MSK imaging

Question 1

what is the benefit of a radiograph (x-ray)

Answer 1

inexpensive, readily available, can be portable and images produced in seconds to minutes

Question 2

How many views should you get when ordering and x-ray

Answer 2

always get 2 or more views

Question 3

What is Radiolucent on xray

Answer 3

air (appears black)

Question 4

what is radio-opaque on x-ray

Answer 4

bone/metal (appears white)

Question 5

what is a CT

Answer 5

computed tomography
images produced in several minutes
produces using ionized radiation

Question 6

What is increased or high attenuation on a CT

Answer 6

white (bone)/soft tissue

Question 7

what is decreased or low attenuation on a CT

Answer 7

Dark (air)

Question 8

What is an MRI

Answer 8

magnetic resonance imaging
images produced via magnetic fields
more expensive than CT and x-ray
images take longer to obtain but better differentiation of soft tissue densities (ligaments, tendons)

Question 9

when is MRI the imaging modality of choice

Answer 9

for non-fracture spine
infection
concern for malignancy
soft-tissue injuries

Question 10

when is an MRI contraindicated

Answer 10

metallic foreign bodies unless specifically designated MRI compatible

(cardiac implants, intraocular metallic FB, other metallic FB, surgical clips, cochlear and other auditory impants)

Question 11

What protocol is used for a patient with a TJA who obtained an MRI

Answer 11

MARS protocol to correct metal artifact

Question 12

What type of MRI is it when the water is dark

Answer 12

T1 weighted image

Question 13

what type of MRI is it when the water is bright

Answer 13

T2 weighted image

Question 14

What are the ABCS of MSK radiographs

Answer 14

1. adequacy
2. alignment
3. bones
4. cartilage
5. soft tissues

Question 15

what falls under adequacy of an MSK radiograph

Answer 15

joint above and below
penetration
rotation

Question 16

what falls under alignment of an MSK radiograph

Answer 16

bones and joint
dislocations/subluxation

Question 17

what falls under bones of a MSK radiograph

Answer 17

cortex regularities
densities

Question 18

what falls under cartilage of a MSK radiograph

Answer 18

joint space
distruption of joint surfaces
any calcifications in joint spaces

Question 19

what falls under soft tissues of a MSK radiograph

Answer 19

disruption
air
swelling
FB/calcifications
metal

Question 20

what are the primary fracture classifications

Answer 20

closed
open
periprosthetic
pathologic
articular
extra-articular
non-displaced
displaced
simple
wedge
complex

Question 21

what are the fracture morphologys

Answer 21

transverse
oblique
spiral
segmental

Question 22

What are the different classifications of periprosthetic hip fractures

Answer 22

Ag: greater trochanter
Al: lesser trochanter
B1 through B2: around prosthesis
C: below tip of prosthesis

Question 23

when does a periprosthetic hip fracture usually require surgery

Answer 23

B1 through B2 most likely need revision and C will need ORIF

Question 24

What is a Salter harris fracture

Answer 24

classifcation for pediatric fractures around or involving the growth plate.
type 1-5

Question 25

What is a salter harris type 1 fracture

Answer 25

seperated growth plate

Question 26

what is a salter harris type 2 fracture

Answer 26

above the growth plate

Question 27

what is a salter harris type 3 fracture

Answer 27

beLOW growth plate

Question 28

what is a salter harris type 4 fracture

Answer 28

Through grow plate

Question 29

what is a salter harris type 5 fracture

Answer 29

erassure or growth plate

Question 30

what is a greenstick fracture

Answer 30

incomplete fracture/bending or splintering of the bone

Question 31

what is a torus/buckle fracutre

Answer 31

impaction of the bone, result of an axial load