Basic Principles of Radiology Flashcards
(94 cards)
1
Q
What are the different imaging modalities?
A
- X-ray
- Computed Tomography (CT)
- Magnetic Resonance (MR)
- Ultrasound (U/S)
- Nuclear Medicine
2
Q
What structure shows as the darkest image on an X-ray?
A
Air
3
Q
What structure shows as a white image on an X-ray?
A
Bone
4
Q
What color shows up as gray on an X-ray?
A
Fluid, blood, and soft tissue
5
Q
What is an X-ray good for?
A
Bones and airspaces
6
Q
Which imaging modality uses a single pulse of ionizing radiation?
A
X-ray
7
Q
What is an X-ray bad for?
A
Soft tissue and overlapping structures
8
Q
Which imaging modality uses multiple pulses (“shots”) of ionizing radiation?
A
Computed Tomography (CT)
9
Q
What are the different X-ray views?
A
- Anteroposterior (AP)
- Lateral (LAT)
- Oblique (OBL)
- Posteroanterior (PA)
10
Q
What are the different views of CT?
A
- Sagittal or Median
- Coronal
- Axial or Transverse or Cross-sectional
11
Q
Which imaging modality uses low doses of radiation?
A
X-ray
12
Q
This imaging modality is a two dimensional representation of a three dimensional object
A
X-ray
13
Q
Which X-ray view shows a magnified heart and fuzzier boarders?
A
Anteroposterior (AP)
14
Q
What is a Magnetic Resonance Imaging (MRI) good for?
A
Soft tissues (nerves, muscles, connective tissue, brain, and joints)
15
Q
Which imaging modality does not use ionizing radiation?
A
Magnetic Resonance Imaging (MRI)
Ultrasound
16
Q
Which type of patients are Magnetic Resonance Imaging bad for?
A
People who cannot hold still or have ferrous metal in the body
17
Q
What are the different types of views for Magnetic Resonance Imaging (MRI)?
A
- Sagittal or Median
- Coronal
- Axial or Transverse or Cross-Sectional
18
Q
Which imaging modality uses sound waves?
A
Ultrasound
19
Q
Which imaging modality is good for determining fluid vs. solids, abdominopelvic imaging, and assessing blood flow?
A
Ultrasound
20
Q
What are ultrasounds bad for?
A
- Things underneath bones (chest)
- Things in chambers of air
- Deep structures
21
Q
What are the ultrasound views?
A
- Longitudinal (same as sagittal)
2. Transverse (same as axial)
22
Q
Which imaging modality is used to screen for cancers?
A
Nuclear Medicine
23
Q
When reading a chest X-ray,
- what is step 1?
- what is step 2?
- what is step 3?
A
- Pre-read
- Assess the technical adequacy of the film (RIP)
- Conduct a systemic evaluation of the film (ABCDE)
24
Q
What six things must be confirmed or check during Pre-Read?
A
- Confirm image is from the correct patient
- Confirm the correct date
- Confirm the correct body part
- Confirm image is of the correct type
- Confirm image has number of views you expect
- Check to see if any comparison films are there
25
How do you assess the technical adequacy of the film of the chest x-ray?
R.I.P
26
What does R.I.P stands for?
Rotation
Inspiration
Penetration
27
When assessing technical adequacy, what are you assessing with rotation?
Clavicles should be equally spaced in relation to the vertebral column
28
When assessing technical adequacy, what are you assessing with inspiration?
1. Should be able to count 9-10 ribs
| 2. Posterior ribs are easier to see (more horizontal and project from the spine)
29
When assessing technical adequacy, what are you assessing with penetration?
1. Should see the ribs through the heart
2. Should barely see the spine through the heart
3. Should see pulmonary vessels near the edges of the lungs (lungs should not be completely black)
30
What does an over penetrated film suggest?
Pneumothorax
31
How does lung fields appear on an over penetrated film?
Lung fields are almost completely black
32
What does an under penetrated film suggest?
Suggest consolidation such as pneumonia
33
What does an under penetrated film looks like?
Image appears bright
34
What systemic method is used when reading a chest X-ray?
```
A - Airway/Airspaces
B - Bones/Soft Tissue
C - Cardiac Shadow
D - Diaphragm
E - Everything else
```
35
When using the systemic method to assess the Airway/Airspaces, what are you looking for in regards to the trachea?
1. Is the trachea midline?
| 2. Is it patent?
36
When using the systemic method to assess the Airway/Airspaces, what are you looking for in regards to the airspaces?
1. Do the blood vessels go all the way to the edges?
| 2. Are there any patches of white suggesting infection, fluid, or foreign objects?
37
On a chest x-ray, when using the systemic method to assess BONES, what are you looking for?
Alignment, lack of symmetry, and fractures
- Clavicles
- Ribs
- Pectoral girdle
- Spine
38
What makes the heart horizontal and larger?
Shallow inspiration
39
1. The transverse diameter of the silhouette should NOT exceed what percentage of the transverse diameter of the thoracic cage?
2. What is this called?
1. 50%
| 2. Cardiothoracic ratio
40
What is the cardiothoracic ratio?
The transverse diameter of the silhouette should not exceed 50% of the transverse diameter of the thoracic cage
41
Which type of films magnify the heart?
AP
42
What cardiac structures are associated with the following cardiac borders?
- Upper right border
- Lower right border
- Left border (from the top)
Upper right border - superior vena cava
Lower right border - Right atrium
Left border:
- Aortic arch
- Pulmonary arteries
- Left atrial appendage
- Left ventricle
43
When using the systemic method to assess the diaphragm, what are you checking?
