Diagnostic Imaging

Question 1

Types of medical imaging

Answer 1

Standard radiography (x-ray)
Fluoroscopy
Computed tomography (CT)
Magnetic resonance imaging (MRI)
Nucler medicine
Bone scans (Scintigraphy)
Diagnostic ultrasound

Question 2

Radiograph

Answer 2

X-ray film containing an image of an antomic part of a pt

Question 3

Radiograph

No contrast used during:

Answer 3

plain/standard/conentional radiographs

Question 4

Radiographs require 3 things:

Answer 4

X-ray beam source
pt
X-ray film/image receptor

Question 5

What must be present to prouce X-rays

Answer 5

Source of electrons
Force to move them rapidly
Something to stop movement

Question 6

X-rays

the primary beam passes through the pt and undergoes a process of

Answer 6

attenuation
(redcution in the # of x-ray photons in the beam)

Question 7

Patient positioning for routine radiographs

Answer 7

A-P
P-A
L lateral
R lateral
Oblique

Question 8

Radiograph advantages

Answer 8

broken bones
screening & diagnosis
universally available
inexpensive
patient friendly

Question 9

Limitations of radiographs

Answer 9

2-D image of 3-D structure
Superimposition of other structure may obscure view
Less detail of soft tissue
Radiation limits frequency of exposure to x-ray

Question 10

Radiodensity of air

Answer 10

Most radiolucent
darkest portion of X-ray

Question 11

Radiodensity of fat

Answer 11

Radiolucent
appears dark

Question 12

Radiodensity of fluid

Answer 12

Intermediate radiolucency
appears gray

Question 13

Radiodensity of bone

Answer 13

Most dense
radio-opaque
appears white

Question 14

ABCDs of X-ray analysis

Answer 14

A=Alignment
B=Bone density and dimensions
C=Cartilage spaces
D=Soft tissues

Question 15

Malalignment of bone usually indicates:

Answer 15

soft tissue damage

Question 16

Bone density and dimensions

Answer 16

Cortical bone is more dense than cancellous
cancellous has consisten trabecular patterns
Size and shape of bones should be consistent

Question 17

Cartilage on radiographs?

Answer 17

usually not seen

Question 18

Cartilage

Dark space between bones in a joint:

Answer 18

indirect assessment of the health and/or thickness of joint cartilage

Question 19

Diagnosis of cartilage damage usually requires:

Answer 19

Contrast imaging or an MRI

Question 20

Soft tissue and radiographs?

Answer 20

Poorly seen on most standard radiographs

Question 21

Soft tissue is best seen:

Answer 21

in MRIs
diagnostic ultrasound may be helpful when assessing soft tissue injuries

Question 22

Reading Diagnostic Imaging Reports

Answer 22

Date
Time
Body (type, part, findings)
Radiologist’s Impression

Question 23

Imaging may be necessary prior to therapy to rule out:

Answer 23

pathology or identify location of malalignments

Question 24

PTs and Diagnostic imagins

Answer 24

US Army PTs
VA PTs
Direct Access PT practice in NJ
PTs in emergency departments

Question 25

Ottawa Ankle & Foot rules (Ankle)

Answer 25

* Bone tender at posterior edge or tip of medial malleolus * Bone tender at posterior edge or tip of lateral malleolus * Weight bearing intolerant

Question 26

Ottawa Ankle & Foot rules (foot)

Answer 26

* Bone tender at base of 5th met * Bone tender at navicular * Weight bearing intolerant

Question 27

Ottawa Knee Rules

Answer 27

Age > 55 years Tenderness at head of fib Isolated tenderness of patella Inability to flex knee to 90° Inability to take 4 WB steps in ER

Question 28

Canadian Cervical Spine Rule

Answer 28

Age>85 Parasthesias in extremities Dangerous mechanism of injury Rotation of cervical spine is less than 45° in either direction

Question 29

Canadian Cervical Spine Rule Imaging is NOT necessary when:

Answer 29

Simple rear-end MVC Sitting position while in ER Ambulatory at any time Delayed onset of neck pain Absence of midline C-spine tenderness

Question 30

Contrast enhanced radiograph

Answer 30

Contrast medium injected/ingested before radiograph is taken

Question 31

Negative contrast

Answer 31

Radiolucent air

Question 32

Positive contrast

Answer 32

radiopaque barium sulfate

Question 33

Examples of contrast radiograph

Answer 33

arthrogram angiography arteriography cholecsytography myelogram

Question 34

Myelogram of lumbar spine

Answer 34

contrast is injected into subarachnoid space mixed with CSF

Question 35

Computed Axial Tomography

Answer 35

* CT * mixes x-ray with computer * x-ray beam and detector system housed in circular scanner moving through arc around patient * computer reconstructs image

Question 36

# Computed tomography Denser strcutures appear:

Answer 36

white or have light shades of gray

Question 37

# Computed tomography less dense structures appear:

Answer 37

dark

Question 38

Indications for CT

Answer 38

Loose bodies of joint Subtle fractures Degenerative changes Serious trauma Spinal stenosis Osseous alignment

Question 39

advantages of CT scan

Answer 39

Available in most hospitals and medical centers Images in any plane absence of superimposed skeletal parts Sharp resolution Better view of soft tissues

Question 40

disadvantages of CT scan

Answer 40

cost limited soft tissue resolution compared to MRI ionizing radiation