LECTURE 2B and C

Question 1

best imaging for dens fx

Answer 1

CT

Question 2

Scintigraphy is…..

Answer 2

bone scan!
good for assessing metabolic activity/bone turn over
***not for soft tissue
-where stress fx are

Question 3

What would I use to see widespread bone disease like metastases, osteomyelitis, Paget’s?

Answer 3

scintigraphy (bone scan)
inject radiolabeled substance, determine whether focal areas of increased met uptake are present

Question 4

MRI is best for

Answer 4

soft tissue/bone marrow
*NOT for fx

Question 5

T1 weighted vs T2 weighted MRI

Answer 5

T1: fat is brightest, best anatomical definition and spatial resolution
T2: water is brightest

Question 6

MRA is for…

Answer 6

arthrogram:
contrast enhances ability to identify intra-articular lesions like LABRAL TEARS

Question 7

ultrasound is good for

Answer 7

soft tissues
allows real-time, dynamic imaging
-convenient, immediate
*NOT LABRUM…JUST SUPERFICIAL
but good at picking up fx (hurts!)

Question 8

bone is what echogenicity on diagnostic ultrasound?

Answer 8

hyperechoic-white

hypoechoic-dark
anechoic-black
isoechoic-relatively same

Question 9

What does DEXA measure?

Answer 9

most frequently for bone density!

Question 10

osteoporosis is

Answer 10

less than -2.5 SDs from mean
osteopenia (-1 and -2.5 SDs from mean)

Question 11

Pittsburgh Guideline for knee trauma is for….

Answer 11

MECHANISM OF INJURY: FALL/TRAUMA

Question 12

Pittsburgh Guideline for knee trauma

Answer 12

1. MOI is fall/trauma? YES
2. Are you younger than 12/older than 50? YES then X RAY!
   No–> then
3. Take 4 WB steps. Cannot? then X RAY!

Question 13

Canadian Cervical Spine Rule

Answer 13

1. Any one high risk factor: 65 and older, dangerous MOI, or numb/ting in extremities —> IMMOB
   if no, then

2.

Question 14

Ottawa Knee rule

Answer 14

X-RAY IF
1. 55 and older
2. tender at head of fib
3. isolated tender patella
4. can’t flex to 90
5. can’t WB immediately an din emergency department 4 steps

Question 15

Ottawa ankle rule

Answer 15

1. tender at post edge or tip of lateral malleolus
   OR medial mal
2. inability to WB

Question 16

ottawa foot rules

Answer 16

1. tender at navicular or base of 5th met
   OR medial mal
2. inability to WB

Question 17

review new orleans criteria and canadian CT head rule

Question 18

SLR positive test 0-30 degrees means

Answer 18

acute MSK or tumor/lesion

Question 19

SLR 30-70 degrees means

Answer 19

compression/nerve irritation

Question 20

SLR positive CROSSED means

Answer 20

large disc herniation!
Very specific (SPIN-rules in)

Question 21

SLUMP test

Answer 21

positive if symptoms when back/neck flexed. better test if symptoms occur prior to 22 degrees of knee EXTENSION

Question 22

a 3 pulse means what?

Answer 22

normal
2-slightly reduced
1-super reduced
0-absent
4-bounding