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Differential Diagnosis/Imaging > Exam I > Flashcards

Exam I Flashcards

1
Q

Abdominal (Convex or Curved Array) Probes

A

Used for general abdominal imaging, transabdominal pelvic imaging, obstetrical imaging, and some musculoskeletal imaging

Wide-angle field of view for large deeper structures (e.g., kidneys)

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2
Q

Cardiac (Sector Array) Probes

A

Produce a triangular sector image
Suited for imaging large, non-superficial structures through narrow sonographic windows (e.g., heart)

Not ideal for imaging superficial structures

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3
Q

Linear (Linear Array) Probes

A

Offer the best image detail but limited depth penetration (5-6 cm maximum from skin surface)

Used for musculoskeletal, peripheral nerves, thyroid gland, breast, and superficial vascular imaging

Produce rectangular-shaped images with constant width from probe face to deepest part

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4
Q

Echogenicity

A

Reflectivity of tissue in relation to surroundings
Visible contrast in brightness at tissue interfaces

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5
Q

Hyperechoic

A

White, high reflectivity

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6
Q

Hypoechoic

A

gray, moderate reflectivity

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7
Q

Anechoic

A

black, little to no reflectivity

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8
Q

Transducer scanning positions: Transverse

A

axial (right to left) orientation of the ultrasound probe with the transducer indicator notch towards the patient’s right such that the left side of the sonogram should display structures on the patient’s right side

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9
Q

Transducer scanning positions: Longitudinal (also called Sagittal)

A

cranial to caudal orientation of the ultrasound probe with the transducer indicator notch towards the patient’s head such that the left side of the sonogram should display structures nearer to the patient’s head

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10
Q

Transducer scanning positions: Radial

A

used in breast US and follows a wagon wheel pattern of scanning with the nipple in the center to visualize the breast plane parallel to the ductal system

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11
Q

Transducer scanning positions: Antiradial

A

used in breast US and is a scanning plane 90 degrees to the radial scanning pattern and is used to visualize the breast plane perpendicular to the ductal system

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12
Q

Attenuation

A

the degree to which x-rays are absorbed/deflected by the body part

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13
Q

Flesh

A

lower atomic weight (transparent)

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14
Q

Bones

A

higher atomic weight (attenuate)

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15
Q

Radiodensity

A

the amount of black on the image, The more dense a tissue is, the LESS blackening and the MORE white the image

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16
Q

Radiolucent

A

Easily penetrated by X ray beams
Example: air= black

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17
Q

Radiopaque

A

Not easily penetrated by X ray beams
Example: metal=white
CT contrast

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18
Q

Fluoroscopy

A

X-Ray examination in real time, continuous x-ray beam. Commonly used in fracture fixation, arthrography, myelography, diskography, biopsy, gastrointestinal evaluation

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19
Q

CT Scan indications

A

Trauma, subarachnoid hemorrhage, acute cervical spine injury, acute appendicitis, ureteric calculus

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20
Q

CT scan contraindications

A

Pregnancy, young age, claustrophobia, allergy to contrast medium, weight/girth

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21
Q

Computed Tomography (CT) Scan

A

Excellent demo of cortical bone anatomy, but poorer soft tissue demonstration

Fast, easy to perform, readily available

shows blood and acute bleeding very well, will show up bright white on CT scan.

usually first imaging choice for trauma patients

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22
Q

Magnetic Resonance Imaging (MR or MRI)

A

non-ionizing,

MRI is based on measurements of energy emitted from hydrogen nuclei following their stimulation by radiofrequency signals.
The energy emitted varies according to the tissues from which the signals emanate.
This allows MRI to distinguish between different tissues

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23
Q

T1 Weighted Image

A

Best for anatomical localization (measures energies rapidly and early)

Balanced images, picks up adipose tissue and bone marrow well, but not CSF

High water content areas appear dark in T1 images

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24
Q

T2 Weighted Image

A

Best for contrasting normal and abnormal tissue (measures energies slowly and late)

High water content areas appear bright in T2 images
-fluid, edema, CSF in spaces, cysts, abscess, tumors, acute hemorrhage

T2 – H20 = Bright white = fat AND water)

