week 2: diagnostic imaging

Question 1

which type of imaging allows for appreciation of basic bony anatomy?

Answer 1

radiography

Question 2

radiopaque material is _____ (more/less) dense and shows up ___ (what color)

Answer 2

more
white

Question 3

radiolucent material is _____ (more/less) dense and shows up ___ (what color)

Answer 3

less
black

Question 4

which type of imaging has excellent demonstration of cortical bone and a high sensitivity to variance in density of tissues?

Answer 4

CT

Question 5

which type of imaging has the highest dose of radiation?

Answer 5

CT

Question 6

which imaging would be used after an upper C spine trauma?

Answer 6

CT

Question 7

which type of imaging has a good sensitivity to metabolism of bone?

Answer 7

bone scan (scintigraphy)

Question 8

which type of imaging would be good to view cancer mets to bone or stress fractures?

Answer 8

bone scan

Question 9

which type of imaging has an excellent demonstration of SOFT TISSUES & bone marrow?

Answer 9

MRI

Question 10

does MRI have radiation?

Answer 10

no

Question 11

what shows brightest on a T1 weight image (MRI)?

Answer 11

fat

Question 12

what shows brightest on a T2 weight image (MRI)?

Answer 12

water

Question 13

which type of MRI would be used to asses swelling?

Answer 13

T2

Question 14

which type of MRI would be used to plan for a complex surgery?

Answer 14

T1

Question 15

if contrast is added to joint space for an MRI, what is the image called?

Answer 15

magnetic resonance arthrogram (MRA)

Question 16

which type of imaging has a good demonstration of soft tissues and allows real-time dynamic imaging?

Answer 16

ultrasound

Question 17

what is the main limitation of ultrasound?

Answer 17

limited view of deeper structures

Question 18

hyperechoic material on an ultrasound shows up ____ (color) and is ____ dense

Answer 18

white
more
ex: bone, tendon, ligament, nerve, muscle

Question 19

hypoechoic material on an ultrasound shows up ____ (color) and is ____ dense

Answer 19

dark
more
ex: nerve, fat

Question 20

hyperechoic material on an ultrasound shows up ____ (color)

Answer 20

black
ex: blood vessel, cyst

Question 21

which type of imaging is suited for serial testing and useful for diagnosis and monitoring? (mostly used for bone density)

Answer 21

DEXA

Question 22

osteoporosis has a T-score of

Answer 22

< -2.5 std

Question 23

osteopenia has a T-score of

Answer 23

-1.0 - -2.5

Question 24

criteria for Pittsburgh Guidelines for Knee Trauma

Answer 24

MOI of fall or blunt trauma
age <12 or >50 –> x-ray
if no to above, inability to take 4 steps –> image

Question 25

criteria for Canadian Cervical Spine Rule

Answer 25

1) ≥65, dangerous mechanism, or numbness or tingling in extremities
yes –> immobilized and image
2) simple rearend MVC, ambulatory at time of scene, no neck pain at scene, no pain during midline palpation
no –> immobilized and image
3) can actively rotate neck 45 degrees L & R regardless of pain
unable –> immobilized and image

Question 26

criteria for Ottawa Knee Rule

Answer 26

≥55
tenderness at head of fibula
isolated tenderness of patella
inability to flex to 90
inability to WB immediately 4 steps

Question 27

criteria for Ottawa Ankle Rule

Answer 27

ankle:
- pain in malleolar zone and
- bone tenderness at posterior edge or
tip of lateral malleolus or medial mal
- or inability to WB
foot:
- pain in midfoot and
- bone tenderness at base of 5th met
or navicular
- or inability to WB

Question 28

criteria for NOLA & Canadian CT Head Rule

Answer 28

HA
vomiting
>60
drug or alcohol intoxication
deficits in short-term memory (30 mins)
evidence of trauma above clavicle
post-traumatic seizures
failure to reach GSC of 15 w/i 2 hours