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Radiology > Final quiz > Flashcards

Final quiz Flashcards

1
Q

Indications for MSK plain films

A
  • first line for evaluating bony anatomy
  • pain
  • following injury or trauma
  • suspect fracture
  • suspect foreign body
  • surgical planning
  • post-surgical changes
  • post-fracture healing
  • osteomyelitis
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2
Q
  • Many MSK complaints/symptoms are related to (…), so we will likely result in ordering (…) after plain film evaluation
  • When in doubt, start with (…)
A
  • soft tissue pathology/injury
  • additional imaging for further evaluation (MRI, CT)
  • plain films
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3
Q

Indications for MSK CT

A
  • assess intra-articular fractures
  • bony reconstitution
  • surgical planning
  • presence of metallic implants
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4
Q

Indications for MSK MRI

A
  • soft tissue
  • tumors
  • surgical planning
  • osteomyelitis
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5
Q

Describe the approach to MSK imaging

A
  • orthogonal views (2 views, placing orders)
  • identify bony landmarks
  • know your anatomy
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6
Q

Describe the systemic approach to MSK plain film interpretation (what you should look for)

A
  • osseous cortex
  • joint space
  • subluxation/dislocation
  • new bone formation
  • subchondral cyst formation
  • subchondral sclerosis
  • soft tissue swelling
  • gas in soft tissues
  • calcification in soft tissues
  • foreign bodies
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7
Q
  • What are the indications for a hip plain film?
  • What views should you get?
A

indications:
- trauma
- pain
- gait abnormalities
- knee pain
- difficulty bearing weight
views:
- AP/lateral
- AP pelvis
- frog leg (used more frequently in peds)

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8
Q
  • What are the indications for a pelvis plain film?
  • What views should you get?
A

indications:
- trauma
- hip pain
- SI joint pain
views:
- plain films: AP pelvis

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9
Q

label

A
  1. Iliac crest
  2. Ilium
  3. Anterior sacral foramina
  4. Sacroiliac joint
  5. Anterior superior iliac spine
  6. Anterior inferior iliac spine
  7. Ischial spine
  8. Superior pubic ramus
  9. Obturator foramen
  10. Inferior pubic ramus
  11. Ischial tuberosity
  12. Symphysis pubis
  13. Coccyx
  14. Femur
  15. Lesser trochanter
  16. Greater trochanter
  17. Femoral neck
  18. Femoral head
  19. Acetabulum
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10
Q

Male or female pelvis

A

male

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11
Q

Male or female pelvis

A

female

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12
Q

Indications for a pelvis CT

A
  • pelvic pain
  • trauma
  • post op
  • evaluate for foreign bodies
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13
Q

What view is this?

A

frog leg view

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14
Q

For hip plain films in a trauma series, what type of imagine (position) will you get?

A
  • usually supine
  • lateral also referred to a cross table lateral
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15
Q

Indications for a femur plain film

A
  • pain
  • fracture
  • dislocation
  • osteomyelitis
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16
Q
  • What are indications for a knee plain film?
  • What are some different views you can order?
A

indications:
- pain
- trauma
- fracture
- dislocation
views:
- AP, lateral, sunrise, standing
- +/- oblique views

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17
Q

What does this view give a good view of?

A

patellar femoral joint
- gives information about position of the patella

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18
Q

What view is this?

A

sunrise view

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19
Q
  • What are indications for tibia/fibula plain films?
  • What views can you order?
A

indications:
- trauma
- deformity
- evaluation of foreign body
- osteomyelitis
views:
- AP and lateral
- +/- oblique
- need to include both knee and ankle

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20
Q
  • What are indications for an ankle plain film?
  • What views can you order?
A

indications:
- trauma
- non-traumatic ankle pain
- inability to bear weight
- tenderness to palpation
views:
- AP
- lateral
- oblique

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21
Q
  • What are indications for a foot plain film?
  • What views can you order?
A

indications:
- trauma
- non-traumatic foot pain
- inability to bear weight
- tenderness to palpation
views:
- AP
- lateral
- oblique

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22
Q

Label

A
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23
Q

Label

A
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24
Q

When do you use ultrasound guided evaluations for MSK?

A
  • joint effusions
  • tendon ruptures
  • ligament injuries
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25
Q

What do MSK ultrasound guided injections help with?

A
  • improves efficiency
  • assists with identifying small joints
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26
Q
  • What are indications for cranial and facial plain films?
  • What views can you order?
A

indications:
- head trauma
- rule out skull fracture
- suspected open or depressed skull fracture
- skeletal survey (multiple myeloma)
- rule out retained metal/foreign body (prior to MRI)
- birth defect
views:
- anteroposterior (AP)
- lateral

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27
Q

In modern medicine (…) and (…) have largely replaced x-rays for diagnosing injury or disease, but x-rays are still helpful to check for problems with any bones

A
  • CT scans
  • MRI scans
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28
Q

How many bones make up the human skull?

A

22 bones:
- 8 cranial bones
- 14 facial bones

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29
Q

What is the lateral view of cranial and facial plain films good for looking at?

