MSK Radiology 4

Question 1

What contrast do we want in joint spaces?

Answer 1

Aim for medium to high contrast for joints

Question 2

Where assesing joint spaces where should the central ray be directed?

Answer 2

Central ray should be directed through the joint space

Question 3

What is an important consideration when injecting contrast into joints and what is an example of one?

Answer 3

• Needs to be done aseptically
• Postive or negative contrast medium: non-ionic iodinated contrast. It can be air or CO2 requires strict aseptic technique

Question 4

Name the structures that are shown below:

Answer 4

1. Bicipital tendon
2. Articular cartiladge

Question 5

Name the structure that is shown below:

Answer 5

Infrapatellar fat pad

Question 6

Describe the changes that are shown below (the left one is for reference):

Answer 6

• Increased synovial mass
• Round shape to caudal margin
• Smaller fat pad that is displaced

Question 7

What are four Ddx for acute and 2 ddx for chronic diseases that cause synovial masses?

Answer 7

Acute diseases:

1. Joint effusion - joint trauma, osteoarthritis
2. Early septic arthritis
3. Early immune mediated diseases or non-erosive diseases
4. Haemarthrosis

Chronic diseases:

1. DJD (OA) thickening synovial tissue and joint capsule
2. Joint effusion

Question 8

What are three Ddx for a narrow joint space?

Answer 8

1. Loss of cartiladge
2. Degeneration (osteoarthritis)
3. Destruction (septic arthritis - usually an immune mediated disease)

Question 9

How does subchondral bone sclerosis typically appear?

Answer 9

• Increased thickness in subchondral bone (seen as increased radiopacity)
• Response to chronic disease

Question 10

Name the finding that is shown below. The left is shown for reference:

Answer 10

Subchondral bone sclerosis