Imaging Flashcards
What is X-ray used for?
- Bone, dense tissue, tumours
- Quick, cheap, low risk, low detail
What is MR used for?
- Detailed images of all tissue types
- Expensive, noisy, lengthy, uncomfortable, cannot be used with metal implants/pacemakers
What is CT used for?
- Bone detail, better detail of soft tissues than XR
- Quick, painless, higher dose radiation, expensive
What is US used for?
- Soft tissue, can be used for blood flow
- Safe, usually non-invasive, cheap, painless
- Not useful for bone or looking in joints (i.e. at ligaments, cartilage etc)
- Difficult in obesity
What is bone scan used for?
- Whole body scanning, early detection, all tissue types
- Usually painless, expensive, lengthy, non-specific
What is the systematic approach for looking at musculoskeletal imaging?
- Alignment
- Bone density & dimensions
- Cartilage spaces
- Soft tissues
What should you look for during “alignment”?
- Size & number of bones
- Smooth, continuous, cortical limes
- Normal articulations with adjacent bones
What should you look for during “bone density & dimensions”?
- How white bones look on the XR
- General density increase/decrease
- Cortical lines
- Trabecular structure
- Size & shape relative to adjacent
What should you look for during “cartilage spaces”?
- Well preserved joint space or disc thickness
- Normal size epiphyses relative to age
- Smooth, subchondral bone
What should you look for during “soft tissues”?
- Normal size of soft tissue
- Consistent lucency
- Fat pads & fat lines
- Capsular lines
What risks/benefits of imaging should be considered when deciding when to request imaging?
- Radiation
- Discomfort
- Expense
- Inconvenience & delay
- Will it change management?
- Will it change prognosis?
When is a greater dose of radiation exposure required?
- Larger patient
- Denser body part
- Longer procedure
Why is there a greater risk associated with radiation exposure in pregnancy & children?
Rapid cell division
What risks/benefits of imaging should be considered when deciding which imaging to request?
- Tissue types
- Differential diagnoses
- Expense & inconvenience
- Technical issues (obesity, anxiety)
What risks/benefits of imaging should be considered how to request imaging?
- Consent & inform
- Patient details
- Clinical details (as much as possible)
- Image requested, special views
- Provider number
- Report to, cc etc
- Note taking
