Deck 7: Normal Variants

Question 1

What is the name of an ossicle located anteriorly between the anterior tubercle of atlas and the occiput?

A) Limbus bone
B) Bergman's ossicle
C) Oppenheimer's ossicle
D) Pro-atlas ossicle

Answer 1

Pro-atlas ossicle

Question 2

Although competing theories of etiology exist, persistence of the odontoid growth center leading to the formation of a separate odontoid bone is known as __________.

A) os terminale
B) os odontoideum
C) odontoid process agenesis
D) Bergman's defect

Answer 2

os odontoideum

Question 3

A single, thin, horizontal, radiolucent shadow of a vascular channel traversing the middle of the vertebral body describes __________.

A) diastematomyelia
B) Hahn's fissure
C) VACTERL syndrome
D) Srb's anomaly

Answer 3

Hahn's fissure

Question 4

An appearance of multiple radiolucent areas of calvarial thinning seen in newborns and infants describes __________.

A) encephalocele
B) lacunar skull
C) diastematomyelia
D) Arnold-Chiari malformation

Question 5

One or multiple levels of blocked segmentation, often associated with a clinical triad of low hairline, limited range of motion, and a short webbed neck, describes __________.

A) Klippel-Feil syndrome
B) Kirner's deformity
C) VACTERL syndrome
D) hemivertebra

Question 6

Which of the following statements is characteristic of a limbus bone?

A) Usually noted at the anterior-superior margin of a middle lumbar segment
B) Typically greater than 1 cm in diameter
C) Caused by central intravertebral disc herniations
D) A permanently separated portion of the vertebra's spinous process

Question 7

Which of the following statements does not pertain to the agenesis of the posterior arch of atlas?

A) A C2 megaspinous may accompany the defect.
B) It is less common than the agenesis of the anterior arch of atlas.
C) Enlargement of the anterior tubercle of atlas may accompany the defect.
D) Flexion-extension radiographs should be taken to view the integrity of the transverse atlantal ligament.

Question 8

Which of the following statements about calcification of the pineal gland is true?

A) It is more concerning when found in an adult than a child.
B) It is more concerning when found in a child than an adult.
C) It is present in about 80% of all children.
D) It is present in about 80% of all adults.

Question 9

A congenital block vertebra often displays all of the following features except __________.

A) a rudimentary intervertebral disk
B) fusion of the posterior arches
C) wasp waist
D) small intervertebral foramina

Question 10

Nuclear impression is marked by subtle, gradual inward defects of the _______. In the lateral radiographic projection, they appear as a ______ deformity.

A) vertebral bodies, concave
B) endplates, concave
C) endplates, convex
D) vertebral bodies, convex

Question 11

Small, irregular islands of bone located within sutures of the skull are known as __________.

A) sesamoid bones
B) wormian bones
C) digital impressions
D) habenular calcification

Question 12

All of the following pertain to cervical ribs except __________.

A) they occur in about 1% of the population
B) they are most common at C7
C) they occur bilaterally two thirds of the time
D) they have an absent costotransverse joint

Question 13

A radiolucent defect of the skull representing a congenital inclusion of ectoderm, mesoderm, and endoderm is seen with a __________.

A) dermoid
B) lacunar skull
C) basilar invagination
D) doughnut lesion

Question 14

Sinusitis, bronchiectasis, and situs inversus are seen with which of the following syndromes?

A) Meckel-Gruber
B) Morgan-Stewart-Morel
C) Goldenhar
D) Kartagener's

Question 15

What is the term for the partial or complete fusion of the atlas to the base of the occiput?

A) Pro-atlas ossicle
B) Lacunar skull
C) Occipitalization of atlas
D) Pseudosubluxation of C1

Question 16

A Swischuk line may be used to differentiate a true injury of C2 from __________.

A) os odontoideum
B) spina bifida occulta at C2
C) pseudosubluxation of C2
D) agenesis of the pedicle at C2

Question 17

The presence of myelomeningocele with varying degrees of caudal displacement of the cerebellar tonsils and hindbrain describes __________.

A) Kirner's deformity
B) Meckel-Gruber syndrome
C) Arnold-Chiari malformation
D) Kartagener's syndrome

Question 18

The combination of a caudal elongation of the L5 spinous and spina bifida occulta of S1, which is associated with pain on lumbar extension, is known as __________.

