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MSK Final > Radiology > Flashcards

Radiology Flashcards

1
Q

What do you observe with Rheumatoid Arthritis on xray? (4)

A

erosions
joint space narrowing
osteopenia (periarticular)
soft tissue swelling (inflammation)

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2
Q

What are the gross deformities of Rheumatoid Arthritis? (4)

A

swan neck
boutenierre
subluxations (ulnar MCP deviation and cervical vertebrae)
ankylosis

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3
Q

Define ankylosis

A

rigid

consolidation of a joint

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4
Q

Define pannus

A

abnormal layer of fibrovascular tissue or granulation tissue over a joint surface
grow in a tumor-like fashion, as in joints where it may erode articular cartilage and bone.

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5
Q

psoriatic arthritis on xray

A

erosions= “pencil in cup” deformity of the phalanges

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6
Q

reactive arthritis: what joints?

A

lower extremity: feet and SI joint

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7
Q

define sclerosis

A

stiffening of a structure, usually caused by a replacement of the normal organ-specific tissue with connective tissue

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8
Q

Define tophus, and name the associated disorder.

A

gout: A nodular mass of uric acid crystals
non-agressive erosions
overhanging edges
White, chalky gross appearance

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9
Q

What is this the most common joint involved in gout?

A

first MTP

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10
Q

Describe the appearance of CPPD deposition on xray.

A

chondrocalcinosis-cartilage calcification
looks like osteoarthritis but in unusual joints (nonweightbearing joints)
- classic is the shoulder or patellofemoral joint (normally the last area of the knee to get osteoarthritis)

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11
Q

Define osteophytes

A

small abnormal bony outgrowth in response to increased joint reactive forces (buttressing)

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12
Q

Define buttressing

A

developing thickened bone in response to increase in stress (often lateral growth where bone is not found normally)
osteophyte growth in response to increased joint reactive forces

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13
Q

Use ultrasound for what in MSK? (5)

A 
nerve blocks
fractures
tendon injury
foreign body
abscess vs cellulitis
The limit does not exist.
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14
Q

ULTRASOUND TERMINOLOGY: Echogenicity

A

tissue’s relative ability to reflect or transmit ultrasound waves

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15
Q

ULTRASOUND TERMINOLOGY: hyperechoic

A

(white on the screen)
hard/dense reflects virtually all ultrasound waves
nerves, fascia, cortex rim of bone, CT (tendon/ligament), epiderm/dermis

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16
Q

ULTRASOUND TERMINOLOGY:

hypoechoic

A

(gray on the screen) Adipose tissue, cartilage, muscle

US can pass

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17
Q

ULTRASOUND TERMINOLOGY:

anechoic

A

(black on the screen)
reflects virtually no ultrasound waves back to probe
vein, fluid

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18
Q

How does a nerve appear on ultrasound?

A

(hyperechoic with stippled “honeycomb” structure)

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19
Q

Explain the appearance of blood/fluid flow on ultrasound.

A

In Doppler mode, flow toward the probe appears red, while flow away from the probe appears blue.
*BART, i.e., Blue Away, Red Toward

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20
Q

What are the uses of high frequency probes (10–15 MHz) in ultrasound?

A

better resolution but have less penetration.

US imaging of superficial structures

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21
Q

What are the uses of a low frequency probe (2–5 MHz) in ultrasound?

A

deeper structures

quality of the image will be substantially poorer

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22
Q

What ultrasound probe do you use for MSK?

A

linear transducer

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23
Q

Describe the appearance of Necrotizing fasciitis on ultrasound.

A

thickened, distorted fascia with adjacent fluid and may have small echogenic foci of gas.

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24
Q

How do cysts a appear on ultrasound?

A

anechoic with posterior acoustic shadowing

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25
Q

How does cellulitis appear on ultrasound?

A

initially: generalized swelling and increased echogenicity of the skin and subcutaneous tissues

worse case:cobblestone appearance: hyperechoic fat lobules become separated by hypechoic fluid-filled areas (edema)

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26
Q

check for wrist alignment on xray: 3 C’s

A

radius-lunate-capitate

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27
Q

Define an “open fracture.”

A

skin broken

infection risk

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28
Q

comminuted fracture

A

more than one fracture plane

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29
Q

intra-articular fracture

A

extends to joint surface
no step off allowed
osteoarthritis risk

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30
Q

XRAY: radiodense/ opaque

A

inhibit the passage of electromagnetic radiation
opaque white appearance of dense materials
(bone, tendons)

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31
Q

XRAY: radiolucent/ lucent

A

allow radiation to pass more freely
darker appearance of less dense materials
(fat)

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32
Q

XRAY: what does “sail sign” refer to

A

effusion

soft tissue swelling around bony fracture

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33
Q

how to name a bone displacement/angulation

A

named for location of distal bone relative to proximal: distal medial displacement

