Orthopedics: Radiology intro Flashcards
Xrays: Form of ___________ radiation
Electromagnetic
Density Principle: Thicker the object —> ________ penentrability
less
Components of xray
Xray tube, beam and film plate
Shape idea
3D –> 2D based on shape and density
Radiopaque vs Radiolucent
Radiopaque (i.e. bone) - relative impenetrability to X rays
Radiolucent (i.e. air) - relative penetrability to X rays
An x-ray (or any test) is only as good as the _______________
History and Physical
Treat _____, not xrays
people
Understand the test you order and its ____________
potential outcomes
Understand ________ and ________ of x rays
Strengths and weaknesses
Metaphysis vs. Diaphysis
Metaphysis - region next to joint
Diaphysis - long part of bone
Epiphysis
Epiphyseal Plate
Epiphyseal plate - growth plate
Epiphysis - bone part distal to growth plate
Apophyseal plate
Apophysis
Growth plate w/ tension from tendon (i.e. elbow)
Distal area
Reasons to get Xrays
Pain - traumatic or nontraumatic
Miscellaneous (congenital, endocrine)
Complete disrupption in the continuity of bone
Fracture
Fracture shows up as ________ on Xray
radiolucent line
Fractures: Obtain ________ views (ideally in ________ planes) of involved bones
AT least 2 views, perpendicular
Obtain X ray of joint _______ and ________ fracture
above and below
Consider ________ views in children
contralateral
Look for __________ of fracture
indirect signs
Indirect signs of a fracture
- Soft-tissue swelling
- Obliteration or displacement of fat stripes
- Periosteal and endosteal reaction
- Buckling of the cortex
- Double cortical line
Which is fracture?
One on left - look at thicker soft-tissue (swelling)
Periosteal reaction - healing
Buckling of cortex
Double cortical line
Describing X ray of fracture
View
Soft tissue abnormalities
Fracture description
Fracture description
Anatomic location
Type of fracture
Direction of the fracture line
Alignment of the fracture
Special features
Associated abnormalities (i.e. tumor)
Simple vs. comminuted
Simple - one line
Comminuted - multiple fracture lines
Displacement vs Angulation
D - movement away from midline
A - angled away from midline (typically in terms of distal fragment)
Valgas vs varus
Valgus - knock-kneed (Gum between)
Varus - in
Foreshortened, distracted
Compacted
Directions of fracture line
Transverse, oblique, spiral, longitudinal
Site and Extent of Fracture
Jct middle/distal third
Supracondylar
Intraarticular
Fracture Type
Buckle (torus)
Greenstick
Differential Dx/Classification of Arthritis (not on test… but good to know)
- Osteoarthritis
- Inflammatory arthritis (RA, SLE, scleroderma, etc.)
- Seronegative spondyloarthropathies (Reiter’s, ankylosing spondylitis, psoriatic, reactive arthritides)
- Crystal deposition arthropathy (Gout, pseudogout)
- Metabolic / endocrine
- Infectious
Radiographic dx of arthritis is based on:
The morphology of an articular lesion
Its distribution in the skeleton
_______ most important radiologic imaging modality of arthritis
x rays
RAdiographic features of arthritis
Periarticular osteoporosis, subchondral sclerosis, soft tissue swelling, subchondral erosion, narrowing of joint space, joint effusion, osteophyte formation, subchondral cystlike lesions
Xray appearance of osteoarthritis
- Marginal osteophytes
- Cortical irregularity
- Subchondral sclerosis
- Subchondral cysts
- Joint space narrowing
RA appearance on xrays
- Periarticular osteoporosis
- Joint effusion
- Joint space narrowing
- Articular erosions/destruction
- Synovial cysts
- Deformities
