Radiographs Upper Extremity

Question 1

radiographic densities: air color

Answer 1

black

Question 2

radiographic densities: fat color

Answer 2

dark gray

Question 3

radiographic densities: water color

Answer 3

light gray

Question 4

RD: bones color

Answer 4

white

Question 5

RD: metal color

Answer 5

whiter than bone

Question 6

Ultrasound benefits

Answer 6

accessible, no radiation

Question 7

indications for Ultrasound of upper extremity

Answer 7

evaluate rotator cuff, long head biceps tendons, joint fluid, radiolucent foreign bodies, palpable abnormalities, vascular structures
-used to guide injections for MR or CT or to administer steroids

Question 8

Computed tomography (CT)

Answer 8

accessible, fast, osseous detail, radiation is downside

Question 9

CT densities: water number

Answer 9

0

Question 10

CT densities: air number

Answer 10

-1000

Question 11

CT density: soft tissue number

Answer 11

-100 to +100 with fat below 0

Question 12

CT density: compact bone number

Answer 12

+3095

Question 13

window level- the hounsfield unit set

Answer 13

set to middle gray
-window width range of gray scale
numbers below width-black
numbers above width are white
wide window width used for bones
narrow width used for soft tissue

Question 14

indications for CT of upper extremity

Answer 14

• complex fractures visualized with XR but need more detail prior to surgery
• abnormal XR with questionable fracture
• evaluating soft tissue (rotator cuff tendons) in patients with MRI contraindications

Question 15

magnetic resonance imaging

Answer 15

slightly less accessible, slower to perform, all palnes, soft tissue contrast, high resolution, no radiation

Question 16

indications for MRI of upper extremity

Answer 16

1) suspected soft tissue abnormality
muscular, ligamentous, tendinous, etc
rotator cuff tear, niceps tendon tear
2) suspected fracture with normal radiographs
3) peripheral neuropathy

Question 17

fluoroscopy

Answer 17

real time imaging, less accessible, radiation, can be used for procedures (arthrography) or in OR (fracture fixation)

Question 18

indications for UE arthrography

Answer 18

suspected labral pathology

suspected rotator fucc pathology with normal or indeterminate MR without intra articular contrast

Question 19

nuclear medicine

Answer 19

less accessible, radiation, used to evaluate physiologic uptake/activity, poor anatomic detail

Question 20

indications for UE nuclear medicine exam

Answer 20

detection of infection, fractures, metastases

Question 21

interpretiing radiographs

Answer 21

ABCS

Anatomy and alignment
Bones
Cartilage and Joints
Soft tissues and foreign bodies

Question 22

osteoarthritis radiographic hallmarks

Answer 22

• joint space narrowing
• subchondral sclerosis
• subchondral cysts
• -osteophytes

Question 23

tumors: enchondroma

Answer 23

benign cartilaginous intramedullary neoplasm

• hand, foot, femur, tibia, humerus
• lytic lesion in hand or foot
• chondroid calcifications with rings and arcs pattern
• scalloped endosteum
• cortical expansion
• no periosteal reaction or soft tissue mass

Question 24

lytic osseous lesions

Answer 24

FOG MACHINES

• Fibrous dysplasia
• Osteoblastoma
• Giant tumor cell
• Metastases. multiple myeloma
• Aneurysmal bone cyst
• Chondroblastoma or chondromxoid fibroma
• Hyperparathyroidism
• Infection
• Non-ossifying fibroma
• Enchondroma
• Simple bone cyst