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IDC Stuff > Radiology Review > Flashcards

Radiology Review Flashcards

1
Q

What are the different image modalities?

A 
X-ray
CT
MRI
US
Nuc Med
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2
Q

Which modality uses a single pulse of ionizing radiation?

A

X-ray

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3
Q

X-ray is good for? bad for?

A

Good-Bones and airspaces

Bad-Soft tissue and overlapping structures

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4
Q

X-ray film starts what color?

A

White

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5
Q

After being hit with ionizing radiation, x-ray turns what?

A

dark

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6
Q

What are the five basic radiographic densities?

A 
Air (darkest)
Fat (less dark)
Fluid/blood/soft tissue (gray)
Bone (white)
Metal/contrast (most white)
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7
Q

Because x-rays are two dimensional views of a three dimensional object it is important to get what?

A

multiple views

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8
Q

What are the x-ray views?

A

Anteroposterior (AP)
Lateral (LAT)
Oblique (OBL)
Posteroanterior (PA)

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9
Q

Anteroposterior is for what?

A

Used for patients unable to stand or sit

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10
Q

Is the PA or AP view higher quality?

A

PA

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11
Q

Which view magnifies the heart and makes borders fuzzy when doing a chest x-ray?

A

AP

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12
Q

Which x-ray view is usually taken in conjunction with PA view and gives three dimension to objects?

A

Lateral

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13
Q

Oblique is at an angle and mostly used on what body parts?

A

limbs

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14
Q

Which modality uses multiple pulses of ionizing radiation?

A

CT

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15
Q

CT is good for? bad for?

A

Good- Bone, airspace, some soft tissue and overlapping structures
Bad-Some soft tissues, nerves, muscles, connective tissues

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16
Q

What are the CT Views?

A

Sagittal or median
coronal
axial or transverse or cross-sectional

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17
Q

MRI uses what to image?

A

electromagnetism and radio frequency

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18
Q

MRI is good for? bad for?

A

Good- Soft tissue(nerves, muscles, connective tissue, brain and joints)
Bad-People who cannot hold still or have ferrous metals in the body

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19
Q

what are the views of MRI?

A

same as CT

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20
Q

What modality uses sound waves and does not use radiation?

A

US

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21
Q

US is good for? bad for?

A

Good-determine fluid vs solid, abdominopelvic, blood flow (doppler)
Bad-Things under bones and air filled chambers, deep objects

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22
Q

What are the US views?

A

Longitudinal (sagittal)

Transverse (axial)

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23
Q

Which modality is used with a radioactive agent and participates in the physiologic processes?

A

Nuclear Medicine

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24
Q

Nuc med is good for? bad for?

A

Good-Detecting normal or abnormal physiologic process

Bad-Showing less anatomic detail

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25
Q

What is the pre-read criteria for a film?

A 
Correct patient
correct date
correct body part
correct type
number of views expected
do comparison films exist
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26
Q

What is the RIP technique for?

A

Assessing technical adequacy

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27
Q

What is the RIP criteria?

A

Rotation
Inspiration
Penetration

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28
Q

What is looked for under rotation in the RIP technique?

A

Clavicles relative to vertebral column and equally spaced

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29
Q

What is examined on inspiration of the RIP technique?

A

Rib count is 9-10

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30
Q

What is looked for in penetration using the RIP technique?

A

See ribs through heart
barely see spine through heart
see pulmonary vessels near the edges of the lungs

31
Q

What is happening if a film shows lung fields almost completely black or a lung field (one or both) shows black with changes in pulmonary vessels?

A

Over-penetrated film

*over-penetration of one side could suggest pneumothorax

32
Q

When soft tissue structures are obscured or image appears bright what happened?

A

under-penetration

33
Q

In a lung fields with some brighter areas (unilateral or bilat) and no evidence of under penetration, indicating consolidation. You could suspect what diagnosis?

A

pneumonia

34
Q

What are the broad steps to reading a chest x-ray?

A

Pre-read
RIP technique
ABCDE method

34
Q

What are the broad steps to reading a chest x-ray?

A

Pre-read
RIP technique
ABCDE method

35
Q

What is the systematic method (ABCDE) to reading a chest film?

A 
A-airway/airspaces
B-bones/soft tissue
C-Cardiac shadow
D-Diaphragm
E-Everything else
36
Q

What are you looking for in the A of ABCDE? (detail)

A

Trachea midline and patent
Blood vessels all the way to edges
are there patches of white?

