SM_226a: MSK Imaging Flashcards
_____ is initial test of choice to assess the MSK system
Radiography is the initial test of choice to assess the MSK system
Advantages of radiography are that it is _____, _____, and _____
Advantages of radiography are that it is inexpensive, reproducible, and has minimal radiation
Limitations of radiography are _____, _____, and _____
Limitations of radiography are occult fractures, limited evaluation of soft tissues, and the need to get at least 2 views
Radiography is used for evaluation of _____, _____, and _____
Radiography is used for evaluation of trauma, infection, and arthritis
(can indicate mechanism of injury and suggest underlying soft tissue injury)
Radiography can suggest _____
Radiography can suggest underlying soft tissue injury
CT is excellent for answering a specific question, such as _____, _____, and _____
CT is excellent for answering a specific question, such as preoperative planning, fracture detail, and occult fracture
Advantages of CT are _____, _____, _____, and _____
Advantages of CT are superior spatial resolution, ability to obtain multi-planar reformatted images, wide availability, and rapid exam time
(better resolution for bone than soft tissue)
Limitations of CT are _____, _____, and _____
Limitations of CT are moderately expensive, ionizing radiation, and artifact with metal
MRI is superior for evaluation of _____, _____, and _____
MRI is superior for evaluation of joints, soft tissue, and cartilage
Advantages of MRI are _____, _____, and _____
Advantages of MRI are superior contrast resolution, no radiation, and multi-planar imaging
Limitations of MRI are _____, _____, _____, and _____
Limitations of MRI are expensive, not patient friendly, longer scan times, and contraindications
Absolute contraindications to MRI are _____, _____, _____, and _____
Absolute contraindications to MRI are pacemakers, stimulators, metal in the orbit, and weight limit
Relative contraindications to MRI are _____ and _____
Relative contraindications to MRI are aneurysm clips and metal
Ultrasound is excellent for viewing _____, such as _____, _____, and _____
Ultrasound is excellent for viewing superficial soft tissues, such as tendons, ligaments, and nerves
Advantages of ultrasound are _____, _____, and _____
Advantages of ultrasound are patient friendly, dynamic imaging, and inexpensive
(no radiation, no contrast)
Limitations of ultrasound are _____ and _____
Limitations of ultrasound are user dependent and limited evaluation of bone
Dual X-ray absorptiometry is used to measure _____ and detect _____
Dual X-ray absorptiometry is used to measure bone density and detect osteoporosis and fracture risk
Dual X-ray absorptiometry is used to image the _____ and _____
Dual X-ray absorptiometry is used to image the lumbar spine and proximal femur
Advantages of dual X-ray absorptiometry are _____, _____, and _____
Advantages of dual X-eray absorptiometry are short exam time, widely available, and inexpensive
Limitations of dual X-ray absorptiometry are _____ and _____
Limitations of dual X-ray absorptiometry are overlying calcifications and compression fractures
T-score of a DXA study is the difference between _____ and _____
T-score of a DXA study is the difference between the bone mineral density of patient and standard young adult population
Describe the scroing of a DXA study
DXA study
T-score: difference between the bone mineral density of patient and standard young adult population
- < 1 SD: normal
- 1-2.4 SD: osteopenia
- >2.5 SD: osteoporosis
- >2.5 + ≥1 low-trauma fractures: severe osteoporosis
Bone scintigraphy is _____ but not _____
Bone scinitigraphy is sensitive but not specific
(normal is usually normal, further imaging to determine the specific pathology)
Bone scintigraphy provides _____
Bone scintigraphy provides physiologic information
Limitations of bone scintigraphy are _____ and _____
Limitations of bone scintigraphy are radiation and time intensive (4-6 hours/study)
Fluoroscopy is most commonly used _____
Fluoroscopy is most commonly used for/during procedures
Advantage of fluoroscopy is _____
Advantage of fluoroscopy is dynamic imaging
Limitation of fluoroscopy is _____
Limitation of fluoroscopy is radiation to patient and operator
Describe image guided procedures
Image guided procedures
- Biopsy: bone or soft tissue
- Arthrography: evaluation of joints and supporting structures
- Myelogram: dynamic imaging, evaluation of bone
- Therapy: corticosteroid injections, calcific tendinitis lavage, vertebroplasty, thermal ablation
Image guided biopsy is a safer alternative to _____
Image guided biopsy is a safer alternative to surgical/open biopsy (outpatient procedure)
Image guided biopsy is used for _____, _____, and _____
Image guided biopsy is used for lesion of unknown etiology, confirming diagnosis, and staging of disease
Arthrography is used to introduce _____ into a joint
Arthrography is used to introduce contrast into a joint
(iodinated contrast, gadolinium based contrast)
Arthrography allows excellent evaluation of _____
Arthrography allows excellent evaluation of joints
(labrum, cartilage, rotator cuff tendons, intrinsic ligaments)
Contraindications to arthrography are _____ and _____
Contraindications to arthrography are contrast allergy and contraindications to MRI
Myelogram is used to introduce _____ into the _____ and is visible with fluoroscopy and CT
Myelogram is used to introduce contrast into the thecal sac and is visible with fluoroscopy and CT
Advantages of myelogram are _____, _____, and _____
Advantages of myelogram are use if MRI is contraindicated, evaluation of bone, and dynamic imaging
Limitations of myelogram are _____, _____, _____, and _____
Limitations of myelogram are contrast allergy, ionizing radiation, invasive, and inferior to MRI for soft tissue evaluation
Image guided therapy includes _____, _____, _____, and _____
Image guided therapy includes corticosteroid injections, calcific tendinitis lavage, vertebroplasty, and thermal ablation
Chronic back pain in an adult is imaged with _____ and _____, while chronic back pain in a child is imaged with _____ and _____
Chronic back pain in an adult is imaged with radiographs and MRI, while chronic back pain in a child is imaged with radiographs and nuclear medicine exam
Acute back pain is imaged with _____, _____, and _____
Acute back pain is imaged with radiograph, CT if trauma, and MRI
Neck pain is imaged with _____
Neck pain is imaged with radiograph
(if normal but significant pain/symptoms consider MRI)
Joint pain is imaged with _____ or _____
Joint pain is imaged with radiographs or MRI if soft tissue injury
(soft tissue: ligament, cartilage, tendon, muscle)
Neoplasm is imaged with _____, _____, _____, or _____
Neoplasm is imaged with radiograph, MRI with contrast, CT, or nuclear medicine study
- MRI with contrast: if osseous image joint to joint to evaluate for skip lesions
- Nuclear medicine study: osseous metastasis
Occult fracture is imaged with _____
Occult fracture is imaged with radiographs
(if X-ray normal then use CT, MRI, or nuclear medicine study)
Osteomyelitis is imaged with _____, _____, and _____ in a diabetic patient, while osteomyelitis is imaged with _____ and _____ in a non-diabetic patient
Osteomyelitis is imaged with radiograph, MRI, and nuclear medicine study in a diabetic patient, while osteomyelitis is imaged with radiograph and MRI with contrast in a non-diabetic patient