A) clasp knife syndrome
B) Baastrup's phenomenon
C) imbrication
D) diastematomyelia

Question 19

The atlantodental interval (ADI) should measure less than ____ mm in adults and less than ____ mm in children.

A) 3, 5
B) 5, 3
C) 2, 4
D) 4, 2

Question 20

The approximation and resulting pseudoarthrosis of two or more spinous processes describes __________.

A) butterfly vertebra
B) shingling
C) Klippel-Feil syndrome
D) Baastrup's phenomenon

Question 21

Multiple Schmorl's nodes that are associated with endplate irregularity and trapezoidal configuration of the vertebrae is seen with __________.

A) Bertolotti's syndrome
B) Scheuermann's disease
C) Kartagener's syndrome
D) Turner-Fong syndrome

Question 22

Which of the following is the most common location for a transitional segment?

A) Lumbosacral junction
B) Cervicothoracic junction
C) Thoracolumbar junction
D) Occipitocervical junction

Question 23

Carpal coalition is most common between the __________.

A) lunate and triquetrum
B) lunate and capitate
C) scaphoid and trapezium
D) scaphoid and lunate

Question 24

Iliac horns are virtually pathognomonic of a rare inherited condition known as __________.

A) Kartagener's syndrome
B) Bertolotti's syndrome
C) Turner-Fong syndrome
D) Goldenhar syndrome

Question 25

Which of the following statements is true in regards to costal cartilage calcification?

A) It is more common in women.
B) It typically has a unilateral and asymmetrical presentation.
C) It generally begins at the first rib level and progresses to inferior levels.
D) It is uncommon.

Question 26

Which of the following is a deformity where the anterior chest wall sharply protrudes anteriorly?

A) Pectus excavatum
B) Srb's anomaly
C) Pectus carinatum
D) Kirner's deformity

Question 27

Inward migration of the medial wall of the acetabulum can be assessed with __________ line.

A) Shenton's
B) Kline's
C) Kohler's
D) Chamberlain's

Question 28

An ununited apophysis at the tip of the superior or inferior articular process of a thoracic or lumbar vertebra is known as a(n) __________.

A) limbus bone
B) Oppenheimer's ossicle
C) Bergman's ossicle
D) nuchal bone

Question 29

Calcification of the vas deferens is associated with chronic __________.

A) diabetes
B) prostatitis
C) prostate cancer
D) alcoholism

Question 30

What type of lumbosacral agenesis demonstrates partial sacral agenesis with bilateral symmetric defects, but intact sacroiliac joints with the first sacral segment?

A) Type I
B) Type II
C) Type III
D) Type IV

Question 31

Of those listed, the least likely vertebra to exhibit spina bifida occulta is __________.

A) Atlas
B) L5
C) T12
D) S1

Question 32

There is a controversial relationship in the literature between the presence of negative ulnar variance and the occurrence of __________.

A) Turner's syndrome
B) Keinbock's disease
C) Leri Weil disease
D) Down syndrome

Question 33

Which of the following is true about pectus excavatum?

A) It is an outward deformity of the chest wall.
B) It is three times more common among females.
C) It is also known as keel chest.
D) It becomes most prominent during the rapid growth phase of adolescence.

Question 34

Which of the following is not a characteristic of injection granulomas?

A) Common in the buttocks
B) Less than 2 centimeters in diameter
C) Stellate shape
D) Homogenous appearance

Question 35

Which of the following is characteristic of accessory ossicles?

A) They are typically displaced from the host bone.
B) They are most often found bilaterally and symmetrically.
C) They are irregularly shaped.
D) They have a partially corticated periphery.

Question 36

Normal, bilateral, and symmetrical irregularities along the lower margin of the medial ends of the clavicles defines __________.

A) Srb's anomaly
B) clavicle companion shadow
C) clavicle medial apophysis
D) rhomboid fossae

Question 37

What is the term for a lumbosacral transitional segment that presents with scoliosis and sciatica?

A) Scheuermann's disease
B) VACTERL syndrome
C) Kartagener's syndrome
D) Bertolotti's syndrome

Question 38

A bilateral triangular-shaped hyperostosis of the lower, medial portion of the ilium immediately adjacent to the lower portion of the sacroiliac joint describes __________.

