of the metacarpals (palm) The number of bones of the carpals (wrist) Total number of the bones in the fingers, hand and wrist Name the two portions of the thumb Distal Phalanx and Proximal Phalanx Name the three portions of each finger (second through fifth digits) Distal Phalanx (the end) Name the three parts to each phalax Head (distal) List the three parts of each metacarpal starting proximally Name the joint between the proximal and distal phalanges of the first digit What are the joints between metacarpals and phalanges What are the eight bones of the carpals Scaphoid Which is the largest of the carpal bones What is the name of the hooklike process extending anteriorly from the hamate? What is the most commonly fractured carpal bone? In the anatomic position, which of the bones of the forearm is located on the lateral (thumb) side? Which is on the medial side? Is the trochlear notch part of the ulna, radius or humerus? Is the Radial notch part of the ulna, radius or humerus? Is the olecranon fossa part of the ulna, radius or humerus? Is the Trochlea part of the ulna, radius or humerus? Is the Coronoid tubercle part of the ulna, radius or humerus? Is the coronoid process part of the ulna, radius or humerus? Is the olecranon process part of the ulna, radius or humerus? Is the coronoid fossa part of the ulna, radius or humerus? Which joint permits the forearm to rotate during pronation? Proximal radioulnar joint The articular portion of the medial aspect of the distal humerus is called? The similar structure to the trochlea is found on the lateral aspect of the distal humerus is called? The deep depression located on the posterior aspect of the distal humerus The criteria for evaluating a true lateral position of the elbow are the appearance of the three concentric arcs. The first and smallest arc is the____________. The criteria for evaluating a true lateral position of the elbow are the appearance of the three concentric arcs. The intermediate double arc consists of the outer ridges of The capitulum and the trochlea The criteria for evaluating a true lateral position of the elbow are the appearance of the three concentric arcs. The third out side arc, which is part of the ulna is What is the correct joint movement Interphalangeal What is the correct joint movement Carpometacarpal of the first digit What is the correct joint movement elbow joint (humeroulnar and humeroradial) What is the correct joint movement metacarpophalangeal of second to fifth digits What is the correct joint movement Radiocarpal What is the correct joint movement intercarpal What is the correct joint movement elbow joint What is the correct joint movement proximal radioulnar joint ellipsoidal joints are classified as freely movable or ____________. diathrodial allows movement in how many directions What are the seven ligaments that are important in stability of the wrist joint? ulnar collateral ligament which ligament of the wrist extends from the styloid process of the radius to the lateral aspects of the scaphoid and trapezium bones? radial collateral ligament What position is most commonly performed to detect a fracture of the scaphoid bone? What is the kV range most commonly used for the upper limb radiography/ low to medium what is the exposure time commonly used for upper limb radiography? Is a large or small focal spot used for the upper limb What is the most common source image receptor distance (SID)? grids are used for the upper limb if the body part measures greater than_________. Type of intensification screens most commonly used for analog imaging for upper limb radiography. For upper limb radiography, small to medium dry plaster casts increase the kV by how much? For larger plaster casts increase the kV Fiberglass casts increase the kV by Correctly exposed upper limb radiographs: Visualize ______________ margins and ______________ marking of all bones. The general rule for collimation for upper limb radiography states: collimation borders should be visible on 4 sides with out cutting of essential anatomy Pertinent factors that help reduce image distortion during upper limb radiography 40 to 44 inches SID True or False Guardians of young pediatric patients who are having upper limb studies can be asked to hold their child during radiographic study A radiographic procedure that uses contrast media injected into the joint capsule to visualize soft tissue pathology of the wrist, elbow and shoulder joints What is the routine positioning for the second through 5th digits of the hand? How much of the metacarpals should be included for PA projection of the digits? distal aspect of metacarpals List the two radiographic criteria used to determine whether rotation is present on the PA projection of the digits. 1) Symmetric appearance of both sides of the shafts of phalanges and metacarpals 2) Equal amount of tissue on either side of phalages Where is the central ray centered for a PA oblique projection of the second digit? Identify which positioning modification(s) should be used for a study of the second digit to reduce distortion for a PA oblique projection Perform the medial oblique rather than the lateral to decrease OID Identify which of the positioning modification(s) should be used for a study of the second digit to reduce distortion for a lateral position. Thumb down lateral (mediolateral) Why is it important to keep the affected digit parallel to the IR for the PA oblique and lateral projections? To prevent distortion of the phalanx and joints To demonstrate small, nondisplaced fractures near the joint. Why is the AP projection of the thumb recommended instead of the PA? The AP Position produces a decrease in OID and increased resolution Which projection of the thumb is achieved naturally by placing the palmar surface of the hand in contact with the cassette? Which IR size should be used for a thumb projection? A sesamoid bone is frequently found adjacent to which joint of the thumb? Where is the central ray centered for an AP projection of the thumb? A Bennet's fracture involves: Which special positioning method can be performed to demonstrate a Bennett's fracture. Modified Robert's Method (AP axial projection of Thumb What degree of CR angulation is required for the modified Robert's Method (AP axial thumb)? Where is