W1- Radiological Evaluation and Diagnosis Flashcards
What are the ABCs of radiologic analysis?
- A = Alignment
- B = Bone Density
- C = Cartilage Spaces
- S = Soft Tissues
What are (3) things we can look at when discussing Alignment? What are some abnormalities of each?
- General Skeletal Architecture (supernumerary bones, congenital abnormalities, absence of bone, developmental deformity)
- General Contour of Bone (cortical/avulsion/impaction Fx, spurring, prior Sx)
- Alignment of Bone to Adjacent Bone (Fx, dislocation, subluxation)
What are (3) things we can look at when discussing Bone Density? What are some abnormalities of each?
- General Bone Density (loss of bone density, thinning/absence cortical margins)
- Texture Abnormalities (fluffy, thin, delicate, coarsened, smudged)
- Local Density Changes (osteophytes, excessive sclerosis, reactive sclerosis)
What are (3) things we can look at when discussing Cartilage Spaces? What are some abnormalities of each?
- Joint Space Width (decreased space)
- Subchondral Bone (increased sclerosis, erosion)
- Epiphyseal Plates (position, size, borders of physes)
What are (5) things we can look at when discussing Soft Tissues? What are some abnormalities of each?
- Muscles (wasting, swelling)
- Fat Pads and Fat Lines (blurring, displacement)
- Joint Capsule (distension)
- Periosteum (observe reactions)
- Miscellaneous Soft Tissue Findings (foreign bodies, gas bubbles radiolucent, calcifications radiopaque)
- What is the sail sign?
- What is it usually indicative of?
Describes the elevation of the anterior fat pad to create a silhouette similar to a sail from a boat.
-Usually occurs from an intraarticular Fx at the elbow.
- What is the difference between errors of observation and errors of interpretation?
- How do we reduce the amount of errors that are to occur?
- Errors of Observation = Related to search patterns (incomplete/faulty).
- Errors of Interpretation = Related to poor ability to link clinical presentation to radiologic findings.
-Interdisciplinary communication, especially with radiologist.
- What is monostotic/monoarticular?
- What is polystotic/polyarticular?
- What is diffuse?
- Monostatic/Monoarticular = Affects only 1 bone/joint.
- Polystotic/Polyarticular = Affects multiple bones/joints.
- Diffuse = Affects nearly all bones or joints.
Mono and polyarticular pathologies can come from congenital, inflammatory, neoplastic, metabolic, traumatic, vascular, and other forms of dysfunction. Which (2) of these dysfunctions can present diffusely?
- Neoplastic
- Metabolic
What are some characteristic findings of RA? (2)
- Ulnar drift (proximal phalanx displacement)
- cylindrical brightening on radiograph (Swan neck/Boutonniere)
What are some characteristic findings of OA? (3)
- No joint space
- Brighter at joint line
- What is most commonly used to diagnose osteoporosis?
- Interpret the T and Z-Scores.
DXA
- T-Score - Anything >2.5 = Osteoporosis
- Z-Score - Anything
What are some characteristic findings of Osteoporosis?
- 30% reduction in bone mass for detection
- Cortical thinning
- Low bone mass
- Trabecular changes
- Fx
Characteristic findings of infection in the bone:
- Soft tissue swelling = ___-___ after onset.
- Radiolucent lytic lesion in ___-___ after onset.
- Sequestra and involucra in ___-___.
- Draining sinus tracts.
- Soft tissue swelling = 24-48hrs
- Radiolucent lytic lesion in 7-10 days
- Sequestra and involucra in 6-8 weeks
Characteristic findings of infection in joint:
- Soft tissue _________.
- Joint _______.
- Periarticular ___________.
- Joint space ________.
- Subchondral _________.
- Soft tissue swelling.
- Joint effusion.
- Periarticular rarefaction.
- Joint space narrowing.
- Subchondral bone erosion.
