Diagnostic Imaging Intro Flashcards by Courtney Dierkes

5 different types of imaging

radiographs, MRI, CT, bone scan, and ultrasound

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Why should we care about imaging?

Our pts often come armed with a diagnosis based off imaging, it’s the language that physicians speak, and it’s another piece of potentially critical information

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a posterior to anterior view is best for scoliosis, because it will have a ______ reduction in lifetime ionizing radiation and it reduces the risk of breast cancer by ________ and thyroid cancer by _________

3-7X; 3-4X; 2X

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Radiographs are most common and are the favorite because they are ____________, but they also use _______________

easy, cheap, and quick; ionizing radiation

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key components to reading radiographs

get good quality images, know your anatomy, realize difference with age, be able to interpret and react to your findings, and know your limits

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X-ray film: black without absorption - ________________ - less dense material

radiolucent

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X-ray film: white with absorption (without penetration) - ___________________ - more dense material

radiopaque

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Osteoblastic activity

bone becomes more dense because of calcium deposition to the area – so it gets stronger and thicker

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Osteoclastic activity

when you have depletion of calcium, bone becomes weakened or more brittle and thinner

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Radiopaque, opacity, sclerosis, hypertrophic bone, increased radiodensity, and blastic lesions (reparative or reactive) are all ______________ activity

Osteoblastic

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Radiolucent, lucency, osteopenia, decreased radiodensity, and lytic lesion or lysis are all _____________ activity

osteoclastic

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From _____________ to ______________, it’s air, fat, water, bone, contrast media, and heavy metals

radiolucent, radiopaque

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What are the ABCs of radiographic evaluation

alignment, bone density, cartilage spaces, and soft tissue

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Don’t immediately focus on the _____________

obvious

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What should you consider when looking at alignment?

size of bone, number of bones, shape and contour of bones, and bone and joint position

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One view is _____________

no view

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critical questions to ask when looking at imaging

is there enough pictures (importance of two views)? are they the right pictures (importance of correct views, capture all areas of concerns)? are they good pictures (Structures well visualized, identification and orientation)?

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2 examples of trauma we should look for

dislocation and fracture

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Salter-Harris

System of classifying physial fractures in kids

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Salter-Harris Grade 1

Fracture through the physis only

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Salter-Harris Grade 2

Fracture through the physis and metaphysis

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Salter-Harris Grade 3

Fracture through the physis and Epiphysis

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Salter-Harris Grade 4

Fracture through the physis, Metaphysis, and epiphysis

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Salter-Harris Grade 5

Crush/compression injury to the physis

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Fractures are classified by ___________________

description or mechanism of injury

Some descriptions of fractures are __________

open vs closed, type, location, deformity, and number of fragments/pieces

Fracture description: types

transverse, oblique, spiral, compression/impacted, torus/buckle, and epiphyseal

locations of fractures

relational or anatomical

Fracture description: deformities

Angulation, displacement, shortened, roatation

Examples of non-traumatic things that imaging can be used for

arthritis, infections, neoplasms, metabolic bone disease, and pathologic fractures

remember to look at ___________ of the affected area and look at joints/area ____________ to the area of concern

stability; proximal and distal

MRI uses ___________________ impulses in a magnetic field

radiofrequency (RF)

MRI aligns nuclei with an odd # of pro/neutrons ______________ to magnetic field

parallel

RF pulses cause _____________ of nuclei resulting in MRI images

Deflections

T1 MRI

best demonstrate anatomic structure

T2 MRI

most helpful in contrasting normal and abnormal tissue

Water, CSF, acute hemorrhage, and soft tissue tumors appear ________ on T1 and _________ on T2 studies

dark, bright

MRI uses

most sensitive method for detection of early osteonecrosis, infection and trauma, excellent for occult fractures, neoplasms, disc disease and herniation, bone marrow changes, ACL, best radiologic test for PCL, and Shoulders (90%) for RC tears, equal to Ct on labral pathology

28% of subjects over 40 years old have abnormality in their ___________ on MRI

C-spine

20-30% of subjects under 40 years old show evidence of _______________________

lumbar disc herniation

__________% of subjects over 60 years old show evidence of degeneration and bulging of one or more lumbar disc

MRI disadvantages

Expensive, 10% of pts can't tolerate it due to claustrophobia, Subject to artifact from metallic objects, can interfere with cardiac pacemakers, and can cause shifting of foreign metallic objects in the eye/brain

Computed tomography uses __________, is computer enhanced, gives a great increase in tissue ___________, can use _____________ agents (arthrography), and is great for spinal lesions

X-ray; contrast; contrasting

CTs demonstrate ____________ better than any other study

bony abnormalities

CTs are used in conjunction with _______, such as in arthrogram CT and myelogram CT

contrast

CTs are useful in measuring ____________ for cervical stenosis

cross sectional dural area

CT is valuable for evaluating subtaler ________ & subtaler ____________

joint and coalitions

Dynamic CT is the best test available for diagnosis of ______________ subluxation

atlantoaxial rotary

Bone scan

uses markers to reflect increased blood flow and metabolism

In a bone scan, the marker is absorbed by hydroxyapatite crystals in bone in areas of _____________

infection, trauma, or neoplasm, etc.

Bone scans are very useful in the diagnosis of ______________________

subtle fractures, avascular necrosis, decreased blood flow, osteomyelitis, and THA/TKA loosening

Ultrasonography of the shoudler

useful in diagnosis of RC tears

Ultrasonography of the hip

useful in diagnosis and follow-up on congenital hip dysplasia, and diagnosis of iliopsoas bursitis

Ultrasonography of the knee

Assess articular cartilage thickness and identify intra-articular fluid/effusion

Ultrasonography of fractures

used for fracture healing progression

Other than the shoulder, hip, knee, and fractures, ultrasonography can also be used for _____________________

soft tissue masses, hematoma, tendon rupture, abscesses, and foreign body location

types of transducers

linear, curved linear, and compact linear

Linear transducers transducers

look at midrange/average depth

Curved linear transducers

look at much deeper structures

Compact linear transducers

look at very superficial structures; good for tendons of fingers

What type of transducer is used for pregnancies?

curved linear transducers