1. Diaphragm is dome shaped
2. Right hemidiaphragm is always higher than or on the same level as left
3. The costophrenic angles (sulcus)
44
How should the costophrenic angles appear?
Should be dark and have sharp points (like upside down cat ears)
45
When using the systemic method, what does "Everything else" consist of?
- Gastric bubble on the left side
| - EKG leads, lines, tubing, and other missed items
46
What is OTTAWA criteria for acute ankle pain?
- Has pain in the "malleolar" zone
- Has bone tenderness at the posterior edge (6cm) of the lateral or medial malleolus
- Inability to bear weight both immediately after the injury and four steps in the evaluation room
47
What is the purpose of ordering imaging?
- To confirm a suspicion
| - To impact the treatment
48
What is considered bearing weight?
- If the patient can transfer weight twice to each foot
| - If the patient limps
49
What is OTTAWA criteria for acute foot pain?
- Has pain in the "midfoot" region
- Has bone tenderness at the base of the 5th metatarsal or the navicular
- Inability to bear weight both immediately after the injury and four steps in the evaluation room
50
What is the preferred imaging choice if there is a suspicion for a stress fracture if initial x-ray imaging is negative?
MRI
51
What is the gold standard imaging modality for trauma?
CT
52
What is the OTTAWA criteria for acute knee pain?
- Age > 55 years old
- Tenderness of the patella
- Tenderness at the head of the fibula
- Inability to flex the knee to 90 degrees
- Inability to bear weight both immediately after the injury and for four steps in the evaluation room (limping is allowed)
53
What is the modality of choice if you suspect ligamentous injury?
MRI
54
What are plain films able to identify for the shoulder?
- Fractures
- Dislocation
- Arthritis
- AC joint (acromioclavicular) injuries
- SC joint (sternoclavicular) injuries
55
What is the criteria for imaging of the shoulder, hand, and wrist?
- Trauma
- Severe pain
- Loss of range of motion
56
What does a plain film of the hand and wrist identify?
- Fractures
| - Dislocations
57
A Tuft fracture involves fractures what structure?
Head of the distal phalanx
58
What is a complex synovial joint formed by the articulations of the humerus, the radius, and the ulna
The elbow
59
What are the three articulations of the elbow?
1. Radiohumeral
2. Ulnohumeral
3. Radioulnar
60
Capitellum of the humerus with the radial head
Radiohumeral
61
Trochlea of the humerus with the trochlear notch of the ulna
Ulnohumeral
62
Radial head with the radial notch of the ulna (proximal radioulnar joint)
Radioulnar
63
When is imaging not indicated in patients with back pain?
The first 4-6 weeks
64
Imaging is not indicated in the first 4-6 weeks unless back pain is present with what?
(a) Progressive neurological findings or cauda equina symptoms
(b) Constitutional findings (fever, weight loss)
(c) Traumatic cause
(d) Current or history of malignancy
(e) Elderly - 50 years old
(f) Infectious risk (IV drug use, immunosuppression)
(g) Chronic steroid use
(h) Failed conservative management with signs of nerve root irritation
(i) At risk for osteoporosis
65
Which type of fracture is this?
Oblique
66
Which type of fracture has an angulated fracture line?
Oblique
67
Which type of fracture is this?
Transverse
68
Which type of fracture is perpendicular to the shaft of the bone?
Transverse
69
Which type of fracture is this?
Spiral
70
Which fracture has a multi-planar and complex fracture line.
Spiral
71
Which type of fracture is this?
Overriding
72
What type of fracture is it when one bone is displaced over the other?
Overriding
73
Which type of fracture is this?
Distraction
74
Which fracture is it when fragments are separated by a gap?
Distraction
75
Which type of fracture is this?
Torus
76
What is an incomplete fracture seen in children, causing bulging of the cortex?
Torus
77
Which type of fracture is this?
Greenstick
78
What is an incomplete fracture seen in children, causing an angular deformity (bend)
Greenstick
79
Which fracture is this?
Comminuted
80
Which fracture has more than two fracture fragments?
Comminuted
81
What color is x-ray film to start with?
White
82
When does x-ray films turn dark?
When it is hit with ionizing radiation
83
What are the five basic radiographic densities?
1. Darkest - Air
2. Less dark - Fat
3. Gray - Fluid/Blood/Soft tissue
4. White - Bone
5. Most white - Metal/Contrast
84
Which x-ray view is used in chest x-ray?
PA - Posteroanterior
85
Which x-ray view is used mostly on limbs?
Oblique
86
Name this x-ray view:
- Used if a patient is unable to stand or sit
- The back is placed against the film
- Lower quality
- Heart is magnified and boarders are fuzzier
AP - Anteroposterior
87
Name this x-ray view:
| - Object has sharper borders
PA - Posteroanterior
88
Which imaging modality uses high levels of radiation?
CT
89
What is CT good for?
- Bone
- Airspaces
- Some soft tissue/overlapping structures
- GOLD STANDARD FOR TRAUMA
90
What is CT bad for?
- Some soft tissue (when compared to MRI)
| - Patients with retained metallic objects
91
Which imaging modality uses electromagnetism and radio frequency properties?
Magnetic Resonance Imaging (MRI)
92
If plain radiographs are negative in patients suffering knee pain, but you still suspect bony fracture, what imaging modality should you consider?
CT
93
How to name an elbow dislocation?
Dislocations of the elbow are named for the direction the radius and ulna dislocate relative to the humerus
94
What is the imaging modality of choice for back pain with prior surgery, suspected infection, spinal cord injury, tumor, or cord compression?
MRI
