5.14 Imaging of MSK System

Question 1

what’s US frequency?

Answer 1

2 – 15 MHz

Question 2

what’s a hemangioma?

Answer 2

A benign tumor of endothelial cells similar to that found in vascular tissue, occurring at infancy.

Question 3

what’s a neurofibroma?

Answer 3

benign nerve sheath tumor in the peripheral nervous system

Question 4

List some advantages to US imaging

Answer 4

Non-ionizing
High-resolution
Realtime
Dynamic
Multi planar
Multi-modality
Portable
Cost effective

Question 5

this one’s a doozy: list the top 10 reasons Musculoskeletal Sonography is an Important Complementary or Alternative Technique to MRI

Answer 5

Reason 1: Every Patient Can Undergo Sonography
Reason 2: Sonography Can Resolve Finer Details than MRI
Reason 3: Sonography Allows Real-Time Dynamic Examination of the Patient
Reason 4: The Ultrasound Probe Can Be Placed Exactly Where It Hurts
Reason 5: Sonography Can Effectively Image Patients with Surgical Hardware
Reason 6: Doppler Sonography Gives Important Physiologic Information
Reason 7: Sonography Is Better for Differentiating Fluid from Solid Material
Reason 8: Sonography Is Better for Guiding Therapeutic Interventions
Reason 9: Sonography Facilitates Bilateral Comparison
Reason 10: Sonography Has a More Flexible Field of View

Question 6

what’s a liposarcoma?

Answer 6

Malignant tumor of fat cells originating in the deep soft tissue

Question 7

list 4 low back pain red flags

Answer 7

Trauma/Fracture
Infections/Cancer
Cauda Equina/Progressive Neurological Deficit
Rupture of Aortic Aneurysm

Question 8

what’s cauda equina syndrome?

Answer 8

Compression of the nerves in the lower portion of the spinal canal

Question 9

what’s Spondylolisthesis?

Answer 9

abnormal forward slip of one vertebral body on a neighboring vertebral body

Question 10

what’s Ankylosing Spondylitis?

Answer 10

Chronic, inflammatory arthritis and autoimmune disease. It mainly affects joints in the spine and the sacroilium in the pelvis, causing eventual fusion of the spine.

Question 11

what’s Osteoporosis?

Answer 11

Change in bone mineralization leading to bone loss

Question 12

there are 4 boring but important diagnostic techniques for Osteoporosis. Name them

Answer 12

1. Take two X-ray images at different energy levels
2. Estimate (by computer) bone mineral content using X-ray absorption due to calcium at known anatomical locations
   - Lumbar spine A-P
   - Proximal femur
3. Compare mineral content with that of a “young adult mean – T-score”
4. Compare mineral content with the “age-matched mean – Z-score”

Question 13

what causes tear drop fracture?

Answer 13

Violent, Hyper Flexion of Neck

Question 14

what’s “ivory vertebra?”

Answer 14

Blastic metastases