Imaging Introduction Flashcards
What are the 4 reasons to study imaging as a PT?
- Adds to….?
- Assist with…?
- ex: motion barriers (bone spur)
- ex: WB/functional levels (bony callus)
- ex: bone stimulator - Contributes to….?
- Better….
- examination and evaluation
- intervention
- prognosis
- communication with involved parties
Which imaging device is typically the first image performed?
radiograph
A major advantage for a radiograph is being most efficient for….?
the initial assessment of bone or joint abnormality
A major disadvantage for a radiograph is being limited for…. ?
complex and subtle bony abnormalities
A radiograph is commonly referred to as _________, _________, or ___-______
plain films, films, or x-rays
At least ___ images at ______° are needed to view all 3 dimenisions for a radiograph
2; 90
__________ typically have irregular edges, whereas _________ bones have smooth round edges
fractures; sesamoid
A. ?
B. ?
C. ?
A. fracture
B. fracture
C. sesamoid bone
The routine for radiographic exam is…
a __________ of position and views
minimize ________ exposure
has a projection of __-_____ beams
- AP> ____
lateral
oblique
standardization
radial
x-ray
PA
Process of an x-ray:
X-ray beam enters the ______
It is absorbed by __________ at differing amounts
It produces a shade of ______
Lastly, the x-ray beam emerges from the patient onto an ________ ________ or image receptor
body
tissues
gray
interpretation device
Understanding the radiograph:
It is the inverse relationship between ________ and _________ density
radiodensity; radiograph
Radiograph colors
Air is _______
Fat and bone marrow- ____/_____
Water; muscle and soft tissue- _____
Bone- _____
Contrast dyes- _________
Metal- ________
black
black/gray
gray
white
bright white
solid white
Radiograph Colors
- ?
- ?
- ?
- ?
- Air
- Fat
- Water
- Bone
With a radiograph viewing, structures that are closer to the receptor are….?
A. more accurate
B. less accurate
A
Place on viewer as if patient is facing ______, except _____/_____ images face up
you; toes/fnger
PA projection is better for viewing ________ structures
anterior
AP projection is better for viewing ________ structures
posterior
The _________ view of a radiograph is hands and feet viewed with toes or fingers pointing up
lateral
With a radiograph, you should identify at least _____ markers
2
Example of a anteroposterior graph
Example of a anteroposterior graph
What are the ABCS of radiographs?
A- alignment
B- bone density
C- cartilage space
D- soft tissues
__________ with the ABCs is general architecture/anatomy- size, number of bones, etc.
Alignment
With alignment, the general contour includes
- 2.
3.
Spurs
Breaks
Markings
L picture
A.
B.
R picture
A.
B.
C.
L picture
A. humeral growth plates
B. avulsion fx
R picture
A. scapular ridge
B. GH fossa
C. humeral head
______ _______ is the contrast between bone and other tissue
bone density
_______ bone is the outer layer of bone and predominately in appendicular skeleton
cortical
_______ bone is denser and whiter
cortical
________ bone is interspersed within marrow and predominantly in axial skeleton
cancellous
_______ bone is less desnse and grayer
cancellous
What is an example of texture/local density with bone density?
sclerotic changes
______ _______ are increased bone density- may be abnormal or normal
sclerotic changes
With _______ ________ it involves narrowing
cartilage spaces
___________ bone sclerosis (body is trying to repair damaged bone) and erosion
Subchondral
________ _________ are involved with position, size, and smooth margin
epiphyseal plates
osteophytes
Soft tissue components on a radiograph:
_______ wasting/edema
____ ______ displacement
________ effusion
muscle
fat pad
capsular
With soft tissue, the ____________ bone is covering that shows up as a soft tissue shadow
periosteum
With the periosteum…
_______- a slow growth of healing or infection
_______ or _______ - layered stress
_______ or _______- breakthrough due to tumor
solid
laminated or layered
spiculated or pointed
What are the other 3 common MSK imaging?
- Comuted Tomography (CT)
- Magnetic Resonance Imaging (MRI)
- Ultrasoung (US) Imaging
____’s are images generated by computerized and targeted x-rays passing through slices of tissue (.1 to 10 mm. thick)
CT
What are the major adavntages of a CT?
______ overlap of structures due to slicing
Able to locate subtle _____ _______
LESS; bone changes
What are major disadvantages of CT?
