X-RAYS

Question 1

What are the advantages to X-rays

Answer 1

• Cost effective
• Quickly and readily obtained
• Augment our understanding and stage of OA

Question 2

What is required for X-rays in OA diagnosis

Answer 2

That the joint of interest is weight bearing

Question 3

We generally need at least ___ views for OA X-rays

Answer 3

2

Question 4

What are the possible views for a knee x-ray

Answer 4

AP weight bearing, lateral, skyline for PF joint

Question 5

What are the possible views for a hip x-ray

Answer 5

AP weight bearing

True lateral

Question 6

Uses of xray

Answer 6

• Diagnosis + stage of OA
• Differentiating OA from other inflammatory joint disorders or conditions mimicking OA
• Rule out red flag causes: Sepsis, Tumour, fracture, inflammatory conditions
• Disease ownership, self management, validation
• Improve clinician understanding of client
• helps in determining treatment
• Surgical planning
• Post surgery
• Monitoring slowly evolving conditions

Question 7

What is septic arthritis? What occurs if it is left untreated

Answer 7

Painful inflammation of a joint due to an infection.

If left untreated: very destructive to the joint and cause severe illness

Question 8

Does bone or soft tissue absorb more radiation

Answer 8

bone

Question 9

What is a CAT scan

Answer 9

Computed tomography cross sectional x-rays

Question 10

What are CAT scans useful

Answer 10

• When planning hip OA surgery and hip dysplasia or structural abnormality is involved
• Total joint replacement failure

Question 11

Can you do an MRI if there is metal in the joint

Answer 11

No

Question 12

Is an MRI required to diagnose OA

Answer 12

No

Question 13

What are the advantages of MRI

Answer 13

Visualizing articular cartilage, bony edema, meniscal tears, ligament ruptures and effusions

Question 14

What are the disadvantages of MRI

Answer 14

• Costly
• Not timely
• Does not stage arthritis
• NWB reporting focuses on soft tissues
• Little information about degree of cartilage involvement

Question 15

What are the criteria to get an MRI of the knee or hip in the lower mainland

Answer 15

Over 40 years of age and…

• MR was recommended on a previous imaging report
• Previous knee or hip surgery
• Suspected infection
• Suspected tumour
• osteonecrosis
• Fixed locked knee
• Pt has had WB xray in past 6months AND referring clinical has confirmed mild or no evidence of OA in the knee of hip

Question 16

What can ultrasounds be used for

Answer 16

• Guided injections with fluoroscopy
• To differentiate calf embolus from a from a Baker’s cyst
• RA management to monitor effectiveness of medication in reducing synovial pannus and for early detection synovitis

Question 17

What is a bone scan used for

Answer 17

• Early detection of OA in hand

- Differential diagnosis of osteomyelitis, bone metastases, metabolic bone disease, implant failure

Question 18

What is symmetrical joint space loss indicative of

Answer 18

Inflammatory condition

Question 19

An inflammatory condition may lead to ______

Answer 19

secondary OA

Question 20

what are the ABCDS of C-rays

Answer 20

• Alignement
• Bone integrity & mineralization
• Cartilage space
• Distribution
• Soft tissue changes

Question 21

How does osteopenia show up on X-ray

Answer 21

Dark

Question 22

How does swelling show up on xray

Answer 22

white shadow in soft tissue

Question 23

Can we see cartilage on Xray

Answer 23

NO but can infer its loss of joint space

Question 24

How does sclerosis appear on xray

Answer 24

whiter than normal - bony cells being laid down

Question 25

Is the interrater agreement for xrays good or poor

Answer 25

poor

Question 26

Grades on Outerbridge arthroscopy

Answer 26

0-4

0= normal

Question 27

Eaton-Littler classification grades

Answer 27

1-4