Musculoskeletal Imaging Flashcards
how to decide on appropriate imaging modality?
DDx, body part of interest, age, pt history, COST, RADIATION DOSE, availability
guidelines for choosing a modality
- clinical question?
- what test most likely to answer this question?
- if more than one, a) safety and b) cost
search pattern for imaging?
hardware; joints; bones; soft tissues: look for fractures, hardware failures, calcifications, tumors, degenerative arthritis. WHAT COULD KILL THEM?
tenet of radiology?
one view is no view!
types of projections
AP, lateral
pitfalls of radiology
inappropriate study/projection, poor quality, satisfaction of search, timing of exam, lack of correlation btwn imaging findings and clinical findings
sesamoid bones
bone embedded within a tendon where tendon passes over joint. eg patella.
limbus vertebral body
look like fragments, but normal variation
ddx mnemonic
VINDICATE
benign v. malignant on xray
benign: well circumscribed.
malignant: periosteal rxn, outside of bone. codman’s triangle.
calcifications
calcific tendonitis (aunt minnie, in shoulder)
abnormal calcifications
crest syndrome; soft tissue hemangiomas
effusions
fluid around joint. easiest to see in knee. also in elbow, ankle, wrist, fingers.
fat floating on blood?
lipohemarthrosis, special effusion. indicates fracture b/c fat is from medullary canal
fracture descriptive terms
location, orientation, displacement, apposition, angulation, intraarticular involvement, comminution, open v closed, associated injuries
jones fracture
transverse fracture in 5th metatarsal. outside joint. high likelihood of not healing
rolando fracture
at base of thumb. displaced intraarticular fracture
intratrochanteric fracture
repairs can be different for the two trochanters at the hip
avulsion fracture
pulls bone off
joint disloctaion
can be severe (twist + break), hip popping out
segond fracture
Avulsion of lateral tibial tubercle from patellar tendon. often with ACL tear, PCL tear, patellar tendon fracture
types of arthritis
OA (common): osteophytes, asymmetric joint loss, predictable pattern. Inflammatory: RA, seronegative syndromes like ankylosing spondylitis, deposition diseases like gout and pseudogout
age vs appearance on x-ray
consider alt diagnosis when age doesn’t match the image: 26 yo w knee pain and loss of cartilage = JIA