A

sphenoid sinus

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30
Q

What bones form the orbit?

A
  • sphenoid
  • ethmoid
  • frontal
  • palatine
  • zygomatic
  • lacrimal
  • maxilla
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31
Q
  • Orbital plain films have largely been replaced by (…)
  • What are indications for an orbital plain film?
  • What views can you order?
A
  • orbital CT scan
    indications:
  • suspected orbital fracture
  • suspected ocular or orbital foreign body
  • screening for metallic foreign body (prior to further imaging)
    views:
  • AP
  • lateral
32
Q

Why are CTs better than plain films for getting images of the orbit?

A

less shadows, able to see more

33
Q

What is the best way to view the orbit?

A

CT scan

34
Q

Indications for orbital CT scan

A
  • ocular/orbital trauma
  • assessment of extraocular muscle pathology
  • orbital mass or lesions
  • orbital infection or inflammation
  • congenital/pediatric orbital anomalies
35
Q
  • muscle damage in eye will make eye move in (…)
  • orbital infection can lead to (…)
A
  • opposite direction
  • vision loss
36
Q
  • What are some indications for sinus plain films?
  • What views can you order?
A

indications:
- suspected acute/chronic sinusitis
- facial trauma
- possible foreign body
views:
- AP
- Water’s (occipitomental, or nose-chin; better view of maxillary sinuses)
- lateral

37
Q

What view is best to see the maxillary sinus?

A

water’s view

38
Q

Indications for sinus CT scan

A
  • same as for plain film, plus:
  • abnormal nasal drainage
  • abnormal finding on x-ray or nasal endoscopy
  • birth defects in sinuses
  • infection in the bones of the sinuses (osteomyelitis)
  • injury to the face over the sinuses from trauma
  • loss of smell
  • masses and tumors, including cancer
39
Q

What views can you order for sinus CT?

A
  • axial
  • coronal
  • sagittal
40
Q

The sphenoid sinus can be best seen in what view on a CT image?

A

sagittal

41
Q

In children, everything is more compact, so (…) get blocked more often

A

sinuses

42
Q

What does IV contrast do in CT brain scans? What is this useful in?

A
  • detects presence of disrupted BBB
  • useful in pts w/ suspected neoplasm, abscess, vascular malformation, or new-onset seizures
43
Q

What can provide good to excellent resolution of the cervical and large proximal intracranial arteries?

A

CT angiography (CTA)

44
Q

What is the main utility of a CTA?

A
  • diagnosis of extracranial carotid stenosis, proximal intracranial stenoses or occlusions, and saccular intracranial aneurysms
45
Q
  • What is an indication for CTAs?
  • What is not always seen well in a CTA?
A
  • suspected bleeding aneurysm
  • subarachnoids
46
Q

CT scans:
- low attenuation appears (…)
- medium attenuation appears (…)
- high attenuation appears (…)

A
  • black
  • gray
  • white
47
Q

What is the dimensionless unit universally used in CT scanning to express CT numbers in standardized and convenient form?

A

Hounsfield units

48
Q
  • Describe hyperdense
  • Describe hypodense
  • Describe isodense
A
  • increased density in comparison, higher Hounsfield units
  • less dense in comparison, lower Hounsfield units
  • same density when compared to another tissue
49
Q

What are the 3 common CT windows in the head? Describe them

A
  • soft tissue: soft tissue injury, swelling or masses
  • bone window: trauma, fractures, bony lesions, metastasis
  • brain window: differentiate between structures, brain, blood and vasculature, air/fluid-filled spaces of the brain
50
Q

What window do you lose complete definition of brain tissue?

A

bone window

51
Q

What are the 2 less common CT windows of the head? Describe them

A
  • subdural window: fluid/blood in subdural space, subdural hematomas brighter in this window
  • stroke window: blood on the brain, accentuates reduction in the gray-white matter differentiation
52
Q
  • MRI is superior to CT for evaluating what?
  • MRI is contraindicated in patients with what?
  • What contrast do you use with MRIs?
  • What do contrasts do?
A
  • brain stem, posterior cranial fossa, spinal cord
  • patients with implanted ferromagnetic objects such as pacemakers, orthopedic pins, and older aneurysm clips
  • gadolinium
  • improve sensitivity and specificity of tumors
53
Q
  • TI weighted MRI scans are best for showing (…)
  • T2 weighted MRI and FLAIR images are best for showing (…)
  • Diffusion weighted images (DWI) are useful for detecting (…)
A
  • anatomy
  • pathology
  • hyperacute ischemia
54
Q
  • Apparent diffusion coefficient (ADC) show a purer image of restricted diffusion caused by (…) which appears black or dark
  • Magnetic resonance angiography (MRA) produce images of the (…) with the brain and skull subtracted out
  • What offers improved resolution over conventional MRA, particularly for evaluating high-grade stenosis of the cervical arteries?
  • Magnetic resonance venography (MRV) is useful for diagnosing (…) but is less sensitive than angiography for detecting (…)
A
  • ischemia and cytotoxic edema
  • extracranial and intracranial cerebral circulation
  • time-resolved contrast enhanced MRA
  • dural sinus thrombosis; cortical vein thrombosis
55
Q

What would not be seen with an MRA but would be with an MRV?

