Diagnosic Imaging/Tests

Question 1

Radiopaque

Answer 1

-Metal/lead/bone
-white/grey

Question 2

Radiolucent

Answer 2

-air/gas
-black

Question 3

CT Scan

Answer 3

-Conventional Tomography
-different depths of bone, complex
-computer mathmatically reconstructs image
-expensive
-high radiation
-some soft tissues

Saggital view: left and right
Coronal: front and back
Axial: transverse

Question 4

Bone Scan

Answer 4

-distribution and metabolic activity of disease in bone
-lack of soft tissue
-substance injected to watch metabolic uptake
-moderate radiation

Question 5

MRI

Answer 5

-Magnetic Resonance imaging
-soft tissue focused (joints)
-no radiation
-body’s absorbed radio frequencies
-expensive

T1:
-weighted image
-fat brightest
-best anatomical definition

T2:
-weighted image
-water shows brightest
-swelling

Magnetic Resonance Arthrogram
-use contrast into joint

Question 6

Diagnostic Ultrasonograph

Answer 6

-reflected sound waves and tissue absorption
-leision to muscles and tendons
-real time
-dependent on operator
-no deeper structures
-based on echogenicity

Question 7

Radigraphy

Answer 7

-bony anatomy
-not good for soft tissues
-xray
-cheaper

Question 8

Echogenicity

Answer 8

Hyperechoic (fast): white (bone, tendon, ligament, nerve, muscle)
Hypochoic: dark (nerve, background of muscle)
Anechoic (slow): black (vasculature, cyst)
Isoechoic: relatively same

Question 9

DEXA

Answer 9

-Dual x-ray absorptiometry
-serial testing
-inconsistent devices
-tissue density, bone mass
-low radiation

Question 10

Bone T-Scores

Answer 10

Osteoporosis: -2.5 SD away from mean
Osteopenia: less than -1.0–2.5 SD from mean

Question 11

Pittsburgh Guidlines for Knee Trauma

Answer 11

-Guidelines for needing imaging after knee injury

-if you’ve had a MOI to knee (imaging)
-<12 (growth plate) or >50 (bone density) (imaging)
-Inabilitty to weight bear for 4 steps (imaging)

Question 12

Canadian Cervical Spine Rule

Answer 12

-guidlines for immobilization and/or imaging after trauma to neck
-positive= refer

1. High risk factor for immobilization (any of these)
   ->65
   - dangerous MOI
   -Numbness and tingling in extremities
2. Low risk factor for assessment of ROM
   -Complex rearending
   -cannot ambulate
   -neck pain
   -pain at midline of c-spine
3. Can Ptt voluntarily actively rotate 45deg
   -yes: treat
   -no: immobilize and image

Question 13

Ottawa Knee Rule

Answer 13

-guidlines for imaging based on pain

->55
-Tenderness at head of fib
-isolated tenderness to patella
-inability to flx 90
-inability to weight bear 4 steps

Question 14

Ottawa Ankle and foot Fracture rules

Answer 14

Midfoot zone Rules:
-Inability to bear weight
-tenderness to base of 5th MT
-Tenderness to navicular

Malleolar zone rules:
-inability to bear weight
-tenderness to posterior lateral malleolus
-tenderness to posterior medial malleolus

Question 15

New Orleans Criteria

Answer 15

-for suspecting head injury (must have GCS 15)

-HA
-vomiting
- >60
- intoxication
-short term memory deficits
-physical evidence of trauma above clavicle
-seizure

Question 16

Canadian CT Head Rule

Answer 16

-for suspecting head injury (must have GCS 13-15)

-failure to reach 15 on GCS within 2 hours
-suspected open skull fx
-signs of basal skull fx
-vomiting 1+
->64y
-amnesia before impact >30mins
-dangerus MOI