________ radiation exposure but getting faster and safer
Limited with _____ _______ abnormalities
Greater; soft tissue
_____’s may be used with contrast agents for even more detail
CT
Which medical imaging device is standard modality for head and abdominal trauma,in the ER due to shorter scanning times and quick availability?
CT
A ______ is quicker than a MRI and US
CT
With a CT, you should start with a ______ image
Scout
With a ______ image, you should locate specific slice position and image
CT
a. scout or slice film?
b. scout or slice film?
a. Scout
b. Slice
With transverse plane slices, the patient is in _______ position so the _______ surface is at the top of each image slice
supine; anterior
With transverse plane slices, looking upward at the anatomic structures from below so your _____ is the patient’s _____
right; left
With sagittal plane slices, it is viewed from _____ to ______
left; right
With a CT, the _______ density is like x-ray regarding shades
tissue
degenerative changes of the left C3/4 facet joint
_____’s are strong magnetic fields with radiofrequency waves
MRI
What are the similarities with CT’s
Generates ______ slices
May also be used with ______ agents for even more detail
thin; contrast
An _______ has less overlap like CT with slicing
MRI
Excellent qualities for MRI
_____ ______ abnormalities
_______ bone/bone marrow conditions
soft tissue
cancellous
With MRI’s, it can read _______ and staging ______
neoplasms; metastasis
With MRI’s, it can read ___________ lesions
osteochondral
MRI fx:
early/less severe fractures are at the _________
late/severe fractures are in the ________ bone
periosteum
cancellous
Left picture is what kind of fx?
Right picture is what kind of fx?
Left- Grade I
Right- Grade IV
With ______’s it has no radiation like CT (high) and x-ray (low)
MRI
Which medical image has a high resolution?
MRI
Major disadvantages of MRI
Contraindiactions with ______ implants except for stable ______ implants
magnetic; joint
Which medical imaging device is a precaution with claustrophobia?
MRI
Left picture-?
Right picture-?
Scout image
Slice image
With a MRI, you should look for what known areas 1st? ….
normal fluid
With an MRI, if the fluid is bright, it is a _____ image
T2
With an MRI, if the fluid is dark, it is a _____ image
T1
A. ?
B. ?
C. ?
a. spinal cord
b. cerebrospinal fluid
c. L5, S1
With a T1 image…
it has bright signals from the ___ and ____ _____
dark signals from the _______ bone and ______
BEST for demonstrating ________ definition of structure
fat/bone marrow
cortical/fluid
anatomical
With a T2 image…
bright signals occur from ______ and _______
BEST for demonstrating _________ and neoplasms particularly in ________ bone
_______ and _________ have an intermediate signal and often gray with both T1 and T2- weighted images
fluid/water
swelling/cancellous
nerve/muscle
Which fx is this?
calcaneous
___________ waves are absorbed, reflected, and diffused differently from varying tissues to construct an image
ultrasound
Which medical imaging device offers real time informtion from SUPERFICIAL tissues?
ultrasound
Which medical imaging device provides higher resolution for SUPERFICIAL tendon, ligament, and muscle than MRI?
ultrasound
Disadvantages of ultrasound or sonography…
inability to scan ________ joint structures
image quality is highly dependent on _______
deeper; operator
(brighter or darker?) signal indicates swelling, tendinosis (fibrosis/degeneration), aka hyperechoic appearance
brighter
With ultrasounds, __________ borders or lack of structure indicate tears
irregular
With ultrasounds, (narrow or widening) structures indicates swelling, thickening?
widening
When should you recommend a imaging for a pt.?
hx and exam
With imaging, CPR are _______ based with research
evidence
With imaging, CPR are based on ________ and _______ decisions
diagnostic and prognostic
The ___________ criteria is…
Foremost decision-making guideline
Guides choice of best imaging tool
Developed by expert radiologists
May use with or without trauma
Appropriateness
What are some factors for decision making for MSK conditions?
age
trauma
mechanism of injury
prior sx
clinical findings
Imaging (-) without clinical findings = ________
normal/asymptomatic
If a suspicious condition e.g., acts like a fracture but x-ray (-) you should consider a more advanced and specific image, like a ____
CT
Imaging is best at ruling in or out?
OUT!!!!!
Imaging (+) without matching clinical findings
indicates what?
negative effect on ________ status
fear of _______
limit _______ potential
psychosocial
activity
rehab
