Exam 2 - Radiology for orthopedics

Question 1

True/false: Never order an x-ray for an ortho case until the history and physical are completed

Answer 1

True - most lesions obvious with clinical history

Question 2

Most common reasons why x-rays are ordered

Answer 2

• Trauma
• Arthritis
• Degenerative changes
• Metastatic lesions

Question 3

What form of imaging should be ordered if the provider wants to visualize a fracture?

Answer 3

X-ray

Question 4

Advantages of an x-ray

Answer 4

• Simple
• Inexpensive
• Readily available
• Easy to interpret

Question 5

Disadvantages of x-rays

Answer 5

• Radiation exposure
• Won’t see soft tissue (poor contrast)
• 2D

Question 6

What form of imaging would the provider order to visualize an occult fracture?

Answer 6

MRI

Question 7

What form of imaging would the provider order to visualize a stress fracture?

Answer 7

Nuclear medicine bone scan

Question 8

What form of imaging would the provider order to visualize metastases?

Answer 8

Nuclear medicine bone scan

Question 9

When would nuclear medicine bone scans be indicated?

Answer 9

• Really specific
• Looks at uptake, metabolic activity (highlights things)
• A lot of radiation exposure

Question 10

What form of imaging would the provider order to visualize osteomyelitis?

Answer 10

X-ray

Question 11

What form of imaging would the provider order to visualize lower back pain?

Answer 11

• Without radiculopathy - no imaging
• With radiculopathy - non contrast CT or MRI

Question 12

What form of imaging provides the highest dose of radiation?

Answer 12

CT

Question 13

What is the advantage of CT/MRI over x-ray

Answer 13

CTs and MRIs are 3D

Question 14

Advantages of CT scans

Answer 14

• Look at different axial levels
• High bony detail
• Done quickly

Question 15

Advantages and disadvantages of MRI

Answer 15

Advantages

• Good for soft tissue contrast (e.g. tendon, ligament)
• Superior contrast resolution

Disadvantages

• Not readily available
• Motion during scan causes artifact
• Contraindicated with devices, indwelling catheters

Question 16

What form of imaging would the provider order to visualize arthritis (non septic)?

Answer 16

X-ray

Question 17

What form of imaging would the provider order to visualize suspected septic arthritis?

Answer 17

X-ray

Question 18

What form of imaging would the provider order to visualize monoarticular joint pain?

Answer 18

X-ray

Question 19

What form of imaging would the provider order to visualize infection of prosthetic joint?

Answer 19

X-ray

Question 20

X-ray views needed to visualize the cervical spine

Answer 20

• Lateral
• Anterior-posterior
• Oblique

Question 21

X-ray views needed to visualize the thoracic spine

Answer 21

• Anterior-posterior
• Lateral

Question 22

X-ray views needed to visualize the lumbar spine

Answer 22

• Anterior-posterior
• Lateral
• Lateral spot view

Question 23

X-ray views needed to visualize the shoulder and humerus

Answer 23

• Anterior-posterior
• Y view
• Axillary view

Question 24

X-ray views needed to visualize the elbow

Answer 24

• Anterior-posterior
• Oblique
• Lateral

Question 25

X-ray views needed to visualize the forearm

Answer 25

• Anterior-posterior
• Lateral

Question 26

X-ray views needed to visualize the hand

Answer 26

• Anterior-posterior
• Lateral
• Oblique

Question 27

X-ray views needed to visualize the wrist

Answer 27

• Posterior-anterior
• Lateral
• Oblique

Question 28

X-ray views needed to visualize the pelvis

Answer 28

Anterior-posterior

Question 29

X-ray views needed to visualize the hip

Answer 29

• Anterior-posterior
• “Frog leg”

Question 30

X-ray views needed to visualize the femur

Answer 30

• Anterior-posterior
• Lateral

Question 31

X-ray views needed to visualize the knee

Answer 31

• Anterior-posterior
• Lateral
• “Sunrise” view
• “Tunnel”view

Question 32

X-ray views needed to visualize the tibia, fibula, ankle, foot

Answer 32

• Anterior posterior
• Lateral
• Oblique (foot)