musculoskeletal radiology

Question 1

minor trauma

Answer 1

• conscious patients
• clear history
• no life-threatening injuries
• conventional x-ray
• sonography
• CT

Question 2

polytrauma

Answer 2

• often unconcious patients
• maybe: life-threatening injuries
• FAST sonography (focused assessment with sonography in trauma) -> free abdominal & pleural fluid
• RUSH (rapid ultrasound for shock and hypotension) -> free abdominal & pleural fluid, pericardial fluid, heart function
• whole body CT: unenhanced head CT, arteriovenous CT from head to pelvis

Question 3

degenerative changes

Answer 3

• mostly affected region: spine, hip, knee, shoulder
• osteopenia, osteoporosis
• joint line narrowing
• subchondral sclerosis
• narrowing of chondral plate
• subchondral cysts
• osteo-, spondylo- phyte

Question 4

inflammation - spread mechanisms

Answer 4

• direct spread: eg) with injuries

- indirect spread: most often hematogenous

Question 5

neoplastic disorders

Answer 5

• benign: well-defined, no destructive changes, no periosteal reactions, slow progression, no metastasis
• malignant: ill-defined, destructive, infiltrative, periosteal reactions, fast progression, metastasis or locally aggressive
• always ask for conventional x-ray -> clue for diagnosis.
• preoperatively or local staging: MRI

Question 6

metabolic changes

Answer 6

• gout
• osteoporosis
• etc