E3- Imaging Flashcards
what are the major advantages for radiology
most efficient for assessing initial bone or jt abnormality
minimize radiation
greatest visualization
what are the disadvantages for radiology
limited for complex and subtle bony and soft tissue abnormalities
what is the routine for radiographic exam
at least 2 images at 90 deg to view all 3 dimensions
what is black in an xray
air
fat/bone marrow
what is gray in an xray
fat/bone marrow
water- m and soft tissue
what is white in an xray
bone
dye- bright white
metal- solid white
when viewing an xray what markers are we looking for
at least 2
health info
side of body
what are the ABCS of xray
alignment
bone density
cartilage space
soft tissue
what are we looking for with alignment in an xray
general anatomy
spurs, breaks, markings
what are we looking for with bone density in an xray
contrast
cortical- outer layer, appendicular, whiter
cancellous- inner, axial, grayer
texture
sclerotic changes
what are sclerotic changes
more metabolic activity in the bone due to compression or stress on the bone
what are we looking for with cartilage spaces in an xray
narrowing
bone sclerosis and erosion
growth plate- position, size, smooth
what are we looking for with soft tissue in an xray
m wasting/edema
fat pad displacement- elbow
periosteum
what can solid periosteum mean
slow growth of healing or infection
what can laminated or layered periosteum mean
repetitive stress
what can spiculated or pointed periosteum mean
breakthrough due to tumor
what is a CT scan
targeted xray are passing through slices of tissue
what are advantages of CT
less overlap
subtle bony changes
can use contrast agents
what are disadvantages of CT
greater radiation exposure
limited soft tissue abnormalities
what is a CT used for
head and abdominal trauma
less time than MRI and US
what are transverse plane slices
pt is supine so anterior is the top of image
your R is the pt L
what is the mechanism of an MRI
radiofrequency waves in presence of strong magnetic field
use contrast agent
what are advantages for MRI
less overlap
soft tissue abnormalities
less dense bone
staging metastasis
no radiation
high resolution
what are disadvantages for MRI
contraindications with magnetic implants except for stable jt implants
claustrophobia
how is fluid in T1 vs T2 MRI
T1- dark
T2- bright
describe a T1 weighted image
bright signals from fat and bone marrow
dark signals cortical bone and fluid
best for anatomical structure
describe a T2 weighted image
bright signals fluid or water
best for swelling and neoplasm
what is considered gray in both T1/2 weighted MRI
n and m
MRI is high sensitivity, explain
so good at finding (+) that when a negative is found you can rule a condition out
what is an ultrasound
ultrasound waves are absorbed, reflected and diffused
what are advantages for ultrasound
real time superficial tissue
higher resolution for superficial tendon, lig, and m than MRI
what are disadvantages for ultrasound
inability to scan deeper jt surface
image depends on operator
what does a brighter signal indicate on an ultrasound
swelling, tendinosis
what does irregular borders indicate on an ultrasound
tears
what do we need to consider with imaging recommendations
thorough hx and exam
psychosocial factor
CDR
appropriateness criteria
what are common views of cervical spine
AP open mouth
AP lower cervical spine
lateral
what is less common for cervical spine
oblique
what is AP open mouth best used for
AA jt
what does “a” mean in AP open mouth for AA
C1 and lateral masses are symmetrical
what does “b” mean in AP open mouth for AA
C1 lateral masses with sup articular process of C2
what does “c” mean in AP open mouth for AA
dens symmetrical of C1 lateral masses
what does “d” mean in AP open mouth for AA
equal C1 on C2 jt spaces
what does “e” mean in AP open mouth for AA
midline C2 sp
what does AP lower cervical spine best demonstrate
lower cervical vb
upper thoracic
ribs
clavicle
how is AP lower cervical spine positioned
vertically aligned vb
midline sp
lateral column
what is difficult about AP lower cervical spine
TPs difficult to discern
U jt
air filled trachea
clavicle
what is lateral view best for
disc space
z jt
what do we look for in the lateral view
ant vb
post vb
spinolaminar
what should stay constant in lateral view no matter the position
the 3 parallel lines should stay constant even in stress views when investigating mechanical instability
how are TPs in lateral view
superimposed over bodies
what is the oblique view good for
intervertebral foramen
what views are best for shoulder
AP in ER
AP in IR
what is in profile for AP ER
greater tuberosity
GH jt space
what is in profile for AP IR
lesser tuberosity
what is scapular Y lateral view used for
assessment of fx or dislocations of proximal humerus
what is visible on the xray
lesser tubercle
AC jt
what does each letter mean on the xray
A- acromion
B- clavicle
C- sup border of scapula
D- corocoid process
E- body of scapula
F- inf angle of scapula
G- humeral head
H- humeral shaft
what is visible on the xray
greater tubercle
GH jt space
what view is best to assess dislocation
axillary view
what do we look for in an xray for ARJC
humeral head alignment and shape
bone density
sclerosis
cartilage space
what is a reason the humeral head is sitting inf
what would we recommend for treatment
supraspinatus tear
shd jt replacement- SS irreparable tear
what indicates tendinopathy in a MRI
bright white tendon
what indicates a trauma to the elbow
displacing of fat pad indicating an intra articular injury
what is the most common carpal fx
scaphoid
what is the most common carpal to dislocate
lunate
where is a scaphoid fx most in danger for avascular necrosis
the poles due to a decrease in blood supply compared to the waist
how do we treat a pt if they dont have a fx but acts like a fx
treat it like a fx- immobilize then reimage in 1-2 wks
