Diagnostic Imaging

Question 1

bone should show up as ______ on xray

Answer 1

white

Question 2

fat would show up as ______ on xray

Answer 2

dark

Question 3

list 3 advantages of xrays

Answer 3

Easily available + Quick
Inexpensive
Relatively low radiation
Good detail (bone definition)

Question 4

list 3 disadvantages of xray

Answer 4

May not reveal process until very advanced
2D image = requires multiple views
Less soft tissue detail

Question 5

4 OA related terms

Answer 5

osteophytes
subchondral sclerosis
subchondral cyst
central erosion

Question 6

what is osteopenia

Answer 6

loss of bone density

Question 7

what are bony outgrowth at edge of joint

Answer 7

osteophytes

Question 8

what are extra dense bones around joint

Answer 8

subchondral sclerosis

Question 9

what are pockets of synovial fluid in bone near joint

Answer 9

subchondral cysts

Question 10

what is a break in cortical bone at the center of the joint

Answer 10

central erosion

Question 11

Joint space narrowing means that

Answer 11

hyaline cartilage thinned

Question 12

osteopenia means that

Answer 12

Less bone being formed
Bone being lost
May be inflammation in or next to the bone

Question 13

osteophytes means that the joint is undergoing ________ and is typically associated with __________

Answer 13

degeneration
OA

Question 14

subchondral sclerosis is seen when there is abnormal _______________, typically associated with _______

Answer 14

mechanical stresses on the bone
OA

Question 15

subchondral sclerosis looks _____ on xray

Answer 15

white

Question 16

subchondral cysts are usually associated with

Answer 16

OA

Question 17

what are subchndral cysts called when large

Answer 17

geodes

Question 18

central erosion means that there is

Answer 18

Degeneration with inflammation resulting in breaks and erosions at joint surface
Occurs with erosive OA

Question 19

what is marginal erosion

Answer 19

loss of bone at joint margin

Question 20

what is juxtaarticular erosion

Answer 20

away from joint margin

Question 21

what is central erosion

Answer 21

in middle of joint

Question 22

marginal erosion is common in

Answer 22

RA, PsA

Question 23

juxtaarticular erosion is common in

Answer 23

gout

Question 24

pencil in cup is typical of

Answer 24

PsA

Question 25

fusion is common in

Answer 25

SpA

Question 26

periostitis is ___________ common in ______

Answer 26

fluffy new bone growth along shaft SpA

Question 27

fusion means

Answer 27

Inflammatory process has occurred + healing resulted in fusion May have been past trauma + bones fused when they healed

Question 28

periostitis means there is ______ affecting the ________ layer of the bone

Answer 28

inflammation periosteal

Question 29

ulna deviation means that there is

Answer 29

Laxity of soft tissue supports at the joints

Question 30

ulna deviation is often seen in

Answer 30

RA

Question 31

what is subluxation

Answer 31

bones not aligned at joint

Question 32

Distribution of affected hand joints more transverse- affects all same joints across hands

Answer 32

RA

Question 33

Affects each individual digit differently, more subluxation, pencil in cup

Answer 33

psoriatic arthritis

Question 34

Mostly PIP and DIP affected, bony but not squishy/ swelling

Answer 34

osteoarthritis

Question 35

scoliosis is

Answer 35

lateral curvature to spine

Question 36

spondylolisthesis

Answer 36

displacement of 1 vertebrae over another

Question 37

sacrolitis is

Answer 37

inflammation of SI joints

Question 38

syndesmophytes is

Answer 38

bony growths along a ligament

Question 39

how does ultrasound work

Answer 39

Cross sectional imaging that relies on reflection of sound waves off tissue interfaces

Question 40

ultrasound bright means

Answer 40

hyperechoic- bone

Question 41

ultrasound dark means

Answer 41

hypoechoic = fluids/ not dense

Question 42

doppler signal measure

Answer 42

blood flow to area

Question 43

echogenicity is

Answer 43

relative to surrounding tissues

Question 44

ultrasound is indicated for

Answer 44

soft tissue pathology bony pathology

Question 45

pros of ultrasound

Answer 45

Inexpensive and portable Can compare both sides of body Dynamic eval of structures (Stress or stretch) Can press with transducer to identify source of pain No ionizing radiation

Question 46

cons of ultrasound

Answer 46

Operator dependent Time consuming U/S waves do not penetrate bone, can not cross air

Question 47

CT is

Answer 47

Cross sectional imaging technique merging xray technology with computer processing/ reconstruction to see 3D images

Question 48

CT indications

Answer 48

Good for bone, soft tissue, blood vessel imaging Gout protocol (dual energy CT gout)

Question 49

CT pros

Answer 49

Very detailed images Widely available Less time consuming than U/S or MRI Less expensive than MRI Safe for those with metal devices

Question 50

CT cons

Answer 50

More radiation Less soft tissue distinction compared to MRI Pt must be still

Question 51

describe how MRI works

Answer 51

cross sectional imaging using a magnetic field and radiofrequency signal to cause hydrogen ions in bodies to emit signals, then convert to image Principle- different tissues contain different amounts of water (H+) = can visualize the distinction

Question 52

gadolinium is a

Answer 52

MRI contrast agent

Question 53

T1 MRI sees fluids as

Answer 53

dark

Question 54

pros for MRI

Answer 54

good for soft tissues no ionizing radiaiton

Question 55

cons for MRI

Answer 55

Expensive Not as readily available + More time consuming Not as good for bone Metal contraindicated + claustrophobia Must keep still for prolonged period

Question 56

how do bone scans work

Answer 56

Nuclear medicine imaging - uses radioactive substance to image a physiologic process in body Radiopharmaceuticals are injected into patient Ex- MDP (TN-99 = radioactive component) Affinity for hydroxyapatite crystals (accumulates in areas with increased bone production) Gamma cameras detect rays emitted by body

Question 57

bone scan indications

Answer 57

bone metabolism in cancer, emtabolic bone diseases, subtle fractures, osteolyelitis

Question 58

T or F: bone scan is good for distinguishing types of arthritis

Answer 58

F

Question 59

bone scan pros

Answer 59

V sensitive Great for picking up things that shouldn't be missed

Question 60

bone scan cons

Answer 60

Pregnancy / breastfeeding Some radiation emission after scan (t1/2 = 1d) Structural details not well seen