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Musculoskeletal system > Lecture 2- MSK radiology > Flashcards

Lecture 2- MSK radiology Flashcards

1
Q

How is an X-ray produced

A

a projectional image generated. by passage of x-rays through an object

the iamge is generated on a detector plate called an x-ray detector

when the x-ray hits the plarte, it turns black- the amount of blackned depends on the number of x-rays penetrating the object and hitting the plate

x-rays only travel in srraight lines- no deflection by bones or metalwork

X-ryas are absrbed by dense materials

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2
Q

if X-ray white

A

ense

◦X-rays are absorbed by dense materials - wont hit the plate ‣ Bones

‣ Metals

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3
Q

if x-ray dark

A

If darker

◦Less dense
‣ Adipose

‣ Air

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4
Q
A
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5
Q

advantage of x-ray

A
  • quick
  • Available
  • Inexpensive
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6
Q

disadvantage of x-ray

A

involve radiation

Poor soft tissue contrast resolution

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7
Q

role of radiographs

A
  1. Initially imaging of choice for skeletal trauma/acute bone or joint injury:
  • Fracture
  • Joint dislocation
  1. Also used for initial evaluation of chronic bone or joint pathoglogies
  • Chronic osteomyelitis
  • Chronic arthritis e.g. osteoarthritis, rheumatoid arthritis
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8
Q

which x-ray view is normal

A

posterior anterior

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9
Q

medullary bone found

A

in the diaphysis centre

  • less dense
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10
Q

cortex

A

made of cortical comapct bone

  • thick and dense
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11
Q

outermost layer of bone

A

periosteum

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12
Q

undispalced fracture of the tibia

A
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13
Q

a fracture is

A

complete or incomplete break in the cortex or continuity if the bone

Sometimes nutrient vessels look like fracture

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14
Q

Displacement

A
  • out of line slightly
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15
Q

cartilage is

A

radiolucent so appears as joint space

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16
Q

types of fractures (7)

A
  1. transverse
  2. linear
  3. oblique nondisplaced
  4. oblique displaced
  5. spiral
  6. greenstick
  7. comminuted
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17
Q

most fractures look like a

A

lucent line

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18
Q

fractur

A
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19
Q

always describe

A

which side you are looking at

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20
Q

draw transverse

A
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21
Q

draw linear

A
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22
Q

draw oblique nondisplaced

A
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23
Q

draw oblique discplaced

A
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24
Q

spiral

A
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25
Q

draw greenstick

A

like a twig being bent in half

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26
Q

draw comminuted

A
27
Q

fracture displacement

A
28
Q

compression fracture

A
29
Q

if a fracture is hard to see, what may make it clearer

A

a CT

30
Q

radiogrpahic changes seen during childhood

A
31
Q

ossification

A

bone growth

32
Q

calcification

A

deposition

33
Q

normal paediatrics x-ray

A
34
Q

what occurs to the bone during childhood to puberty

A

ossification of epiphysis

35
Q

ossification of carpal bones

A
36
Q

basic fracture healing process

A

1) haematoma formation
2) procallus formation
3) bony callus formation
4) bone remodelling

37
Q

the inflammatory phases of fracture healing

A
  • haematoma formation
  • tissue death
  • inflammation/ cellular proliferation
    • hours to days
38
Q

reperative phase of fracture healing

A
  • angiogenesis/ granulation tissue/ procallus
  • soft (fibrocartilaginous) callus formation
  • consolidation/ hard callus formation
39
Q

remodelling phase

A

duration- months to years

  • remodelling of the callus so that the fracture line becomes completely obscured (radiographic union)
40
Q

x-ray of bone repair

A
41
Q

CT scans use

A

radiation to build cross sectional images of the body

  • thin slices give detailed info about the bone structure and pathology

Soft tissue detail is better than plain X-ray

42
Q

How long does a CT take

A

Whole body CT can be performed in a short time to look for bone or soft tissue injury

◦Slower than x ray

43
Q

what type of fractures are better to view on a CT than x-ray

A

Subtitle in-displaced fractures are better visualised on CT scan than plain x-ray

Spinal fractures and other complex rate like pelvic fractures can be seen in great detail- aid pre-

operative planning

Slices can be reformatted to create multiple planar and 3D images

44
Q

disadvantages of CT

A
  • radiation higher than x-ray
  • Motion artefact if patient moves - elderly confused
  • Poor soft tissue detail compared with MRI (but better than x-ray)
45
Q

in CT scans the density of body tissues is emasured in

A

hounsfield units (HU)

46
Q

tissue <0 HU

A

appear dark

e.g. air, fat and water

47
Q

tissue with 0- + 40 HU

A

shades of grey- soft tissue

48
Q

tissue of >100 HU

A

appears white

  • trabecular and cortical bone
49
Q

CT great at looking at different tissues in different concentrations

A

window can be selected e.g. can see lungs or soft tissue

50
Q

MRI

A

Utilises magnetic resonance of the hydrogen nuclei o produce high quality cross-sectional images of the body in any plane

no use of ionising radiation

Utilises radiofrequency pulses in presence of carefully- controlled magnetic field

51
Q

musculoskeletal MRI fundamental objectives

A

◦Define normal anatomy

◦Detection of pathology

52
Q

MRI is betetr than CT and X-ray at

A

assessing soft tissue

53
Q

MRI can also be used in assessment of

A

MSK infection- osetomyelitits

54
Q

MRi poor at showing

A

micro-architecture of the bone

55
Q

two tyoes of sequences in MRI

A

T1 and T2

56
Q

T1

A

Anatomy defining sequences

57
Q

T2

A

fluid sensitive

  • most MSK pathologies appear bright on fluid-sensitive sequences
58
Q

advantages of MRI

A
  • good detail: ligaments,tendons and muscle
  • Excellent for bone marrow imaging
59
Q

Disadvantages of MRI

A

scan are long time (45-60 mins)

Noisy

Claustrophobic

Non compatible with metallic/ electronic devices like pacemaker

60
Q

advantages of ultrasound MSK imaging

A
  • no radiation involved
  • Excellent soft tissue resolution for superficial soft tissue
  • Excellent imaging modality for assessment of tendons a nd peripheral nerves
  • Fluid collection
  • Superficial foreign bodies
  • Dynamic imaging
  • Excellent for image guided MSK intervention
61
Q

disadvantages of ultrasound

A
  • operator dependent
  • Poor deep tissue resolution
  • Limited bone and intra-articulation imaging
62
Q

example of ultrasound

A
63
Q

nuclear imaging

A

Radioisotope-labelled, biologically actve drugs that are administered to the patient to serve as a marker of biological activity

64
Q

why is nuclear imagibng used

A

They are used to assess areas of metabolically active bone such as when trying to localise

◦Bone forming metastatic lesions
◦Healing fracture
◦Area of osteomyelitis

Musculoskeletal system (7 decks)

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