A) osteitis condensans ilii
B) ankylosing spondylitis
C) iliac horns
D) iliac vascular channel

Question 39

An anomalous bony eminence at the base of the second or third metacarpal is known as __________.

A) a carpal coalition
B) Kirner's deformity
C) Madelung's deformity
D) a carpal boss

Question 40

Which type of transitional vertebrae consists of a pseudojoint between the broad transverse process of the transitional lumbar segment and the superior margin of the sacrum?

A) Type II
B) Type I
C) Type III
D) Type IV

Question 41

A femoral angle less than 120 degrees is known as ____________.

A) coxa valga
B) acetabular protrusion
C) coxa vara
D) pes planus

Question 42

A 58-year-old male patient with low back pain discloses no history of previous medical diagnoses on initial work-up in your clinic. Radiographic evaluation reveals bilateral, tube-like Y-shaped calcifications in the lower middle pelvic soft tissues. Which laboratory evaluation would likely be positive?

A) Erythrocyte sedimentation rate
B) C-reactive protein
C) Alkaline phosphatase
D) Prostate-specific antigen
E) Glucose tolerance test

Question 43

The posterior ponticle of the atlas is observed bilaterally in what percent of the general population?

A) 1%
B) 5%
C) 10%
D) 15%
E) 25%

Question 44

In order to accurately determine lumbarization or sacralization in the case of transitional lumbosacral vertebra, segment count must be made down from which vertebrae?

A) C0
B) C1
C) T1
D) T12
E) L1

Question 45

Nuclear impressions normally demonstrate what radiographic sign on computed tomography examination?

A) Oppenheimer
B) Cupid's bow
C) Owl
D) Scottie dog
E) Bowline of Brailsford

Question 46

Which diagnosis best explains unilateral absence of a pedicle with contralateral pedicle sclerosis and hypertrophy in a young patient with acute onset low back pain?

A) Metastasis
B) Osteoid osteoma
C) Neurofibromatosis
D) Congenital agenesis
E) Osteomyelitis

Question 47

Which ligament is typically ossified in patients complaining of pain in the orbit and temporal region, foreign body sensation in the throat, and dysphagia?

A) Anterior longitudinal
B) Posterior longitudinal
C) Interspinous
D) Petroclinoid
E) Stylohyoid

Question 48

A 22-year-old male patient presents with the chief complaint of intermittent low back pain. Radiographic examination reveals a slightly narrowed L5 intervertebral disc without evidence of osteophytosis, intervertebral disc vacuum, subchondral sclerosis, or endplate defects. Which of the following best explains the morphology of the L5 intervertebral disc?

A) Degeneration
B) Infection
C) Hypoplasia
D) Inflammatory disease
E) Disc herniation

Question 49

Where is the second fragment located in type III bipartite patella?

A) Lateral
B) Superolateral
C) Inferior
D) Inferomedial

Question 50

Which radiographic projection would be most helpful in differentiating ankylosing spondylitis from osteitis condensans ilii in a 35-year-old male patient with bilateral sacroiliac joint pain?

A) AP lumbar
B) AP pelvis
C) Oblique lumbar
D) Oblique sacroiliac joint
E) Lateral sacrum

Question 51

Which radiographic projection would be most helpful in differentiating prominent calcification of the first costal cartilage from apical lung mass?

A) PA chest
B) Apical lordotic
C) AP thoracic
D) AP cervical
E) Expiration chest

Question 52

The most common congenital malformation of the hand is __________.

A) Madelung's deformity
B) polydactyly
C) clinodactyly
D) Kirner's deformity

Question 53

Which of the following diagnoses best explains a well-marginated 9 mm ossicle in close proximity to the anterior superior margin of the L3 vertebra in a young nontrauma patient with low back pain?

A) Intercalary ossicle
B) Teardrop fracture
C) Intervertebral disc calcification
D) Peripheral Schmorl's node
E) Limbus bone

Question 54

A patient of short stature presents to your office with wrist pain, decreased wrist ranges of motion, and bowing deformity of the distal upper extremity. Radiographic examination of the wrist reveals a short radius, elongated ulna, decreased carpal angle, and V-shaped proximal carpal row. Which diagnosis is most likely?

A) Achondroplasia
B) Pyknodysostosis
C) Dyschondrosteosis
D) Down syndrome
E) Chondroectodermal dysplasia