37
Q

What are you looking for in B of ABCDE? (details)

A

Clavicle, ribs, pectoral girdle and spine alignment, symmetry and fractures

38
Q

What are you looking for in C of ABCDE? (details)

A

Transverse diameter of the silhouette should not exceed 50% of the transverse diameter of the thoracic cage (PA only)

Cardiac borders

38
Q

What are you looking for in C of ABCDE? (details)

A

Transverse diameter of the silhouette should not exceed 50% of the transverse diameter of the thoracic cage (PA only)

Cardiac borders

39
Q

What are you looking for in D of ABCDE? (details)

A 
Diaphragm should be dome shaped
right hemidiaphragm is higher or same level as left
costophrenic angles (sulcus) - dark and sharp points
40
Q

What does E for ABCDE include? (details)

A

Gastric bubble

Check for EKG leads, equipment

41
Q

Imaging should be ordered to do what?

A

confirm a suspicion or diagnosis

42
Q

Examples of common issues in primary care that receive imaging are?

A 
acute foot pain
acute ankle pain
acute knee pain
low back pain
HA
43
Q

Acute ankle pain ottawa rules are?

A

Pain in malleolar zone
Tenderness to posterior edge (6cm) of lateral/medial malleolus
Inability to bear weight both immediately and four steps at evaluation

44
Q

Acute foot pain ottawa rules are?

A

Pain in midfoot
Bone tenderness at the base of the 5th metatarsal or navicular
Inability to bear weight immediately or for four steps in evaluation

45
Q

What are the steps if suspicion of stress fracture?

A

X-ray
Bone scan
CT or MRI

46
Q

Acute knee pain ottawa rules are?

A 
Age >55 
tenderness of patella
tenderness of head of fibula
unable to flex knee 90 degrees
Inability to bear weight immediately or for four steps in the evaluation
47
Q

If you suspect a ligamentous injury, what type of imaging should be used?

A

MRI

48
Q

If plain radiographs are negative what should you consider if you still suspect fracture?

A

CT

49
Q

What is the criteria to get imaging of shoulder?

A

Traumatic cause
presence of pain
loss of ROM

50
Q

Plain films of the shoulder should be able to identify what?

A

Fracture
Dislocation
Arthritis
AC or SC joint injuries

51
Q

Tuft fractures refer to fractures involving what?

A

head of distal phalanx

52
Q

What is a complex synovial joint formed by the articulations of the humerus, the radius and the ulna?

A

The elbow

53
Q

What are the three articulations of the elbow?

A

radiohumeral -capitellum of the humeus with the radial head
ulnohumeral -trochlea of the humerus with the trochlear notch of the ulna
radioulnar -radial head with the radial notch of the ulna

54
Q

The presence of a joint effusion in adults on a elbow film should be treated as?

A

non-displaced radial head fracture

55
Q

What is the term for an elevated fat pad due to fluid in the joint capsule raising the pad?

A

sail sign

56
Q

Dislocations of the elbow are named how?

A

the direction the radius and ulna are in relation to the humerus

57
Q

The UCL and lateral epicondylitis would be best assessed using what imaging modality?

A

MRI

58
Q

Imaging of the back is generally not indicated for how long?

A

4-6 weeks

59
Q

Imaging of the back is indicated if a patient presents with what?

A 
Neuro findings/cauda equina
Constitutional findings
traumatic cause
current/history of malignancy
Elderly (>50yo)
Infectious risk
chronic steroid use
nerve root irritation post conservative management
risk of osteoporosis
60
Q

Imaging of the head should be considered if a patient presents with?

A 
head/neck trauma
headache(new, worse, abrupt onset)
Focal neuro sxs
thunderclap
HA radiating to neck
positional HA
temporal HA > 55 yo
suspect infection
61
Q

What is the preferred imaging for trauma to rule out hemorrhage, bone abnormalities or prior lumbar puntcures?

A

CT

62
Q

What is preferred imaging for soft tissues such as tumors or vascular?

A

MRI

63
Q

What are the common fractures?

A 
Oblique
Transverse
Spiral
Overriding
Distraction
Torus
Greenstick
Comminuted
64
Q

what fractures has an angulated fracture line?

A

oblique

65
Q

what fracture runs perpendicular to the shaft of the bone?

A

transverse

66
Q

what fracture has a multiplanar and complex fracture line?

A

spiral

67
Q

what fracture has one bone displaced over another?

A

overriding

68
Q

what fracture has fragments separated by a gap?

A

distraction

69
Q

what fracture looks like a bump and is classified as an incomplete fracture in children?

A

torus

70
Q

what fracture is bending and is an incomplete fracture seen in children?

A

greenstick

71
Q

What fractures have more than two fracture fragments?

A

comminuted

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