S1_L1: Introduction to Musculoskeletal Imaging Flashcards
Gold standard for imaging and the initial line for screening (first order diagnostic study or first imaging procedure to be done following the clinical examination).
x-ray
A branch of medicine concerned with radiant energy and radioactive substances, including x-rays, radioactive isotopes, ionizing radiation, and the application of the information to prevention, diagnosis, and treatment of disease.
Radiology
Note: Radiology is both diagnostic imaging and medical imaging. Radiology may be used to virtually evaluate all systems of the body.
The gold standard against which all imaging modalities are measured after. It is simple and accessible, and the cheapest option for patients.
Film radiography
It is a type of modified photograph that is sensitive to light and radiation.
X-ray film
Provides real time imaging of physiological function and allows for active diagnosis during the examination.
A. Film radiography
B. Fluoroscopy
C. Computed Radiography
D. Digital Radiography
B. Fluoroscopy
- Images taken may be recorded like x-rays or may be recorded like video.
- Film replacement technology
A. Film radiography
B. Fluoroscopy
C. Computed Radiography
D. Digital Radiography
- B
- C
Direct digital radiography uses an x-ray ____ material to convert x-rays into an electrical charge.
sensitive semiconductor
Indirect digital radiography uses an x-ray ____ material to convert x-ray photons into light photons.
absorbing scintillating
TRUE OR FALSE: The denser the object, the more absorbant the x-ray.
True
Note: When this happens, the bone becomes most white (it is the most dense structure).
Radiodensity is determined by either of these 2 properties
- Composition (effective atomic number and volume density)
- Thickness
A thicker object has more radiodensity than a thinner one. The greater the object’s effective atomic number and volume density, the less its radiodensity.
A. Only the 1st statement is true
B. Only the 2nd statement is true
C. Both statements are true
D. Both statements are false
A. Only the 1st statement is true
Note: Radiodensity is directly proportional to EAN and VD.
Found in all soft tissues of the body including blood, muscle, cartilage, tendons, ligaments, nerves, and fluid-filled organs
Water
Note: Radiographs have limited value in assessing soft tissue structures without the additions of a contrast medium.
TRUE OR FALSE: Fat is more radiodense than water.
False
TRUE OR FALSE: Fat is more radiodense than air.
True
Subspecialty of diagnostic radiology in which radiologists diagnose and treat diseases non-operatively with the help of imaging modalities
Interventional radiology
____ are of human origin, but invisible to the human eye and
produced in wavelengths varying from 10^-8 to 10^-11 cm.
X-rays
Traditionally only used by the MDs and now used by health professionals to know the functional anatomy of the patient.
Diagnostic imaging
Main goal of diagnostic imaging is ____ to enhance the quality of patient care.
professional collaboration
TRUE OR FALSE: An object with great radiodensity will attenuate almost all the x-rays from the beam so the expression of the radiographic image will be gray black.
False, the radiographic image will be white.
It is also known as body section radiography, the radiographic evaluation of one predetermined plane of the body.
Conventional tomography
TRUE OR FALSE: Ultrasonography is non-invasive and non-ionizing.
True, it uses sound waves, not radiation.
Selective destruction of nerve tissue for chronic pain disorders such as nerve pain or osseous metastases.
A. Epidural steroid injections
B. Spinal nerve blocks
C. Radiofrequency ablation
D. Diskography
E. Percutaneous Vertebroplasty, Kyphoplasty, Cementoplasty
F. Percutaneous Biopsy of the Spine
C. Radiofrequency ablation
- Used for detecting sources of radicular pain
- Applicable for patients with spinal stenosis, disk herniation, or intractable neck or back pain
A. Epidural steroid injections
B. Spinal nerve blocks
C. Radiofrequency ablation
D. Diskography
E. Percutaneous Vertebroplasty, Kyphoplasty, Cementoplasty
F. Percutaneous Biopsy of the Spine
- B
- A
Performed by injecting a contrast medium into the disk to check for disk-related sources of pain.
A. Epidural steroid injections
B. Spinal nerve blocks
C. Radiofrequency ablation
D. Diskography
E. Percutaneous Vertebroplasty, Kyphoplasty, Cementoplasty
F. Percutaneous Biopsy of the Spine
D. Diskography
A procedure done to relieve intractable pain caused by fractures, malignancies, and structural damage to the spinal cord. Bone cement (Methyl methacrylate) is injected into the vertebral body using image-guided injection.
