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Selected Topics > Diagnostic Imaging > Flashcards

Diagnostic Imaging Flashcards

1
Q

Why is diagnostic imaging lower on an evaluation algorithm?

A
  • it could bias the evaluation process
  • should support the evaluation, not form it
  • it is considered as a special test
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2
Q

How many views should you get when ordering diagnostic imaging?

A

At least two

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3
Q

What views should you get for the lumbar spine?

A

anterior-posterior and lateral (not oblique)

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4
Q

Should you get AP or PA views when imaging for scoliosis? Why?

A

PA… there is a 3-7x reduction in lifetime ionizing radiation

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5
Q

definition: film comes out as black/grey due to the lack of absorption of ionizing radiation in LESS dense materials

A

radiolucent

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6
Q

definition: film comes out as white due to the absorption of ionizing radiation in MORE dense material

A

radiopaque

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7
Q

definition: when the bone becomes more dense due to calcium deposition to the area causing the bone to become thicker/stronger

A

osteoblastic activity

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8
Q

definition: when there is a depletion of calcium making the bone weaker/thinner

A

osteoclastic activity

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9
Q

What type of radiograph activity is radiopaque (whiter) indicating an increased radiodensity? Osteoblastic or osteoclastic?

A

osteoblastic

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10
Q

What type of radiograph activity is radiolucent (darker) indicating a decreased radiodensity? Osteoblastic or osteoclastic?

A

osteoclastic

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11
Q

What has the highest radiodensity?

A

heavy metals

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12
Q

What has the lowest radiodensity?

A

air

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13
Q

What does the acronym ABCs stand for?

A

Alignment
Bone density
Cartilage spaces
Soft tissues

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14
Q

What is important about spaces between the bones?

A

it can give information on how healthy the surrounding soft tissue is

–> decreased space can be indicative of OA

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15
Q

(true/false) When looking at radiographs, you should look at the most obvious things first.

A

False

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16
Q

What can you see on a radiograph that can be an indication of a fracture?

A

lightening bolts in the periosteum and cortex

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17
Q

What could a twisting line on a bone be instead of a fracture?

A

it could be a nutrient artery going into the bone

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18
Q

What are looked for when inspecting the alignment of the spinal column?

A

Spinal lines

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19
Q

What are the spinal lines?

A

anterior spinal line
posterior spinal line
spinolaminal line
spinous process line

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20
Q

When looking at a tag in a radiograph, if the ball-bearings are in the middle, what position was the photo taken in?

A

NWB

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21
Q

A Hangman’s fracture is a fracture in the ____ vertebrae.

A

C2

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22
Q

A clay shoveler’s fracture is a fracture in the ____ vertebrae.

A

C6/C7

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23
Q

Describe a Grade I fracture.

A

Fracture is only through the physis

24
Q

Describe a Grade II fracture.

A

fracture is through the physis and metaphysis

25
Q

Describe a Grade III fracture.

A

fracture is through the physis and epiphysis

26
Q

Describe a Grade IV fracture.

A

fracture is through the physis, metaphysis, and epiphysis

27
Q

Describe a Grade V fracture.

A

crush/pressure injury to the physis

28
Q

What are characteristics of a vertebrae that has arthritis?

A

Bumps/bone spurs/beaking
Rough surface
Vertebral bodies begin to look like an hourglass
Can start in mid-20s

29
Q

definition: imaging that uses radio frequency impulses in a magnetic field with a small amount of radiation

A

MRI

30
Q

MRI works by alignment of nuclei with an odd # of protrons/neutrons (parallel/perpendicular) to the magnetic field

A

parallel

31
Q

What are T1 weighted images?

A

fattier contents become white

32
Q

What are T2 weighted images?

A

Water contents become white

33
Q

What type of weighted MRI best demonstrates anatomic structure?

A

T1

34
Q

What type of weighted MRI is most helpful in contrasting normal and abnormal tissue?

A

T2

35
Q

Water, CSF, acute hemorrhage, and soft tissue tumors appear (dark/bright) on a T1 MRI and (dark/bright) on a T2 MRI.

A

dark, bright

36
Q

What type of radiography is the most sensitive method for detection of early osteonecrosis?

A

MRI

37
Q

What type of radiography is the most sensitive method for detection PCL?

A

MRI

38
Q

What type of radiography is the most sensitive method for detection of occult fractures?

A

MRI

39
Q

What percent of subjects > 40 y/o have an abnormality found in their c-spine on an MRI?

A

28%

40
Q

What percent of subjects < 40 y/o show evidence of lumbar disc herniation with MRI imagining?

A

20-30%

41
Q

What percent of subjects > 60 y/o show evidence of degeneration and bulging of one or more lumbar disc on an MRI?

A

93%

42
Q

What percent of patients cannot tolerate MRI machines due to claustrophobia?

A

10%

43
Q

What diagnostic imaging is great for identifying spinal lesions?

A

CT

44
Q

What diagnostic imaging demonstrates bony abnormalities better than any other study?

A

CT

45
Q

What diagnostic imaging is valuable for evaluating the following:
- C1/C2 subluxation
- subtalar joint and coalitions

A

CT

46
Q

definition: Uses marker (Technetium-99m phosphate) to reflect increased blood flow & metabolism/metabolic uptake

A

bone scans (nuclear medicine tests)

47
Q

What diagnostic is very useful in diagnosis of subtle fractures, avascular necrosis, decreased bloodflow, osteomyelitis, THA/TKA loosening?

A

bone scan (nuclear medicine tests)

48
Q

What ultrasound transducer is a mid-range transducer?

A

linear

49
Q

What ultrasound transducer is used for deeper structures (hip joint, fetus, etc)?

A

curved linear

50
Q

What ultrasound transducer is used when looking at very superficial structures?

A

compact linear (hockey stick)

51
Q

What is the single most over-requested diagnostic imaging procedure?

A

lumbar radiography

52
Q

What is not recommended for acute LBP (<1 month)?

A

lab tests
radiographs
advanced imaging

53
Q

What are exceptions to order special tests for acute LBP (<1 month)?

A

age > 50
history of primary cancer
unexplained weight loss
progressive neurological deficit
severe radicular pain
suspicion for Fx or infection
patient request

54
Q

What is the indication for an oblique projection view of the lumbar spine?

A

suspicion of a fracture in the pars interarticularis

55
Q

What is it called when a lumbar vertebrae has no anterior migration but the pars interarticularis is fractured?

A

spondylolysis

56
Q

What is the weakest portion of a vertebrae?

A

pars interarticularis

57
Q

(true/false) MRI is probably not medically necessary in adult patient with low back pain without neurological deficits AND without signs of serious disease or “red flags” unless surgery is being considered.

A

true

Selected Topics (8 decks)

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