Radiographs Upper Extremity Flashcards
radiographic densities: air color
black
radiographic densities: fat color
dark gray
radiographic densities: water color
light gray
RD: bones color
white
RD: metal color
whiter than bone
Ultrasound benefits
accessible, no radiation
indications for Ultrasound of upper extremity
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
Computed tomography (CT)
accessible, fast, osseous detail, radiation is downside
CT densities: water number
0
CT densities: air number
-1000
CT density: soft tissue number
-100 to +100 with fat below 0
CT density: compact bone number
+3095
window level- the hounsfield unit set
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
indications for CT of upper extremity
- 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
magnetic resonance imaging
slightly less accessible, slower to perform, all palnes, soft tissue contrast, high resolution, no radiation
indications for MRI of upper extremity
1) suspected soft tissue abnormality muscular, ligamentous, tendinous, etc rotator cuff tear, niceps tendon tear 2) suspected fracture with normal radiographs 3) peripheral neuropathy
fluoroscopy
real time imaging, less accessible, radiation, can be used for procedures (arthrography) or in OR (fracture fixation)
indications for UE arthrography
suspected labral pathology
suspected rotator fucc pathology with normal or indeterminate MR without intra articular contrast
nuclear medicine
less accessible, radiation, used to evaluate physiologic uptake/activity, poor anatomic detail
indications for UE nuclear medicine exam
detection of infection, fractures, metastases
interpretiing radiographs
ABCS
Anatomy and alignment
Bones
Cartilage and Joints
Soft tissues and foreign bodies
osteoarthritis radiographic hallmarks
- joint space narrowing
- subchondral sclerosis
- subchondral cysts
- -osteophytes
tumors: enchondroma
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
lytic osseous lesions
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
