Session 1 MSK radiology Flashcards

1
Q

What is a radiograph/ X-ray?

A
  • projectional image generated by passage of x-rays through an object onto a x-ray detector.
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2
Q

how do X-rays generate an image?

A
  • x-rays travel in a straight line, are absorbed by dense material with a lot of electrons, so don’t hit the detector plate hence appears white.
  • whereas if x-ray pass through it appears black (lungs)
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3
Q

discuss the advantages and disadvantages of radiographs.

A
  • quick
  • readily available and inexpensive

X involves ionising radiation increasing risk for apoptosis (dose less than CT)
X poor soft tissue contrast resolution

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4
Q

where are X-rays used in MSK imaging?

A
  • skeletal trauma or acute bone and joint injury like fractures or dislocations.
  • initial chronic bone or joint pathologies, like chronic osteomyelitis and arthritis.
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5
Q

how would you define a fracture?

A
  • complete or incomplete break in continuity of the bone.
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6
Q

what are the types of fractures? (6)

A
  • transverse : horizontal crack
  • linear : medullary vertical crack.
  • oblique : diagonal fracture can be non-displaced or displaced.
  • spiral : may appear oblique
  • greenstick : common in kids.
  • comminuted : fragmented bone usually accidents.
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7
Q

what are some radiographic changes seen during childhood?

A
  • ossification of epiphyses and calcification.

- epiphyseal growth plate separating metaphysis and epiphysis decreasing in size.

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8
Q

Fracture healing is consisting of three phases. what are they?

A
  • Inflammatory phase : no radiographic signs.
  • reparative phase : callus on x-rays.
  • remodelling phase : radiographic union.
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9
Q

describe the inflammatory process.

A
  • haematoma, tissue death and inflammation.

- hours to days.

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10
Q

describe reparative phase.

A
  • angiogenesis, granulation, pro-callus.
  • fibrocartillaginous callus.
  • hard callus.
  • days to weeks.
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11
Q

What is CT scanning?

computed tomography

A
  • use of radiation to build cross sectional images of body to give detailed info about bone structure and pathology to guide injections, biopsies and aspirations in real time.
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12
Q

what are some disadvantages of CT imaging?

A
  • high radiation dose.
  • motion artefact if patient moves.
  • poor soft tissue detail compared to MRI.
  • 1 in million chance of fatal cancer increased to 1 in 2500.
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13
Q

how do you interpret CT scans?

A
  • density of body tissues measured in hounsfield units (HU).
  • air and fat appears black as less than 0HU.
  • trabecular cone and cortical appear white as more than 100HU.
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14
Q

what is an MRI scan?

A
  • utilizes magnetic resonance of the hydrogen nuclei to produce cross sectional images of body in any plane to define normal anatomy and detect pathology.
  • no ionising radiation.
  • used to assess bones, joints and soft tissue, assess MSK infections.
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15
Q

differentiate between T1 weighted and T2 weighted MRI.

A
  • T1 is anatomy defining so fats whiter.

- T2 fluid sensitive so brighter.

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16
Q

what are the advantages and disadvantages of MRI scans?

A
  • soft tissue imagine excellent.
  • detailed anatomy of joints.
  • bone marrow imagine excellent.

X long time and noisy
X claustrophobic patients struggle
X metallic compatibility with pacemakers

17
Q

what are the advantages and disadvantages of using ultrasound?

A
  • no radiation
  • excellent soft tissue
  • superficial foreign bodies detected
  • dynamic imaging
  • MSK interventions

X operator dependent
X poor deep tissue resolution
X limited bone and intra-articular imaging

18
Q

what is nuclear imaging?

A

radioisotope labelled, biologically active drugs administered to serve as marker for biological activity

  • assess metabolically active bone to localise metastatic lesions, healing fractures, osteomyelitis.
  • darker areas where contrast high shows abnormal uptake.