the CR centered for a PA projection of the hand? How much of the forearm should be included for a PA projection of the hand? (inches or cm) a minimum of 1 inch (2.5 cm) True/ False Slight superimposition of the distal third, fourth, and fifth metacarpals may occur with a well positioned PA oblique projection of the hand. Which preferred lateral position of the hand best demonstrates the phalanges without excessive superimposition? Which lateral projection of the hand best demonstrates a possible foreign body in the palm of the hand? What is the proper name for the position referred to as the "ball-catcher's position"? The ball catcher's position is commonly used to evaluate for early signs of: The elbow generally should be flexed ______ degrees for the routine positions of the wrist joint. How much rotation is required for an oblique projection of the wrist? Which alternative projection to the routine PA wrist best demonstrates the intercarpal joint spaces and wrist joint? AP projection with the hand slightly arched Which positioning error is involved if a majority of the carpal bones are superimposed in a PA oblique wrist projection? Excessive lateral rotation from PA Which one of the following fractures is not demonstrated in a wrist routine? A) Barton's B) Pott's C) Smith's D) Colles' B) Pott's a complete fracture to the distal fibula During the PA axial scaphoid projection with CR angle and ulnar flexion, the CR must be angled how? How much are the hand and wrist elevated from the IR for the modified Stecher method? With special projection of the wrist best demonstrates the interspaces on the ulnar side of the wrist between the lunate, triquetrum, pisiform and hamate bones? PA projection with radial deviation How much CR angulation to the long axis of the hand is required for the carpal canal (tunnel) projection? 25-30 degrees The less of the angle from the IR the more the angle of the CR Which special projection of the wrist helps rule out abnormal calcifications in the carpal sulcus? Tangential infrosuperior (the Gaynar-Hart projection) (Carpal Canal) How much CR angulation from the long axis of the forearm is required for the carpal bridge projection? 45 degrees toward the forearm A three-projection study of the hand was taken using the following analog exposure factors: 64 kV, 1000 mA, 1/100 second, large focal spot, 36-in SID, and high-speed screens. Which of these factors should be changed on future hand studies to produce more optimal images? Small focal spot 40 in SID Detail Speed Screens A radiograph of a PA projection of the second digit reveals that the phalanges are not symmetric on both sides of the bony shafts. Which specific positioning error is involved? A radiograph of a PA oblique projection of the hand reveals that the fourth and fifth metacarpals are super imposed. Which specific positioning error is involved? excessive lateral rotation In a radiographic study of the forearm, the proximal radius crossed over the ulna in the frontal projection. Which specific positioning error led to this radiographic outcome? PA was performed rather than AP A PA axial scaphoid projection of the wrist using a 15 degree distal CR angle and ulnar flexion was performed. The resultant radiograph reveals that the scaphoid bone is foreshortened. How mush this projection be modified to produce a more diagnostic image of the scaphoid? The CR needs to be angled 15 degrees proximal, toward the elbow A radiograph of a lateral projection of the elbow reveals that the humeral epicondyles are not superimposed and the trochlear notch is not clearly demonstrated. Which specific type of positioning error is involved? The forearm and humerus are not ion the same plane Situation: A patient with a metallic foreign body in the palm of the hand enters the emergency room. Which specific positions should be used to locate the foreign body? PA and lateral in extention Situation: A patient with a possible fracture of the radial head enters the emergency room. When the technologist attempt to place the arm in the AP oblique-lateral rotation position, the patient is unable to extend or rotate the elbow laterally. Which other positions can be used to demonstrate the radial head and neck without superimposition on the proximal ulna? Coyle method for radial head Situation: A patient with a trauma injury enters the ER with an evident Colles' fracture. Which positioning routine should be used to determine the extent of the injury? AP and lateral forearm and include wrist Situation: A patient with a dislocated elbow enters the ER. the patient has the elbow tightly flexed and is careful not to move it. Which specific positioning routine can be used to determine the extent of the injury? 2 AP projections with acute flexion and lateral flexion Situation: A patient with a possible fracture of the trapezium enters the ER. the routine projections do not clearly demonstrate a possible fracture. Which other special projection can be taken? modified Robert's method (AP thumb with CR at 15 degrees toward wrist). Situation: A patient with a history of carpal tunnel syndrome comes to the radiology department. The orthopedic physician suspects that bony changes in the carpal sulcus may be causing compression of the median nerve. Which special projection best demonstrates this region of the wrist? Gaynor-Hart method (carpal canal position) Situation: A patient comes to the radiology department for a hand series to evaluate early evidence of rheumatoid arthritis. Which special position can be used in addition to the routine hand projections to evaluate this patient? Norgaard method (Ball catcher's position) Situation: A patient is referred to radiology with a possible injury to the ulnar collateral ligament. The patient complains of pain near the first MCP joint. Initial radiographs of the hand do not indicate any fracture or dislocation. Which special projection can be performed to rule out an injury to the ulnar collateral ligament? PA stress (Folio method) Projection Situation: A patient enters the ER with a possible foreign body in the dorsal aspect of the wrist. Initial wrist radiographs are inconclusive in demonstrating the location of the foreign body. What additional projection can be performed to demonstrate this region of the wrist? Tangential