W3- T-Spine/Ribs, Shoulder, and Elbow/Wrist/Hand Viewing Radiographic Images Flashcards

1
Q

PART 1: T-SPINE AND RIBS

A

PART 1: T-SPINE AND RIBS

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2
Q

T-Spine and Ribs Viewing Indications. (12)

A
  • Trauma
  • Pain radiating around the chest wall
  • ROM limitations
  • Pre-op/ post-op
  • Malignancies
  • Osteoporosis/ compression frx
  • Arthropathy
  • Health conditions associated with spinal abnormality
  • Evaluate scoliosis & kyphosis
  • Suspected congenital abnormality
  • Monitoring known abnormality
  • Suspected instability
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3
Q

T-Spine:

  • What are the (2) most common views when looking at the T-spine?
  • What are some other views utilized and what are their purposes?
A

-AP and lateral

  • Swimmers = great for looking at CT junction
  • Oblique
  • Coned views = highly zoomed looking at vertebrae segments
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4
Q

Sternum:

  • Which view is utilized to view the sternum as a whole?
  • What are (2) views utilized to view the SC joints?
  • Why is a lateral view of the sternum useful?
A
  • RAO for sternum (patient position), called posterior oblique (projection)
  • RAO and LAO to view SC joints
  • Lateral view utilized to distinguish malalignment of the sternum.
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5
Q

Ribs:

  • What (3) views are utilized to view the ribs?
  • Can also utilize what other x-rays to see the ribs?
A
  • AP, PA, Oblique

- Chest x-ray

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6
Q

-Where does the central ray pass through in AP and lateral views of the T-spine?
-Where does the central ray pass through in posterior oblique and lateral view of the sternum?
-

A
  • T7

- midway between jugular notch and xiphoid process

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7
Q

Things to look for in an AP view of the T-spine? (8)

A
  • pedicle alignment
  • distance between pedicle and SP
  • symmetry and interpedicular distance, abnormalities indicative of Fx
  • vertebral bodies/lateral border
  • disc space
  • TP
  • midline of SP
  • articulation between ribs and vertebrae
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8
Q

Things to look at in a lateral view of the T-spine? (10)

A
  • anterior and posterior bodies, with spinolaminar line
  • disc heights
  • pedicles superimposed (cant discern)
  • open lateral foramen
  • partial viewing of some z-joints
  • bodies box-like
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9
Q

Things to look at in a posterior oblique (RAO position) of the ribs? (7)

A
  • sternum vs ipsilateral SC joint
  • anterior and posterior ribs
  • lungs
  • manubrium and sternal body
  • sternal angle
  • sternal body/xiphoid process junction
  • sternocostal joints
  • 1st rib under clavicle
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10
Q
  • Are we able to see the posterior ribs more clearly with an AP or PA view?
  • Are we able to see the anterior ribs more clearly with an AP or PA view?
A
  • AP = Posterior

- PA = Anterior Ribs

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11
Q

CT Spine Indications. (9)

A
  • Acute trauma (adults)
  • Degenerative conditions
  • Post-op assessment
  • Infection
  • Image-guided intervention procedures
  • Neoplasm
  • Inflammatory lesions
  • Congenital/ developmental conditions
  • Cord Syrinxes/ masses (with MRI contraindicated)
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12
Q

MRI Spine Indications. (9)

A
  • Acute Trauma with suspected cord encroachment
  • DDD
  • Neoplasm
  • Intrinsic spinal cord pathology
  • Congenital/developmental conditions
  • Cord masses
  • Pre/post-op assessment
  • Meningeal abnormalities
  • Infection
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13
Q

ABCDs of MRI.

A
  • Alignment
  • Bone signal
  • Canal space
  • Disc integrity
  • Soft Tissue
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14
Q

When utilizing MRI, T1 weighted images are used for _________ while T2 weighted images are used for ______.

A
  • anatomy

- fluid

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15
Q

PART 2: SHOULDER

A

PART 2: SHOULDER

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16
Q

Shoulder Viewing Indications. (11)

A
  • Trauma
  • Bone involvement with metabolic diseases/systemic disease/nutritional deficiencies
  • Neoplasm
  • Infection
  • Arthropathy
  • Pre-op/post-op
  • Suspected congenital/developmental abnormality
  • Vascular lesions
  • Foreign body/soft tissue lesion
  • Pain
  • Correlation with other studies
17
Q

What views are looked at with the shoulders? (2)

A
  • AP External Rotation

- AP Internal Rotation

18
Q

What views are looked at with the AC joint?

A

-Upright AP (with and without weights on wrist)

19
Q

What views are looked at with the Scapula? (2)

A
  • AP

- Lateral

20
Q

What are some other views utilized at the shoulder?

A
  • Axillary view of the GH

- Scapular “Y”

21
Q

Why would we use the IR or ER view of the shoulder?

A
  • IR = View lesser tuberosity

- ER = View greater tuberosity

22
Q

What is abnormal when performing Upright AP with weights at the AC joint?

A
  • Abnormal = Separation of AC joint when holding weights.

- Normal = Ligaments able to hold weight without separation of AC joint.

23
Q
  • Coroclavicular normal distance?

- AC joint space normal distance?

A

Coroclavicular = 1-1.3cm

AC Joint = .3-.8cm

24
Q

Which view is best for looking at orientation of humeral head in relation to glenoid fossa?

A

Axillary View

25
Q

PART 3: ELBOW/WRIST/HAND

A

PART 3: ELBOW/WRIST/HAND

26
Q

What views are utilized to view the elbow and forearm? (2)

A
  • AP

- lateral

27
Q

What are some things we can see with an AP view of the elbow? (5)

A
  • Carrying angle
  • Humeroulnar/humeroradial joint spaces
  • Distal humerus
  • Radial head/neck/tuberosity
  • Proximal ulna
28
Q

What is a normal carrying angle?

A

15 degrees

29
Q

What can be seen with lateral views of the elbow? (6)

A
  • olecranon and olecranon fossa
  • superimposed eppicondyles, circular trochlear sulcus directly below
  • coronoid process
  • radial head
  • fat pads anterior and posterior to distal humerus
30
Q

What is the sail sign?

A

Effusion (most commonly caused by intraarticular fx) pushes fat pad up and outward.

31
Q

What can be seen with a lateral view of the forearm? (4)

A
  • normal bowing of radius and ulna
  • elbow structures
  • radial head superimposed over coronoid process
  • proximal and distal articulations
32
Q

What views are utilized for the wrist/hand/digit? (3)

A
  • PA
  • lateral
  • oblique
33
Q

What is another view taken when certain carpal pathologies are of concern?

A

carpal tunnel view

34
Q

What can be seen with PA of the hand? (3)

A
  • spatial relationship (long axis of 3rd metacarpal and long axis of radius, oblique line along met heads 3-5, overlapping met bases 2-5, overlappping trapezium/trapezoid and pisiform/triquetrium)
  • Symmetry
  • Continuity
35
Q

Why are oblique images of the hand performed?

A

Digits do not superimpose in view.

36
Q

What can be seen with PA of the wrist? (3)

A
  • spatial relationship (carpal sublux/dislocations, overlap trapezium/trapezoid and pisiform/triquetrium)
  • Symmetry
  • Continuity (hook of hamate)
37
Q

What can be seen with PA of the wrist? (3)

A
  • trapezium articulations
  • hamate
  • triquetrium
38
Q

What can be seen with PA of the wrist?

A
  • volar tilt of the articular surface of radius
  • scapholunate angle
  • capitolunate angle
39
Q

What view provides the best visualization of the hook of hamate?

A

carpal tunnel view