34
Q

XRAY: distraction

A

bony fragments seperate

35
Q

complications of fracture (5)

A 
non/malunion
avascular necrosis
physeal arrest/fusion (growth)
neurovascular injury
early osteoarthritis
36
Q

fractures in children (3)

A

torus (buckle fx), greenstick, physeal

37
Q

salter harris fracture classification (5)

A 
1 physeal plate
2 physeal + metaphysis
3 physeal + epiphysis
4 metaphysis + physeal + epiphysis
5 crush of physeal plate
38
Q

seenm on XRAY: 2-3 weeks after fx

A

increased vascularity
wider fx line
resorption of Ca2+
remodeling

39
Q

XRAY: lytic

A

(low density - black)

40
Q

XRAY: sclerotic

A

higher density - white

41
Q

CT: based on differences in…

A

attenuation/density

42
Q

CT: low attenuation

A

black

air

43
Q

CT: high attenuation

A

white

bone

44
Q

MRI: signal intensity= hyperintense= High

A

bright/white

liquid/fat

45
Q

MRI: signal intensity= hypointense= low

A

dark/black

tendons/ligaments/bones

46
Q

MRI: use for T1-weighted image

A

anatomy

47
Q

MRI: use for T2-weighted image:

A

liquid//edema, tumor, infarction, inflammation, infection,

fat suppression***
pathology

48
Q

What is the gold standard for diagnosing bone tumors?

A

Conventional radiography

49
Q

What is the term for “benign” bone tumors?

A

Indolent

50
Q

What are the 3 locational divisions of bone on an axial plane?

A

Central: in the medulla
Eccentric: off-center in the medulla
Cortical: in the cortex (edge)

51
Q

Describe an 1A margin, and its implications

A
  • geographic
  • well-defined (can draw a clear line around it)
  • sclerotic around the edges (slow-growing enough that the bone can respond)
  • differential diagnoses are all benign
52
Q

What are the features of a non-ossified fibroma

A
  • benign
  • 1A margin
  • eccentric
  • very common in children and young
53
Q

Describe a 1B margin

A
  • geographic
  • Well-defined border
  • no sclerosis around the edges
  • Can be benign or malignant
54
Q

Describe a 1C margin

A
  • geographic
  • ill defined border
  • diagnosis usually malignant
55
Q

Describe a II margin

A

moth-eaten

  • can tell the location but the extent is very unclear
  • diagnosis usually malignant
56
Q

Describe a III margin

A
  • permeative
  • hard to distinguish from moth-eaten, but tends to be even harder to locate specifically in bone
  • diagnosis usually malignant, except for osteomyelitis
57
Q

What are the patterns of periosteal reactions with a nonaggressive tumor growth pattern? (4)

A
  • solid
  • buttressing
  • expansion
  • septation
58
Q

What are the patterns of periosteal reactions with an aggressive tumor growth pattern? (4)

A
  • Codman triangle
  • laminated
  • hair on end
  • sunburst
59
Q

best study for soft tissue and joints

A

MRI

60
Q

best study for spinal cord and brain

A

MRI and CT

61
Q

Myelography

A

combines dye with X-ray to evaluate problems with the spine that CT scans and an MRI might not be able to find.
can see bones, spinal cord, and nerve roots (compression of masses)

62
Q

indicators for imaging the spine/back

A 
low back pain
acute trauma
neoplasms
infections (abscess)
MS
vascular disease
63
Q

best study for bones

A

xray

64
Q

best study for reductions of fractures and guiding procedures

A

fluoroscpoy

65
Q

best study for vessels and best contrast for bones

A

CT

66
Q

best study for functional or metabolic information

A

nuclear medicine

67
Q

best study for soft tissue foreign body

A

US

68
Q

Xray: pros

A

cheap
rapid
good resolution

69
Q

xray: cons

A

need several views

radiation to pt

70
Q

fluoroscopy: cons

A

high dose of radiation to pt

71
Q

CT: pros

A

rapid
good resolution
can see behind structures

72
Q

CT: cons

A

decreased soft tissue contrast (volume averaging artifact)

73
Q

MRI: pros

A

great soft tissue contrast and internal joint derangement

no radiation to pt

74
Q

MRI: cons

A 
expensive
long
magnetic field (no metal)
75
Q

nuclear medicine: cons

A

limited resolution

radiation to pt

76
Q

US: cons

A

limited contrast

air and bone limit deep field imaging

77
Q

used to study stress fractures, infection, and localizing tumors

A

nuclear medicine

78
Q

Codman triangle

A

triangular area of new subperiosteal bone that is created when a lesion, often a tumour, raises the periosteum away from the bone

79
Q

sequestrum

A

a piece of dead bone that has become separated during the process of necrosis from normal or sound bone.

It is a complication of osteomyelitis

80
Q

greenstick fx

A

common in flexible child bone

bone bends and cracks, instead of breaking completely into separate pieces.

MSK Final (15 decks)

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