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MSK > 1 Radiology Of MSK > Flashcards

1 Radiology Of MSK Flashcards

1
Q

How do x rays work?

A

A beam of electrons are projected through an object onto an image detector

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2
Q

What are the 4 main densities?

A

Most dense - brightest
Bone
Soft tissue
Muscle/fat
Air
Least dense - darkest

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3
Q

Advantages of x rays

A

Quick
Readily available
Inexpensive
Can be portable

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4
Q

Disadvantages of x rays

A

Ionising radiation
Poor soft tissue contrast resolution

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5
Q

Roles of x ray in MSK imaging

A
  • initial imaging for skeletal trauma (fracture), acute bone/joint injury (joint dislocation)
  • initial evaluation of chronic bone or joint pathologies
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6
Q

What is chronic arthritis?

A

Loss of joint space due to wear and tear of cartilage

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7
Q

Fracture definition

A

Complete or incomplete break in the continuity of the bone

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8
Q

Name the 7 types of fractures

A

Linear
Transverse
Oblique non displaced
Oblique displaced
Spiral
Green stick
Comminuted

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9
Q

Transverse fracture

A

Crosses bone at right angle to long axis of bone <—>

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10
Q

Linear fracture

A

Parallel to long axis of bone ^

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11
Q

Oblique non displaced

A

Diagonal
Aligned edge of fracture

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12
Q

Oblique displaced

A

Diagonal
Non aligned edge

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13
Q

Greenstick fracture

A

One side of cortex broken, one side in tact

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14
Q

Who are greenstick fractures more common in?

A

Children

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15
Q

Comminuted fracture

A

More than one break
Multiple small fragments

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16
Q

What are the three phases of fracture healing?

A

Inflammatory phase
Reparative phase
Remodelling phase

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17
Q

Describe the inflammatory phase

A

Hours-days
No radiographic callus
Haematoma formation
Tissue death
Inflammation/cellular proliferation

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18
Q

Haematoma definition

A

Solid swelling of clotted blood

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19
Q

Callus defintion

A

Thickened/hard part of skin/soft tissue

20
Q

Describe the reparative phase

A

Days-weeks
Callus on x ray
Angiogenesis
Soft (fibrocartilaginous) callus formation
Hard callus formation

21
Q

Angiogenesis defintion

A

Development of new blood vessels

22
Q

Describe the remodelling phase

A

Months - years
Fracture line becomes completely obscured

23
Q

What does CT stand for?

A

Computed tomography

24
Q

How does a CT scan work?

A

Uses radiation to build cross sectional images/slices which can be made into 3D images

25
Q

How long do CT scans take?

A

A few minutes

26
Q

What can CTs be used for?

A

Detailed images of bone structure and soft tissue
To guide infections, biopsies and aspiration in real time

27
Q

Spiral fracture

A

Fracture line spirals round in multiple planes

28
Q

Epiphyseal separation fracture

A

Fracture line extents through unfused growth plate

29
Q

Who are epiphyseal separation fractures more common in?

A

Overweight young boys during rapid growth spurts

30
Q

Disadvantages of CT

A
  • Use radiation - more than x ray
  • Motion artefact if patient moves so patient must remain still
  • Poor soft tissue detail compare to MRI
31
Q

Interpreting CT scans

A

Densities measured in Hounsfield units HU
< 0 HU dark e.g. air, fat
0 - 40 HU shades of grey e.g. soft tissue
> 100 HU white e.g bone

32
Q

What appears white, shades of grey and dark on a CT scans?

A

White - bone
Shades of grey - soft tissue
Dark - air, fat

33
Q

What can be used to see different structures clearer in CT?

A

CT windowing

34
Q

What does MRI stand for?

A

Magnetic resonance imaging

35
Q

How does an MRI work?

A

A strong magnet is used to generate a magnetic field which causes the protons in hydrogen atoms (body is mainly water) to line up.
Radio frequency signal pulses displace the alignment
Protons realign after pulses stop which emits a signal
Signal is made into image

36
Q

What are MRIs used for in MSK medicine?

A

Define normal anatomy
Detect pathology

37
Q

How will most MSK pathologies appear on fluid sensitive sequences?

A

Bright

38
Q

How do fat and fluid look on T1 weighted images?

A

Fat bright
Fluid dark

39
Q

How does fat and fluid appear on T2 weighted images?

A

Fat and fluid appear bright

40
Q

Advantages for MRI

A
  • excellent soft tissue (tendons, ligament, muscles imaging
  • detailed anatomy of joints
  • excellent bone marrow imaging
41
Q

Disadvantages of MRI

A

Noisy
Claustrophobia
Takes a long time 40-60 mins patient must stay still
Doesn’t work with meal/electronics e.g. pacemakers

42
Q

Questions of ask patient before MRI

A

Claustrophobia
Wearing any metal or pacemakers?

43
Q

Advantages ultrasound

A

No radiation
No contraindications/side effects
Excellent superficial soft tissue resolution
Excellent for tendons and peripheral nerves
Dynamic imaging
Fluid collections
Superficial foreign bodies

44
Q

Disadvantages of ultrasound

A

Operator dependent
Poor deep tissue resolution
Limited bone and intra-articular imaging

45
Q

How does nuclear medicine work?

A
  • radioactive material and carrier molecule injected into body and travels to intended part of body
  • material decays via gamma radiation which is emitted and detected by gamma plates
  • image is created
46
Q

What is nuclear medicine used for?

A

To asses areas of metabolically active bone
- bone forming metastatic lesions
- healing fractures
- areas of osteomyelitis

MSK (25 decks)

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