Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK/Derm > SM 226: MSK Imaging > Flashcards

SM 226: MSK Imaging Flashcards

1
Q

What is the common first-line test for assessing the MSK test?

A

Conventional radiography = Xray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the advantages of Xray?

A

Inexpensive
Reproducible - universal technology
Minimal radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the disadvantages of Xray?

A

Cannot visualize occult fractures
Limited evaluation of soft tissues
Always need at least 2 views

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Explain the “One view is no view” idea?

A

With Xray, a 3D structure is compressed into a 2D view, so always need at least two images to get a good picture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Can Xray determine the mechanism of underlying injury?

A

No, but it can suggest underlying soft tissue injury based on the pattern of bone deformities

Ex = shoulder dislocation from displaced Humerus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What should be done if an Xray suggests an underlying soft tissue injury?

A

Follow up with an MRI on the same patient to determine the cause of the bone change on Xray

Ex = displaced shoulder on Xray may show a torn ligament on MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When should CT be performed?

A

Do a CT after you see an abnormality on XR, or a history strongly suggests an abnormality

Also for pre-op planning, better detail of a fracture found on XR, and occult fractures not seen on XR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the advantages of CT?

A

Superior spatial resolution than XR, especially for bone
Able to create mutliplanar reformatted images
Widely accessible tech with rapid exam time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the limitations of CT?

A

Expensive
Ionizing radiation
Artifact with metal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the ideal imaging modality for soft tissue?

A

MRI > XR and CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the advantages of MRI?

A

Superior contrast
No radiation
Multiplanar imaging like CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the limitations of MRI?

A

Expensive
Not patient friendly - claustraphobia
Longer scan times
Contraindications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Can MRI be used on pregnant women? Can CT?

A

MRI yes, b/c no radiation

CT no, b/c radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which provides multiplanar imaging, MRI or CT?

A

Both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are absolute contraindications for MRI?

A

Pacemakers/stimulators
Metal in the eye
Weight limits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are relative contraindications for MRI?

A

Aneurysm clips

Metal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What joints are commonly assessed with MRI?

A 
Knee MRI (ex ligament tears)
Shoulder MRI (ex tendon tears)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is ultrasound good for?

A

Ultrasound is good at assessing superficial soft tissues like ligaments, tendons, and nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the advantages of ultrasound?

A

Patient friendly
No radiation or contrast
Dynamic imaging
Inexpensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Why is dynamic imaging needed?

A

Some pathologies can only be seen when a patient is moving

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the limitations of ultrasound?

A

User dependent

Limited evaluation of bone since ulltrasound can’t penetrate bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Can ultrasound evaluate bone?

A

Not particularly, since the waves don’t penetrate bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Why do we measure bone density?

A

Detect osteoporosis and bone fracture risk via DXA

24
Q

What is DXA?

A

Uses low res CT to image the density of bones and score them with a T and Z score

25
What are the pros of DXA?
Short exam time, widely available, inexpensive
26
What are the limitations of DXA?
Cannot detect overlying calcifications and compression fractures because it as a 2D representation of a 3D structure
27
What is a DXA T-score?
The difference between bone mineral density of a patient and a healthy young adult population
28
How is the DXA T-score graded?
< 1 St. Dev = normal 1 - 2.4 St. Dev = Osteopenia > 2.5 St. Dev = Osteoperosis > 2.5 St. Dev + Fractures = Severe Osteoperosis
29
What does a Bone Scintigraphy scan detect?
Bone Scintigraphy uses a radionucleotide tracer to identify areas with high bone turnover: Healing fracture, infection, cancer
30
What are the test characteristics of Bone Scintigraphy and how do they guide treatment?
Bone Scintgraphy is sensitive but not specific, so abnormal findings tend to be abnormal, but can't determine a specific pathological cause Ned followup imaging
31
What are limitations of Bone Scintigraphy?
Radiation due to tracer | Time intensive because tracer needs to distribute throughout entire body
32
What is fluoroscopy?
A real time low resolution Xray used for and during procedures
33
What are the advantages of Fluoroscopy?
Dynamic imaging allows for real time guidance of procedures
34
What are the limitations of Fluoroscopy?
Radiation exposure to patient and operator
35
What are common imaging guided procedures?
Biopsies Arthography Myelogram Therapeutic injections and lavages
36
What are the benefits of image guided biopsy?
Safer alternative to open biopsy and outpatient procedure
37
What are image guided biopsies used for?
Determine the cause of a lesion of unknown etiology Confirm a diagnosis (cancer) Stage a diagnosis (cancer)
38
What is Arthography?
A technique used to introduce contrast into a joint
39
What type of contrast does Arthography introduce for CT?
Iodinated contrast
40
What type of contrast does Arthography introduce for MRI?
Gadolinium
41
What is Arthography good for?
Evaluating joints and their components
42
What are contraindications for Arthography?
``` CT-Arthography = contrast allergy MRI-Arthography = MRI contraindications ```
43
What is a Myelogram?
A procedure used to introduce contrast into the Thecal sac
44
What are advantages of a Myelogram?
Useful if MRI in contraindicated Evaluate bone Dynamic imaging
45
What are limitations of Myelogram?
Contrast allergy Radiation Invasive Inferior to MRI for soft tissue evaluation
46
What's more useful, MRI or Myelogram?
MRI > Myelogram unless the patient is contraindicated for MRI
47
What are examples of image-guided therapies?
Corticosteroid injections Calcific tendinitis lavage - remove Ca deposits Vertebroplasty - stabilize fracture Thermal ablation - tumors
48
What two factors should be considered when thinking about imaging?
Index of suspicion - high = jump to a specific modality, low = start with XR If study wont change management, don't do the imaging
49
Describe the imaging algorithm for chronic back pain?
Adult: Plain radiograph - bone damage MRI - Radiograph negative, suspect soft tissue or disc damage Child: Plain radiograph MRI - suspect bone fracture
50
Describe the imaging algorithm for acute back pain?
Plain radiograph first Consider CT if related to direct trauma MRI if soft tissue injury is suspected
51
Describe the imaging algorithm for neck pain?
Plain radiographs first | Consider MRI if pain/symptoms persist
52
Describe the imaging algorithm for joint pain?
Plain radiographs first | Consider MRI if looking for soft tissue injury, especially deeper tissues
53
Describe the imaging algorithm for neoplasm?
Plain radiography first - find bone destruction MRI with Contrast - look for blood flow abnormalities Nuclear medicine study - metastatic spread of Cancer
54
Describe the imaging algorithm for occult fracture?
Plain radiograph first | If Xray normal: CT, then MRI, then nuclear medicine
55
Describe the imaging algorithm for Osteomyelitis?
In Diabetics: Plain radiograph MRI - degree of osteomyelitis (no contrast due to Renal Failure in Diabetics) Nuclear Medicine study - sources of infection Non-diabetics: Plain radiograph MRI with contrast

MSK/Derm (46 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions