Week 5 - Int. and Eval. X-rays Flashcards
Radiolucent
relative penetrability to X-rays
Radiopaque
relative impenetrability to X-rays
Any test you order as a dr. is only. . .
as good as history & physcial exam
Fractures definition:
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
What are the 5 indirect signs of a fracture?
- Soft-tissue swelling
- Obliteration or displacement of fat stripes
- Endosteal and periosteal reactions (see bone healing)
- Buckling of the cortex
- Double cortical line
What are these: Gamma, X, Ultraviolet, Visible light, Infrared, Microwaves, Radar?
Forms of electromagnetic radiation!
What is metaphysis?
The transition from middle bone (diaphysis) to joint/end of bone (epiphysis)
What is diaphysis?
The long shaft of the bone
What is between the metaphysis and the epiphysis?
Epiphyseal plate/growth plate - only seen in still growing children/young adults
What is the epiphysis?
End of bone - Area of bone toward the joint where the growth occurs
What is the apophysis
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
What does valgus indicate?
gus/gum between the knees - away from midline
What is the most imp. radiologic imaging modality for joint pain/arthritis?
X-rays!
What joints are involved in osteoarthritis?
hip, knee, base of first metatarsal, DIP joints, PIP joints
What joints are involved in Rheumatoid Arthritis?
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
What joints are involved in Psoriatic/Reiter’s Arthritis in adults?
Lumbar region, ankle, sacroiliac joint, DIP, PIP, MCP and tips of fingers
What joints are involved in Psoriatic/Reiter’s Arthritis in children?
Lumbar, sacroiliac, knee, ankle, toes, DIP, PIP, MCP joints
What happens in/signals osteoarthritis? (on X-ray)
- 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
What happens in Rheumatoid Arthritis?
- 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
What happens in Gouty Arthritis?
- 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
What happens in pseudogout?
CPPD deposition - chondrocalcinosis
-Similar findings to OA
