Imaging Flashcards
Uses of MRI in orthopedics?
-Evaluate soft tissue
-Evaluate soft tissue mass (lipoma, hematoma, osteosarcoma,
ganglion cyst)
- R/O fluid collection in body (effusion of joint, shoulder, hip, or infection fluid collection)
- define abnormalities within bone seen on XRAY (stress fx, lytic lesion, AVN, osteomylitis)
- R/O stress fx or infection
- evaluate spinal injury (herniated disk, spinal stenosis, compression fx, neoplasm, pars defect)
What is a CT myelogram?
Which imaging is preferred for cervical injury?
CT with radiographic dye injected into the dura.
CT scan is preferred for cervical injury, may not always see on XRAY.
Bone Scans:
- uses
- how does this work?
Uses:
- prostate CA
- stress fx
- infection
- occult fx (cannot be seen on xray until several weeks after the injury. )
How:
-shows osteoblastic activity, NOT osteoclastic activity.
Plain Xray in Orthopedics:
- how do we describe a fx?
- how many views are necessary?
- when do pts return for F/U xray?
Describe fx:
- displacement (how far off from normal anatomy it is)
- angulation (where is the apex)
- avulsion (tendon or ligament insertion where a fragment of bone gets pulled off)
- impaction
- intra-articular
- comminuted
- spiral
- greenstick
- buckle
- transverse vs oblique
Views:
-get at least 2 vies or XRs 90 degrees to eachother.
Return in about 1 wk for F/U
What are the orthogonal (3D as 2D) views of the shoulder?
AP, Axillary, Y-view, Grashey
What views are required for wrist xray? Hand?
What views are required for Lumbar spine?
What views are required for pelivs?
What views are required for ankle?
Wrist and hand:
-Lateral, oblique, and AP
Lumbar spine:
-AP and Lateral
Pelvis:
-AP
Ankle:
-Ankle mortis & lateral
What is a common XRAY finding in pars defect?
WHat is the MC site of clavicular fx? MC in boys/girls
What type of imaging is indicated if there is articular involvment of glenoid and humeral head fxs?
Scotty dog.
Mid clavicle is MC site of fx.
Clavicle fx is MC in boys
CT if articular, glenoid and humeral head involvement.
Tx of humeral head fx?
Tx:
- treat comorbidities:
- -osteoporosis
- -alcoholism
- -tobacco use
- -mental illness
- -steroid use
- -Rhem dz
- -surgery; but outcome is just about as good as not performing it.
Humeral Shaft Fx:
- worry about which nerve?
- cause
Worry about radial nerve
Cause; high energy, fall, MVA, dirt biking accidents.
Describe the positioning of the humeral head in an anterior dislocation? posterior?
Anterior dislocation = head looks like its sitting low.
Posterior: head looks like its sitting high.
Midforearm Fx:
- are these stable or unstable?
- what is a collies fx?
- what is smith fx?
These are unstable.
Collies fx: backwards(dorsal) displaced distal radias fx
Smith: reverse collies.
Why do we worry about scaphoid fxs?
Scaphoid fxs:
- what do we look for on xray?
- complications
- how long do we wait for F/U xray?
b/c blood flow is distal to proximal leading to bone death and wrist collapse.
Scaphoid fx:
-look for widening of scapholunate distance (scapholunate ligament torn)
Complication:
- high risk of nonunion.
- necrosis of scaphoid
F/U xray is in 10-14d
–could do bone scan, MRI, or CT
Metacarple Fx:
- what is bennetts fx?
- rolando fx?
- boxer fx?
- cause
- when do we do surgery?
Bennetts: fx combined with subluxation or dislocation of metacarpal joints.
Rolando: T or Y shaped fx involving joint surface.
Boxer: pinky metacarpal fx
Cause:
-MC caused by malalignment of joints when punching an inanimate object. (rotation)
Surgery if rotated.
Which fx heals faster transverse or horizontal?
Distal phalanx fx:
- what is this called?
- tx
spiral fx will heal faster.
Distal phalanx fx:
-Tuft
Tx:
-aluminum splint over tip of finger for 3-4wks leave PIP free.
What deformity is known to have the pistol grip deformity?
Arthritis is MC in which aspect of the tibia?
Do we treat isolated fibular fx?
When you see proximal fibula fx you must also look where?
acetabular femoral impingement.
Arthritis = MC medial.
No, we dont do anything for this surgically. They can still walk straight but they have pain with twisting.
Make sure to check the ankle.