A

cavernous sinus thrombosis

56
Q
  • Which radiology term shows lesions that originate in the brain parenchyma and outside of the brain substances (meninges)?
  • Which term includes the cerebellum, brainstem, fourth ventricle, and cerebellopontine angles?
  • Which term includes the cerebral hemispheres and the sella?
A
  • intra-axial/extra-axial
  • infratentorial
  • supratentorial
57
Q

Indications for CT head/brain scan

A
  1. alterations in mental status (acute delirium, rapid onset mental status deterioration/baseline awareness, dementia)
  2. suspicion of: ischemic stroke, intracerebral hemorrhage, CNS infection
  3. seizures
  4. trauma (penetrating trauma, trauma w/ mental status changes or neurologic deficit)
  5. headaches (worst headache, nick stiffness, age of 50, thunderclap headache or extreme intensity, pregnant patient, cancer)
58
Q

What is one of the more common reasons for neuroimaging of CT scan of head/brain?

A

headaches

59
Q
  • In most cases, CT of the head is ordered (…) contrast
  • For head CT, you have to specify what?
  • Contrast may be added in a CT scan head/brain when?
  • In most cases (…) of brain is superior, just not easy to access
A
  • without
  • if you want with contrast or without
  • high clinical suspicion of cancer of brain, intracranial infection
  • MRI
60
Q

In a head CT in the brain window, white matter is (…) and appears (…)

A
  • hypodense
  • dark
61
Q

What CT window can the cerebellum be seen in?

A

brain window

62
Q

Indications for a CTA of the head and neck

A
  • ischemic CVA to detect occlusions/thrombosis
  • TIA to detect carotid artery stenosis
  • subarachnoid hemorrhage to detect intracerebral aneurysms
  • cerebral parenchymal bleeding to assess for AVM (arteriovenous malformation)
63
Q

Indications for an MRA of the brain?

A
  • cerebral aneurysm
  • stroke
  • vasospasm
  • vasculitis
  • internal carotid stenosis/occlusion
  • intracerebral vessel occlusion
  • arteriovenous malformation
64
Q

Indications for a digital subtraction angiography (DSA)?

A
  • suspected vertebrobasilar insufficiency (#1 reason)
  • cerebral aneurysm and dissection vascular malformations
  • carotid stenosis and thrombosis
65
Q

What is the number one reason to get a DSA and this can be used for people with what?

A
  • suspected vertebrobasilar insufficiency
  • dizzy spells
66
Q

Advantages of DSA?

A
  • diagnostic and therapeutic
  • time lapse blood flow dynamics
  • high spatial/temporal resolution
  • takes away background structures
67
Q

Indications for a cervical spine plain film

A
  • trauma to head or neck
  • rule out fracture
  • severe neck pain (acute or chronic)
  • radicular pain
  • impingement
  • infection
68
Q

Views for a cervical spine plain film

A
  • AP
  • lateral
  • odontoid
  • oblique
  • swimmer’s view
  • flexion/extension
69
Q

What are the views for a cervical spine plain film used to assess:
- AP
- lateral
- oblique
- odontoid
- flexion/extension
- swimmer’s view

A
  • AP: assess alignment
  • lateral: count/assess vertebral bodies
  • oblique: neural foramina (narrowing/impingement)
  • odontoid: AP with open mouth
  • flexion/extension: assess for vertebral body instability
  • swimmer’s view: if can’t evaluate C7-T1
70
Q
  • In a cervical spine plain film, examination of the anterior soft tissues and spaces should be done at (…)
  • Examination of the bony contour lines is done to exclude (…)
A
  • several vertebral levels
  • subluxations
71
Q

What are the most common cervical spine plain films?

A
  • AP
  • lateral
72
Q

What are the 3 main reasons you get an oblique view of the cervical spine in a plain film?

A
  • degeneration
  • impingement
  • pars defects
73
Q
  • Uncovertebral joints, also known as (…), are present from (…)
  • The lateral aspect of these vertebral bodies have superior projections known as (…) and with approximation with the vertebra above, they form the (…)
A
  • Luschka joints
  • C3-C7
  • uncinate processes
  • uncovertebral joints
74
Q

What is the function of the uncovertebral joints?

A
  • maintain stability and mobility in the cervical spine by limiting the side-to-side movement
  • the overlapping effect allows axial rotation and lateral bending of the cervical vertebra
75
Q

Indications for a cervical spine MRI

A
  • same as plain film plus:
  • suspected herniated disc
  • suspected spinal stenosis
  • metastatic and primary malignancies
  • cervical vertebral osteomyelitis +/- epidural/paranasal abscess
  • postoperative scarring with stenosis
  • spinal cord abnormalities such as myelomalacia, spinal cord contusion, edema, syringomyelia
76
Q

A cervical spine MRI is better at seeing what than a CT scan?

A
  • soft tissue
  • muscle
  • spinal cord and nerve roots

Radiology (6 decks)

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