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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
Q

MRI contraindications

A

-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
Q

Radionuclide Bone Scan (Scintigraphy)

A

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
Q

Radionuclide Bone Scan (Scintigraphy) pros

A

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
Q

Radionuclide Bone Scan (Scintigraphy) cons

A

Not specific, requires injection

29
Q

DEXA Scan

A

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
Q

Vascular procedures

A

Angioplasty
Vascular stenting
Thrombolysis/thrombectomy
Chemotherapy

31
Q

Non Vascular procedures

A

Biopsies
Abscess drainage

32
Q

Epidural Steroid injections

A

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
Q

Nerve block

A

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
Q

Radiofrequency Ablation

A

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
Q

Vertebroplasty, Kyphoplasty, Cementoplasty contraindications

A

Contraindications include the presence of infection, acute traumatic fracture, coagulopathy, radiculopathy, cord compression, or complete vertebral collapse.

36
Q

Angles of Projection

A

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
Q

Intervertebral foramina positions

A

Cervical spine: Oblique 45 degree
Thoracic spine: lateral
Lumbar spine: lateral

38
Q

Zygapophyseal (facet joints)

A

Cervical spine: Lateral
Thoracic spine: Oblique 70
Lumbar spine: Oblique 45

39
Q

Image Quality factors

A

Photographic
Density = blackness
Contrast = variation amongst densities

Geometric
Detail = sharpness/motion
Distortion
Object is not perpendicular to x-ray beam

40
Q

Intra-articular fractures

A

Fracture line crosses into the joint

41
Q

Inter-articular fractures

A

Fracture line crosses outside of the joint

42
Q

Pelvic fracture possible complications

A

Hemorrhage

43
Q

Femur fracture possible complications

A

hemorrhage, occurs with closed fractures

44
Q

Multiple or crushing type fractures possible complications

A

Fat embolism

45
Q

Elbow fracture possible complications

A

Brachial artery injury

46
Q

Proximal humeral fracture possible complications

A

Axillary nerve injury, parathesis over deltoid

47
Q

Shoulder dislocation possible complications

A

axillary artery injury, brachial plexus, axillary nerve injury

48
Q

Elbow dislocation possible complications

A

brachial artery injury, median and ulnar nerve injury

49
Q

Hip dislocation possible complications

A

Femoral nerve and artery injury

50
Q

Knee dislocation possible complications

A

popliteal artery injury, peroneal nerve injury

51
Q

Insufficiency fracture

A

Deficient elastic resistance or weakened by decreased mineralization

52
Q

Pathologic fracture

A

Bone abnormally fragile by neoplastic or disease

53
Q

Type 1 Salter Harris fracture

A

injury at birth, Fracture extends through the physis displacing the epiphysis. Good prognosis for normal growth

54
Q

Type II Salter Harris fracture

A

Most common. Children over 10 y/o. Fracture extends through the physis and exits the metaphysis. Good prognosis for normal growth

55
Q

Greenstick Fracture

A

Seen in young children <10 yo
Incomplete fx
Mid-diaphyseal
Forearm/lower leg

56
Q

Nursemaid’s Elbow

A

Subluxation of the radial head into the annular ligament, which usually spontaneously or easily reduces

Pull on extended pronated arm

57
Q

Creeping Substitution

A

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
Q

Key feature

A

Specific to a disorder and not others

59
Q

Rejecting feature

A

If present is not the disorder and probably something else

60
Q

Non-Differentiating feature

A

Common to several disorders = narrowing possibility of other disorders

61
Q

Differentiating feature

A

Specific to one or two disorders = further narrowing possibility to the most likely disorders

Differential Diagnosis/Imaging (2 decks)

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