Musculoskeletal Imaging Flashcards
WHat are the 6 modalities we can choose from for imaging?
radiographs
fluoroscopy
CT
US
MRI
Nucelar Medicine
How do you decide on the appropriate imaging modality? (7 ways)
body of interest
differential diagnosis consideration
age of patient
cost of exam
radiation dose
availability
What are the 3 guidelnes for choosing a modality? (What 2 things should you ask yourself when choosing, and then what do you do it more than one test will work?)
- what is the clinical qustion
- what test is most likely to answer this question (what tests are available to you)
- if more than one test will work
- safety of patient
- cost of procedure
What should you use when looking at an imaging study to ensure you don’t miss anything?
a search pattern
- ex: hardware-joints, bones, soft tissues
- fractures, hardware failure, calcifications, tumors degenerative arthritis
What are common pitfalls in radiology?
- inappropriate study
- incorrect projection (ex: pathology may be seen only on 1 view)
- poor quality exam
- size of patient
- satisfaction of search
- specifics
- vascular channels
- accessory bones
- developmental abnormalities
- timing of exam
- lack of correlation between imaging findings and clinical findings
WHat two imagin modalities don’t have radiation?
MRI and ultrasound
what are sesamoid bones?
bone embedded within a tendon where the tendon passes over a joint
what is an example of a sesamiod bone?
fabella
what are 3 examples of developmental abnormalities that can be seen on radiograph?
lunotriquetral coalition
marfans
sarcral agenesis
What does VINDICATE stand for?
a pneumonic to help come up with all differential diagnosis
Vascular
Infection
Neoplasm
Drugs
Inflammatory/idiopathic
COngenital
Autoimmune
Trauma
Endocrine/metabolic
How can you distinguish between benign and malignant on radiograph?
- benign is usually well circumscribed
- malignant has ill-defined borders and often is spreading acorss tisue types. for example a bone tumor that is visible in the surrounding soft tissue
- malignant may also have key distinguishing feature, for exx: Codman’s triangle which is suggetsive of Osteosarcoma
what are 3 examples of ablnormal calcifications that can be seen on radiograph?
calcific tendonitis
crest syndorme
soft tissue hemangiomas
Effusions can be a very helpful sign! WHat joints will manifest an effusion radiographically?
knee
elbow
ankle
wrist
fingers
**seen in Rheumatoid arthritis
What is lipohemarthrosis and what is it suggestive of?
fat in your joints. common after a fracture
what are some things to include in a fracture description
location
orientation
displacement
apposition
angulation
intraarticular involvement
comminution
open vs closed
associated injuries
WHat is commonly seen with an ACL tear?
Segond fracture
Why is it important to know a patient’s age when looking at a radiograph?
bc age and appearance matter. for examples a shallow joint space in an elderly person is more suggestive of a degenrative arthritis and is not very alarming. howver if the same image is seen on a young person it is more alarming and likely not arthritis. in the example in class it was actually caused by constant bleeding into the joint space due to hemophelia
