Investigation Flashcards
things to consider before imagine bone?
flat/long?
diaphysis/metaphysis/ epiphysis?
medulla/cortex / trabecular?
diffuse/local?
diffuse bone disease?
brittle bones- osteoporosis
soft bones- rickets/ osteomalacia, paget’s
local bone disease?
trauma, neoplastic, inflammatory, degenerative
a bone scan is…
a map of osteoblastic activity
3 spinal deviations from normal?
lordosis- cervical deviation
kyphosis- thoracic deviation
lordosis- lumbar deviation
a normal vertebrae (C3-L5) is made up of?
vertebral body with posterior arch (have 2 pedicles), laminae, 1 spinous process and 2 transverses processes
neural foramen
facet joints superiorly and inferiorly
what are 2 abnormal vertebrae?
C1 and C2
how does C1 differ from the normal vertebra?
has no vertebral body- only anterior and posterior arches
how does C2 differ from the normal vertebra?
has an odontoid process that projects superiorly into C1
what mode of imaging is used for fractures?
CT
what mode of imaging is used for ligamental damage?
MRI- ligament damage appears light
what is a diagnostic MRI findings to indicate spinal ligament damage?
abnormal vertebral alignment
explain the use of different imaging techniques for the identification of bone tumours?
Xray & CT: shows bone sclerosis
MRI: shows bone marrow infiltration, extradural mass and spinal cord compression
what are intra-vertebral discs?
they cushion the vertebras
what imaging is used for IV disc disease e.g. disc prolapse or herniation?
MRI- disc prolapses
what is disc dehydration?
it commonly precedes disc prolapse
what imaging is used for spinal cord?
MRI
what are the tell tale signs of osteoarthritis?
- asymmetric jt space reduction
- sclerosis (dense bone)
- cysts
- osteophyte formation
what are tell tale signs of RA?
- jt involvement is symmetrical
- soft tissue swelling
- periarticular osteoporosis
- marginal erosion*
what does periarticular osteoporosis look like on x-ray?
appears less white
what are tell-tale signs of seronegative arthritides?
synovitis, enthesitis
sacroiliac jt and spine involvement
ill defined periarticular new bone formation
ossification of ligaments/ bone fusion across jts
what does isotope bone scan show?
inc vascularity around inflamed joints
what does doppler USS show?
thickening of synovium and inc blood flow
which x-rays should you get with trauma presentation?
AP, horizontal beam
things to remember when doing x-rays…
fracture appearance variable always assess bony alignment check for soft tissue abnormalities look for other fractures some FBs don't show on x-ray
which fractures should you be extra aware of?
posterior shoulder dislocation, supracondylar fracture (brachial artery), scaphoid fracture (AVN), Bennett’s fracture
how do children have different bones?
bend more (plastic bowing fracture)
greenstick (incomplete) fracture
soft tissue injuries more common
salter-harris fractures
what are salter-harris fractures?
epiphysis fracture
which x-ray should you get to diagnose posterior shoulder dislocation?
oblique view
MRI used to assess…
deep soft tissue
USS used to assess…
superficial soft tissue
CT good for…
resolves many x-ray limitations- good to further assess bones
what are the 4 accessory ossification centres in young
5th MT, calcaneus, fabella (sesamoid bone in gastrocnemius), rounded sesamoid bone in 1st MT head
