Week 5 - Int. and Eval. X-rays

Question 0

Radiolucent

Answer 0

relative penetrability to X-rays

Question 1

Radiopaque

Answer 1

relative impenetrability to X-rays

Question 2

Any test you order as a dr. is only. . .

Answer 2

as good as history & physcial exam

Question 3

Fractures definition:

Answer 3

Complete disruption in the continuity of the bone.

-Shows as a radiolucent line on an X-ray -actual fracture leaves a gap in the bone

Question 4

What are the 5 indirect signs of a fracture?

Answer 4

1. Soft-tissue swelling
2. Obliteration or displacement of fat stripes
3. Endosteal and periosteal reactions (see bone healing)
4. Buckling of the cortex
5. Double cortical line

Question 5

What are these: Gamma, X, Ultraviolet, Visible light, Infrared, Microwaves, Radar?

Answer 5

Forms of electromagnetic radiation!

Question 6

What is metaphysis?

Answer 6

The transition from middle bone (diaphysis) to joint/end of bone (epiphysis)

Question 7

What is diaphysis?

Answer 7

The long shaft of the bone

Question 8

What is between the metaphysis and the epiphysis?

Answer 8

Epiphyseal plate/growth plate - only seen in still growing children/young adults

Question 9

What is the epiphysis?

Answer 9

End of bone - Area of bone toward the joint where the growth occurs

Question 10

What is the apophysis

Answer 10

Bottom part of ulna near elbow - looks like a fracture.

• Normal developmental growth of a bone which arises from a separate ossification center and fuses to bone later in development
• Usually tendon or ligament insertion point

Question 11

What does valgus indicate?

Answer 11

gus/gum between the knees - away from midline

Question 12

What is the most imp. radiologic imaging modality for joint pain/arthritis?

Answer 12

X-rays!

Question 13

What joints are involved in osteoarthritis?

Answer 13

hip, knee, base of first metatarsal, DIP joints, PIP joints

Question 14

What joints are involved in Rheumatoid Arthritis?

Answer 14

Neck, shoulder, elbow, hip, knee, ankle, DIP, PIP, MP, carpal joints
In Juvenile - also sacroiliac joint but not DIP joints of 4 fingers in adults

Question 15

What joints are involved in Psoriatic/Reiter’s Arthritis in adults?

Answer 15

Lumbar region, ankle, sacroiliac joint, DIP, PIP, MCP and tips of fingers

Question 16

What joints are involved in Psoriatic/Reiter’s Arthritis in children?

Answer 16

Lumbar, sacroiliac, knee, ankle, toes, DIP, PIP, MCP joints

Question 17

What happens in/signals osteoarthritis? (on X-ray)

Answer 17

• Marginal osteophytes - overgrowth
• Cortical irregularity - irregular
• Subchondral sclerosis
• Subchondral cysts - radiolucent spots
• Joint space narrowing
• Not as much joint destruction
• No periarticular osteoporosis (no bone thinning)
• DONT NEED ALL IN EACH CASE
• Sometimes its difficult to tell difference between this and age-related changes

Question 18

What happens in Rheumatoid Arthritis?

Answer 18

• INFLAMMATORY DISEASE
• 3,000-8,000 WBC w/high percentage PMNs that produce acidic destructive fluid
• Periarticular osteoporosis (thinning of bone)
• Joint effusion - fluid
• Joint space narrowing - concentric, symmetrical
• Articular erosions/destruction
• Synovial cysts - slight radioopacity around joint
• Deformities

Question 19

What happens in Gouty Arthritis?

Answer 19

• Skip lesions - caused by interdispersed lesions
• Erosions - “overhanging edge, partial joint preservation”
• Tophi
• Lack of osteoporosis
• Can persist as any pain or form
• He always thinks of it in soft tissue cases

Question 20

What happens in pseudogout?

Answer 20

CPPD deposition - chondrocalcinosis

-Similar findings to OA