Session One Flashcards
Describe what Radio dense/Radiopaque is?
Light/white area on the radiograph due to presence of dense objects in paths of photons that are strong absorbers e.g., metal replacement
Describe what Radiolucent is?
dark/black area on the radiograph due to maximum number of photons passing through the object e.g., air
What is contrast?
The degree of difference between adjacent densities
What is Density?
Radiographic density is dependent on amount of radiation received and refers to the degree of darkening of an exposed radiograph e.g.,
- white areas = no density
- black areas = maximum density
What condition could have Uniform joint space loss?
Rheumatoid Arthritis
What condition could have Non - Uniform joint space loss?
Osteoarthritis
What are the 3 types of arthritis?
Inflammatory
Degenerative
Metabolic
What is an example of a local congenital segmental defect?
Block vertebrae
What is an example of a generalised congenital skeletal anomoly?
Achondroplasia
Name 2 examples of trauma
Fracture / Dislocation
What different types of fractures are there when looking on an x-ray?
complete/incomplete; spiral; oblique; transverse; comminuted ( more than 3 separate pieces)
Name 2 bone marrow disorders
Anaemia
Leukaemia
What is a condition associated with lack of blood supply?
Avascular necrosis
Name a bone infection
Osteomyelitis
Name a joint infection
Septic arthritis
What are the main two types of tumours?
Malignant or benign
What conditions can be as a result of Endocrine, Nutritional, Metabolic?
Osteoporosis / Osteomalacia / Rickets / Scurvy / Hyperparathyroidism / Steroids use
Name 2 conditions that calcifications indicate in pathology?
Lupus or scleroderma
What could swelling on a radiograph indicate?
Inflammation / bleeding
What is the pneumonic - CATBITES?
C – Congenital
A – Arthritis
T – Trauma
B – Blood
I – Infection
T – Tumours
E – Endocrine, Nutritional, Metabolic
S – Soft Tissue
What is the pneumonic - VINDICATE?
V – Vascular
I – Infection / Inflammatory
N – Neoplastic
D – Degenerative / Deficiency / Drugs
I – Idiopathic / Intoxication / Iatrogenic
C – Congenital
A – Autoimmune / Allergic / Anatomic
T – Traumatic
E – Endocrine / Metabolic
What condition is most common inflammatory arthritis?
Rheumatoid Arthritis
Name a degenerative arthritis?
Osteoarthritis
Do patients with Osteoporosis have a high or low bone density?
Low
Do people with Osteoporosis have more brittle bones compared to those without the condition?
Yes
If people with osteoporosis have brittle bones, is the first point of treatment to be doing manipulation?
No
What are the ABCDS?
A - Anatomy, Alignment & Articular
B - Bone
C - Cartilage
D - Deformity, Density &Distribution
S - Soft Tissue
Is the radiolucent area on the radiograph light or dark?
Dark
Is the radiodense area on the radiograph light or dark?
Light
Is the radiopaque area on the radiograph light or dark?
Light
What are the 5 areas/shades for density?
Air
Fat
Water
Bone
Metal
On an x-ray, which material is darkest?
Air
On an x-ray, which material is lightest?
Metal
What are the 4 important things to write in a report?
- Location
- Side - R/L
- Severity - Mild, Moderate, Severe
- Diagnosis
When assessing a radiograph, what should you NOT do first?
Do not think of a diagnosis first - look at the signs and see where the evidence leads
What are you looking for with Articular in an x-ray?
Erosions.
Localisation: marginal - bare area or subchondral
What are you looking for when looking at Bones on an X-ray?
Any Productive changes i.e osteophyte formation, scelrosis subchondral, enthesophyte or spur formation, syndesmophytes and chondrocalcinosis
Diminished bone density - osteoporosis (non-focal), osteomyelitis (focal), cyst formation
What are you looking for when looking at Cartilage on an X-ray?
Joint space narrowing
What are you looking for in distribution on an x-ray?
Symmetric v asymmetric
Proximal vs peripheral (small or large joints)
Monarticular, polyarticular
What are the E - Extra Findings?
Demographics (age and sex)
Systemic symptoms or laboratory data
What are you looking for under soft tissue on an x-ray?
Deformity, swelling
massing (nodules, calcifications, urate crystals)
What are marginal erosions?
They occur at the bare area of the joint, where the bone is not covered by articular cartilage. They are typically seen in rheumatoid arthritis (MCP-joints) and psoriatic arthritis (DIP).
They present with small, round erosions.
What are subchondral erosions?
They occur at the subchondral bone plate of the articular surfaces. They are a typical feature of erosive osteoarthritis.
They present like jagged edges
What is a gullwing deformity?
In erosive osteoarthritis the combination of central erosions and osteophytes results in a gullwing deformity
What is pencil in cup deformity?
In psoriatic arthritis the combination of marginal erosions and bone proliferation can result in a pencil-in-cup deformity
What are Peri- or juxtaarticular erosions?
Gout erosions are a bit more eccentric juxta-articular located, where the joint capsule attaches to the bone. They are most often seen in the MTP1-joint.
What is the typical erosion pattern of RA?
Typical marginal erosions in MCP-joints.
What is the typical erosion pattern of Erosive Osteoarthritis?
Subchondral erosions in DIP- and PIP-joints. The concurrent formation of osteophytes results in a gull-wing deformity.
What is the typical erosion pattern of Gout?
Eccentric erosion with an overhanging edge.
What is the typical erosion pattern of Infection?
Destructive changes with cartilage loss and erosions.
What is the typical erosion pattern of Psoriatic arthritis?
Bony erosions narrowed the end of the proximal phalange as a “pencil”, which rests in the “cup” formed by the expanded base of the distal phalanx as a result of bony proliferations.
What is the typical erosion pattern of Scleroderma?
And other multisystem disorders can produce erosions at the distal tufts, this is called acro-osteolysis.
How do you tell the difference between RA and OA?
Osteophytes are only present in OA, no erosions. Most often in weight bearing joints. OA=Non uniform joint loss
RA = Uniform joint loss. Marginal erosions predominantly in MCP-joints and the carpus, not in DIP-joints. No bone proliferation.