Excellent at detecting inflammation

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25
MRI contraindications
-Pacemakers (malfunction) -Aneurysmal clips -Metal/foreign bodies in the eye -Hardware (Orthopedic hardware does not represent a health hazard) -Large area tattoos -Cochlear implants
26
Radionuclide Bone Scan (Scintigraphy)
Information is gained by viewing where and how much the radiopharmaceuticals have concentrated in the body. Abnormal conditions = increased uptake of the radiopharmaceuticals Normal bone appears transparent and gray “Hot spots” are black or white areas indicative of increased metabolic activity Highly sensitivity test, an early indicator of increased bone activity. Poor specific test
27
Radionuclide Bone Scan (Scintigraphy) pros
Cheap Most valuable in confirming the presence of disease and demonstrating the distribution of disease in the skeleton (Stress fxs, tumors, infections, avascular necrosis, decreased blood flow, prosthetic loosening)
28
Radionuclide Bone Scan (Scintigraphy) cons
Not specific, requires injection
29
DEXA Scan
Preferred way to measure bone mineral density and body composition indications are osteopenia on x-ray, height loss >2.5”, metabolic disorder, chronic disease, hormone replacement, non-traumatic vertebral fx in postmenopausal female
30
Vascular procedures
Angioplasty Vascular stenting Thrombolysis/thrombectomy Chemotherapy
31
Non Vascular procedures
Biopsies Abscess drainage
32
Epidural Steroid injections
used to relieve pain in patients with spinal stenosis, disk herniation, or intractable neck or back pain of uncertain cause by decreasing nerve root inflammation and swelling at the nerve–disk interface. Epidural injections may be administered at the sacral hiatus, at a lumbar interlaminar level, or at the C7–T1 interlaminar level
33
Nerve block
Spinal nerve blocks can be used for therapeutic or diagnostic purposes. Diagnostically, these procedures are helpful in identifying the source of radicular pain, especially when prior imaging is inconclusive. After a nerve or joint is identified as the source of pain by “blocking” its transmission of pain via administration of an anesthetic to it, therapeutic steroids are then administered.
34
Radiofrequency Ablation
Radiofrequency ablation (RFA) is the selective destruction of nerve tissue to treat chronic pain disorders. the procedure involves thermal ablation from radio waves applied to the nerve via placement of a needle electrode under imaging guidance.
35
Vertebroplasty, Kyphoplasty, Cementoplasty contraindications
Contraindications include the presence of infection, acute traumatic fracture, coagulopathy, radiculopathy, cord compression, or complete vertebral collapse.
36
Angles of Projection
A single radiograph provides only 2 dimensions: LxW To determine depth, a 2nd radiograph is required at a right angle (90 deg) to the 1st.
37
Intervertebral foramina positions
Cervical spine: Oblique 45 degree Thoracic spine: lateral Lumbar spine: lateral
38
Zygapophyseal (facet joints)
Cervical spine: Lateral Thoracic spine: Oblique 70 Lumbar spine: Oblique 45
39
Image Quality factors
Photographic Density = blackness Contrast = variation amongst densities Geometric Detail = sharpness/motion Distortion Object is not perpendicular to x-ray beam
40
Intra-articular fractures
Fracture line crosses into the joint
41
Inter-articular fractures
Fracture line crosses outside of the joint
42
Pelvic fracture possible complications
Hemorrhage
43
Femur fracture possible complications
hemorrhage, occurs with closed fractures
44
Multiple or crushing type fractures possible complications
Fat embolism
45
Elbow fracture possible complications
Brachial artery injury
46
Proximal humeral fracture possible complications
Axillary nerve injury, parathesis over deltoid
47
Shoulder dislocation possible complications
axillary artery injury, brachial plexus, axillary nerve injury
48
Elbow dislocation possible complications
brachial artery injury, median and ulnar nerve injury
49
Hip dislocation possible complications
Femoral nerve and artery injury
50
Knee dislocation possible complications
popliteal artery injury, peroneal nerve injury
51
Insufficiency fracture
Deficient elastic resistance or weakened by decreased mineralization
52
Pathologic fracture
Bone abnormally fragile by neoplastic or disease
53
Type 1 Salter Harris fracture
injury at birth, Fracture extends through the physis displacing the epiphysis. Good prognosis for normal growth
54
Type II Salter Harris fracture
Most common. Children over 10 y/o. Fracture extends through the physis and exits the metaphysis. Good prognosis for normal growth
55
Greenstick Fracture
Seen in young children <10 yo Incomplete fx Mid-diaphyseal Forearm/lower leg
56
Nursemaid’s Elbow
Subluxation of the radial head into the annular ligament, which usually spontaneously or easily reduces  Pull on extended pronated arm
57
Creeping Substitution
direct osteoblastic activity at the fracture site with no callus formation if fragments are in close contact Termed Primary bone union Example: Surgically compressed bone healing
58
Key feature
Specific to a disorder and not others
59
Rejecting feature
If present is not the disorder and probably something else
60
Non-Differentiating feature
Common to several disorders = narrowing possibility of other disorders
61
Differentiating feature
Specific to one or two disorders = further narrowing possibility to the most likely disorders

Differential Diagnosis/Imaging (4 decks)

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