projection- Carpal bridge projection Situation: (Trauma axial lateral projection) Coyle Method for coronoid process A radiograph of an AP oblique medial rotation projection of the foot reveals that the proximal third to fifth metatarsals are superimposed.What type of positioning error led to this radiographic outcome? Over rotation of the foot medially A radiograph of a plantodorsal axial projection of the calcaneus reveals considerable foreshadowing of the calcaneus. What type of positioning modification is needed on the repeat exposure? Increase cephalaud angel of CR to correctly elongate the calcaneus A radiograph of an AP oblique with medial rotation of the knee to demonstrate the proximal fibula reveals that there is total superimposition of the proximal tibia and the fibula. What must be modified to correct this projection? The wrong oblique position of the knee was obtained. This describes a lateral oblique position of the knee A radiograph of an AP lateral tibia and fibula reveals that the ankle joint is not included on the AP projection, but both the knee and the ankle are included on the lateral projection. What should the technologist do in this situation? Repeat the AP projection to ensure ankle joint is demonstrated A patient with a history of degenerative disease of teh left knee joint comes to the radiology dept. The orthopedic surgeon orders a radiographic study to determine the extent of damage to the joint space. Which projection should be performed? AP or PA weight-bearing bilateral knee projection A patient with a history of pain in the feet comes to the radiology dept. The referring physician orders a study to evaluate the longitudinal arches of the feet. Which positioning routine should be used? AP and lateral weight bearing projection A patient with bony, loose bodies (or joint mice) within the knee joint comes to radiology for a knee series. The AP and lateral knee projections fail to demonstrate any loose bodies. What additional knee projection can be taken to better demonstrate them? Intercondylar fossa projection including PA axial projections (Holmblad, Rosenburg, and Camp Coventry) A young male patient comes to the radiology department with a clinical history of Osgood-Schlatter disease. Which single projection of the basic knee series will best demonstrate this condition? Which of the following is not an aspect of the metatarsal? Head Where are the sesamoid bones of the foot most commonly located? Plantar surface near head of first metatarsal True or False The distal portion of the fifth metatarsal is a common fracture site. False What is the name of the tarsal bone found on the medial side of the foot between the talus and three cuneiforms?
Which tarsal bone is considered to be the smallest? What is another term for the talocalcaneal joint? The distal tibial joint surface is called the True or False The mortise of the ankle should be totally open and visible on a correctly positioned AP projection of the ankle. False The lateral aspect of the ankle joint would not be open The trochlear process is located on what bone? the lateral malleolus is located on which bone? What is the second largest tarsal bone? Found between the navicular and base of the first metatarsal What is the proximal part of a metatarsal bone called Found between the calcaneus and talus The anterior tubercle is found on which bone? What is the correct central ray centering placement for an AP projection of the toes? Which type of central ray angle is required for an AP projection of the toes? What projection is used for the sesamoid bones of the foot? How much foot rotation is required for the medial oblique projection of the foot? What is another term for the AP projection of the foot? What CR angle is generally required for the AP projection of teh foot? Which projection of the foot best demonstrates the cuboid? AP oblique with medial rotation What is another term for the intercondyloid eminence? What is the name of the deep depression found on the posterior aspect of the distal femur? A line drawn across the most distal aspect of the medial and lateral femoral condyles would be __________ from being at a right angle (90 degrees) to the long axis of the femur. True or False The angle from the most distal aspect of the medial and lateral femoral condyles would be less than 5 to 7 degrees on a tall, slender person. The upper or superior portion f the patella is called the Which two ligaments of the knee joint help stabilize the knee from the anterior and posterior perspective? Which structures serve as shock absorbers within the knee joint? Which one of the following conditions may cause the tibial tuberosity to be pulled away from the tibial shaft? Gout Which of the following pathologic conditions involves a large band ligament found in the foot? Reiter's syndrome Which one of the following conditions may produce the radiographic appearance of a destructive lesion with irregular periosteal reaction? Osteogenic sarcoma What is the common term for chondromalacia patellae? Where is the CR placed for a polantodorsal axial projection of the calcaneus? Base of the third metatarsal Which ankle projection is best for demonstrating the mortise of the ankle? AP oblique (15 to 20 degree medial rotation) Which projection of the knee will best demonstrate the neck of the fibula without superimposition?Ch 6-7 Bontrager. What is one advantage of the Lateromedial projection of the foot?The lateromedial projection is useful in evaluating the relationship of the distal phalanx with the hoof capsule and distal limb (hoof-pastern axis), location of break-over, shoe placement, and quantitative parameters.
How much flexion of the knee is recommended for the lateral projection of the patella?RADT 316. Which of the following imaging modalities and/or procedures will provide the best assessment for osteomyelitis of the foot?Magnetic resonance imaging is the most sensitive and most specific imaging modality for the detection of osteomyelitis and provides superb anatomic detail and more accurate information of the extent of the infectious process and soft tissues involved.
|
Which one of the following projections will best demonstrate signs of osgood-schlatter disease?
zusammenhängende Posts
Urheberrechte © © 2024 paraquee Inc.