A. Epidural steroid injections
B. Spinal nerve blocks
C. Radiofrequency ablation
D. Diskography
E. Percutaneous Vertebroplasty, Kyphoplasty, Cementoplasty
F. Percutaneous Biopsy of the Spine
E. Percutaneous Vertebroplasty, Kyphoplasty, Cementoplasty
Additional: Cementoplasty is used primarily as a palliative treatment in cancer patients.
Used to detect possible pathologic fractures, malignant lesions, osteomyelitis or disciitis.
A. Epidural steroid injections
B. Spinal nerve blocks
C. Radiofrequency ablation
D. Diskography
E. Percutaneous Vertebroplasty, Kyphoplasty, Cementoplasty
F. Percutaneous Biopsy of the Spine
F. Percutaneous Biopsy of the Spine
Enumerate the ABCs of radiologic analysis
Alignment
Bone density
Cartilage space
Soft tissues
It is the ability of higher forms of radiation to disrupt the composition of matter and, as a result, may disrupt life processes. It is also the process by which a neutral atom gains or loses an electron, thus acquiring a net charge.
Ionization
Additional: Ionization may come from natural or artificial radiation. Medical and dental x-ray exposures constitute the greatest artificial source of radiation exposure.
- Changes in epiphyseal plate
- Textural abnormalities
- Changes in fat pads and fat lines and muscles
- Changes in bone contour
A. Alignment
B. Bone density
C. Cartilage space
D. Soft tissues
- C
- B
- D
- A
- Changes in joint capsule and periosteum
- Changes in subchondral space
- Changes in the gross size, appearance, and number of bones
- Less radiopaque bones
A. Alignment
B. Bone density
C. Cartilage space
D. Soft tissues
- D
- C
- A
- B
- Nuclear medicine
- First image intensifier for television viewing system for conventional radiograph
- Military use of X-Rays during WWI
A. 1910s & 1920s
B. 1930s & 1940s
C. 1950s & 1960s
D. 1970s & 1980s
E. 1990s to 21st Century
- B
- C
- A
- Sonar Technology
- Radiation protection
- Computer assisted diagnostics & three-dimensional image/ computer assisted/ robotics guided surgery
A. 1910s & 1920s
B. 1930s & 1940s
C. 1950s & 1960s
D. 1970s & 1980s
E. 1990s to 21st Century
- A
- C
- E
- Digital Radiography (Digital subtraction angiography, invasive radiology)
- Positron Emission Tomography (PET/CT, PET/MR)
- Little consideration for adverse effects of radiation
A. 1910s & 1920s
B. 1930s & 1940s
C. 1950s & 1960s
D. 1970s & 1980s
E. 1990s to 21st Century
- D
- E
- B
- Shift from analog to digital through the use of charge-coupled devices
- Computed Tomography, Magnetic Resonance Imaging, & Functional MRI
- Precursor of diagnostic US (would eventually evolve to US)
A. 1910s & 1920s
B. 1930s & 1940s
C. 1950s & 1960s
D. 1970s & 1980s
E. 1990s to 21st Century
- E
- D (CT: 1970s, MRI: 1984, Functional MRI: 1990s)
- A
It is the precursor of diagnostic US (would eventually evolve
to US) and was used to help find enemy submarines.
Sonar technology
TRUE OR FALSE: All x-rays created are artificial.
True
One of the founding scientists who discovered radiation and kept a sample of radioactive element in her pocket which contributed to her eventual death.
Marie Curie
TRUE OR FALSE: The average range of age of death of radiologists was 50-60 y/o d/t high radiation absorption and leukemia. They usually die of cancer-related problems
because of excessive radiation exposure.
True
Moving MRI used in neurologic examination of brain to view
electrical impulses and composition of the brain in thought processes
Functional MRI
Energy that is transmitted through space or matter
Radiation
Energy that may be mechanical, heat, nuclear, gamma rays/alpha particle or electromagnetic.
Radiation
Note: MRI falls under electromagnetic radiation and US falls under mechanical radiation.
Fundamental tool of the musculoskeletal radiologists that screens for a significant portion of pathologies, with little risk to the patient and extreme time and cost effectiveness.
Conventional radiography (X-Rays)
3 requirements for production of a radiograph
- X-ray beam source
- Patient
- Image receptor (either digital or analog/film receiver)
It is composed of Roegentographs/radiographs (WWI), plain films, and X-ray film containing images or parts of a patient’s anatomy.
Conventional radiography (X-Rays)
Formerly known as musculoskeletal radiology and orthopedic radiology
Musculoskeletal imaging
A form of ionizing electromagnetic radiation discovered by Wilhelm Conrad Roentgen in 1895.
X-rays