Imaging Notes Flashcards
What are the basic projection for the Acromioclavicular joint?
AP, bilateral without weights
AP, bilateral with weights
What are the basic projections for the shoulder?
AP external rotation
AP internal rotation
What is the normal distance between the clavicle and the coracoid process?
1.0- 1.3cm
what is the normal distance between the clavicle and the acromion?
0.3- 0.8cm
What are the routine radiologic evaluation of the scapula?
AP
Lateral
What are the common radiograph views for a shoulder dislocation?
Axillary view and the scapular Y lateral view
What are the fundamental tenets of musculoskeletal MRI for any joint?
Define anatomy
Detect abnormal fluid
What are the ABCDS of MRI
Alignment Bone signal Cartilage Edema Soft tissue and synovial fluid
Fractures of the body of the scapula are usually the result of ?
a direct blow or violent trauma and are relatively rare
What are the basic projections of the elbow?
AP
Lateral
Obliques
What are the basic projections of the hand?
PA
Lateral
Obliques
What are the basic projections of the wrist?
PA
Lateral
Oblique
The degree of severity of degeneration will affect the ability of the spine to withstand what ?
- trauma
- to assume postural changes
- make functional gains in mobility and movement patterns
What is an example of a direct trauma to the spine?
Hit directly on the spine like getting hit with a bat
What is an example of indirect trauma to the spine?
Severe fall or car accident
What should physical evaluations of the spine include besides a diagnostic study?
Ligamentous stability test are very important to include after a trauma
What are the basic projections of the cervical spine?
AP open mouth
AP lower C- spine
Lateral
Right and left oblique
Why is the AP open mouth view important?
This view demonstrates the articulation of C1 and C2
What would indicate ligamentous laxity or tear, fracture, or dislocation of the atlantoaxial joint?
Any alterations of landmarks in the AP openmouthed view
What is important about the C2-C3 articulation and T1?
C2-C3 possesses the first intervertebral disk
T1 possesses the first rib articulation
What is the lateral view of the cervical spine good for?
evaluating the intervertebral disks space
Right and left obliques of the cervical spine are good for showing what?
intervertebral foramina
What is the lateral; flexion and extension stress view used for?
to examine the joints at the end ranges of voluntary flexion nd extension
What are the ABCDS of MRI for the spine?
Alignment Bone signal Canal space/ Central nervous system Disk integrity Soft tissues
What is the main projection for TMJ?
Transcranial view
Why would imaging of the cervical spine be included in the assessment of TMJ disorders?
- Pain associated with TMJ is usually in the sensory distribution of C2, C3, and C4 dermatomes
- Postion of sub cranial joints can influence the biomechanics of the TMJ
Chain of events that occur with the loss of cervical lordosis:
Mid cervical lordosis is flattened of reversed with forward head position
- leads to a shift of load from lower cervical to midcervical and sub cranial spine
- premature osteoarthritic changes of the facet joint
- increased incidence of headaches
What are the basic projections for the thoracic spine?
AP thoracic spine
Lateral thoracic spine
What are the basic projection of the sternum?
Posterior oblique
Lateral
What are the basic projections of the ribs?
AP or PA
Anterior oblique or Posterior oblique
What does the AP and PA view of the ribs show?
AP shows the posterior ribs
PA shows the anterior ribs
What does the oblique rib projection show?
Axillary ribs
What imaging is generally used now for the thoracic and lumbar spines after a blunt trauma?
CT scan
What is the primary modality to evaluate neural compromise, cord edema, cord contusion, epidural hematoma or ligamentous disruption?
MRI
What is Risser’s sign of skeletal maturity?
- 1+ indicates an excursion of the apophysis over 25% of the crest
- 2+ means 50% of the crest is “capped”
- 3+ is 75% is capped
- 4+ is 100% capped
- 5+ indicates osseous fusion is complete
What is the Cobb method of measurement?
The Cobb method is a widely accepted radiographic measurement of scoliotic curves
What is the general treatment guidelines for idiopathic scoliosis?
- Patients with curves of minimal magnitude: no active treatment; just observation
- Patients with curves between 20 and 40 degrees: spinal bracing and exercise for several months
- Patients with curves over 50 degrees: surgical fixation
What are the basic projection of the chest?
PA
Left Lateral
What does a PA view of the chest show?
Lung fields from the apices down to the costophrenic angles, air filled trachea, the heart, the great vessels, and the bony thorax
What structures are best seen from the left lateral view of the chest
- Heart
- Aorta
- Posterier tracheal wall
- Posterior esophageal wall
- Left lung
What information can echocardiography provide?
information on abnormalities in the pattern of blood flow, cardiac output and ejection fractions, function of the valves, thickness and motion of the heart wall etc.
What are the basic projections of the lumbar spine?
AP
Lateral
Right and left obliques
Lateral L5-S1
What is spondylolysis?
only a fracture on one side “dog with collar”
What is spondylolisthesis?
both sides have fractured and separated “dead dog”
What is the basic projection of the Pelvis?
AP
What is the basic projection of the hip and proximal femur?
AP
Lateral Frog leg
What are the basic projections of the knee?
AP
Lateral
PA axial “tunnel”
Tangential view “sunrise”
What does the PA axial “tunnel” view of the knee show?
detects loose bodies in the joint, and possible osteochondral defects
What is considered to be the most commonly injured, major weight bearing joint in the body?
The ankle
why can subtle ankle and foot fractures be missed in initial examinations?
because the subtle fractures can be very similar to ankle sprains
What are the basic projections of the ankle?
AP
AP oblique
Lateral
What are the basic projections of the foot?
AP
Lateral
Oblique
What are accessory bones?
an anomalous bone that usually form because of a failure of one or more ossification centers to unite with the main mass of bone
What are the most commonly occurring accessory bones of the foot?
os trigonum
os intermetatarseum
os tibiale