Exam 1

Question 1

Role of PTs play in diagnostic imaging

Answer 1

-recognize need for imaging
- integrate imaging reports into treatment plan
- understand visually to develop treatment and modify treatment plan
- know when imaging is and is not needed for optimal outcome
-communicate effectively with physician, radiologist

Question 2

Factors of over utilization

Answer 2

-physician self referral
-incomplete evidence
- patients desire
- liability risk
- med student education

Question 3

Indications for diagnostic imaging

Answer 3

• pt history, systems review, and measures make it evident that further diagnostic is needed
• if imaging results will change the course of treatment or alter the outcome of the problem
• in the absence of appropriate response to PT

Question 4

Types of imaging modalities

Answer 4

Radiographs (x-ray)
Nuclear imaging
MRI
Ultrasound
Conventional and computed tomography

Question 5

Can radiographs distinguish the difference between bone, air, calcification, fat, soft tissue and fluids

Answer 5

Yes

Question 6

Are radiographs good at detecting early stress fractures

Answer 6

No

Question 7

What is a: injection into specific artery to demonstrate blood flow

Answer 7

Ateriography

Question 8

What shows upper GI tract

Answer 8

Barium swallow

Question 9

Who looks at: gall bladder, urograms, pyelograms, cystograms

Answer 9

Cholecystography

Question 10

What contrast study is this: injected into joint. May be used with other media such as MRI and CT

Answer 10

Arthography

Question 11

Contrast material injected into subarachnoid space to look at the spinal cord, nerve roots and dura mater is what

Answer 11

Myelography

Question 12

For radiographs more x-ray beam absorbed means the tissue has greater what

Answer 12

Radiodensity

Question 13

Form an AP view will the lateral borders or the middle of the bone be more radiopaque

Answer 13

Lateral borders because it is “thicker”

Question 14

When an object absorbs the X-rays fewer photons produced, film stays light what is this

Answer 14

Radiopaque

Question 15

X-rays not absorbed, screen produces photons when struck, and exposes the film, turning it dark is what

Answer 15

Radiolucent

Question 16

When were x-rays discovered

Answer 16

1895

Question 17

In a radio graph air is what color

Answer 17

Black

Question 18

In a radiograph fat is what color

Answer 18

Grey-black

Question 19

What color is water on a radio graph

Answer 19

Grey

Question 20

What color is bone on a radiograph

Answer 20

White

Question 21

What color is contrast media or heavy metal on a radiograph

Answer 21

Bright white

Question 22

What does the ABC’s pattern stand for

Answer 22

Alignment
Bone changes
Cartilage spaces
Soft tissues

Question 23

When checking bone density in the vertebral column where should you look

Answer 23

Segments above and below

Question 24

Decreased joint space implies what on a radiograph

Answer 24

Cartilage or disk thinning

Question 25

Subchondral bone changes indicates what

Answer 25

RA or gout, decrease reparative sclerosis and create cysts

Question 26

Lipohemarthrosis- Fat-blood interface (FBI)

Answer 26

-Fat floats on surface of blood - should left you to intra-articular fracture

Question 27

What are the 7 elements to describe a fracture

Answer 27

- anatomic site and extent - type - alignment of segments (from anatomical position) - direction of fracture - special features - presence of abnormalities such as dislocated joint - special types of fracture

Question 28

Salter Harris fractures are named from what position

Answer 28

Anatomical position

Question 29

Salter Harris fractures classifications

Answer 29

1- separated 2 - above 3 - lower 4- through 5 - rammed

Question 30

Most common sites of traumatic injury in C spine

Answer 30

C1-C2 and C6-C7

Question 31

Commonly missed fractures

Answer 31

C1-C2, C6-C7, scaphoid and femoral neck

Question 32

Signs of RA using ABCS

Answer 32

A - B joint involvement, MCP subluxation and ulnar deviation, swan neck or boutonnière deformity in IPs, acetabular profusion of hip B - localized area of decreased bone density; periarticular osteoporosis C - Articular cartilage erosion, joint space narrowing, subchondral erosions, subchondral cysts or synovial pseudocysts S - periarticular swelling of joints

Question 33

Two types of degenerative joint disease

Answer 33

Primary - idiopathic Secondary - result of injury

Question 34

Radiologic signs of OA using ABCS

Answer 34

A - unilateral involvement, heberdens nodes DIP, Bouchard nodes PIP B - Sclerotic subchondral bone C - loss of articular cartilage w joint space narrowing S- joint effusion

Question 35

Heberdens nodes are where

Answer 35

DIP

Question 36

Bouchard’s nodes are where

Answer 36

PIP

Question 37

Types of bony reactions

Answer 37

Sclerosis Buttressing Periosteal

Question 38

What is sclerosis

Answer 38

Bone growth to fortify an area subjected to increased stress

Question 39

What is buttressing

Answer 39

Formation of bony exostosis or osteophytes to strengthen architecture of joint

Question 40

What is periosteal

Answer 40

Solid, laminated (onion skin), speculated (sunburst), Colman’s triangle

Question 41

Types of abnormal periosteal reactions

Answer 41

- solid - laminated or onion skin - speculated or sunburst - Codman’s triangle

Question 42

What is nuclear imaging

Answer 42

Pt is injected with a radioactive substance that collects in areas of increased metabolic activity

Question 43

Both PET and SPECT are nuclear medicine imaging techniques that provide metabolic and biochemical function of your ____ and _____ ( CT and MRI unable)

Answer 43

Tissues and organs

Question 44

Diagnostic imaging is effective at imaging what

Answer 44

Superficial soft tissue strictest such as muscle, tendon, ligament nerve and foreign bodies

Question 45

Hypoechoic is what

Answer 45

Tissue that reflects little energy produce dark image

Question 46

Hyperechoic is what

Answer 46

Tissue that reflects much energy. Produce bright images

Question 47

Is bone hyper or hypoechoic

Answer 47

Hyeperechoic

Question 48

Are tendons hyper or hypoechoic

Answer 48

Hyper

Question 49

Are ligaments hyper or hypoechoic

Answer 49

Hyper

Question 50

Is fat hyper or hypoechoic

Answer 50

Hypo

Question 51

Advantages of US

Answer 51

- higher resoluation - low cost and portability - no known hazards - a lot more

Question 52

Disadvantages of US

Answer 52

- limited ability to show joint surfaces and intra-articular structures - only shows cortical outline of bone - obese pt not imaged well - metal not imaged well Etc

Question 53

What is this : exposes patients to higher doses of ionizing radiation but is confined to smaller areas

Answer 53

CT

Question 54

Lateral views of a CT scan are called what

Answer 54

Sagittal views

Question 55

Benefits of CT

Answer 55

- best for identify subtle or complex Fx - best for eval of degenerative bony changes - often 1st imaging choice in trauma - CT excels in eval of spinal stenosis Etc

Question 56

CT negatives

Answer 56

- CT has limited ability to differentiate between types of soft tissues (tendon, ligaments) - higher doses of radiation - price

Question 57

MRI absolute contraindications

Answer 57

Ferry magnetic implants

Question 58

MRI relative contraindications

Answer 58

- PT intolerance due to claustrophobia - inability of patient to remain motionless during scan - expensive

Question 59

MRI best at diagnosing _____

Answer 59

Disk herniations

Question 60

Disadvantages of MRI

Answer 60

- Long scanning times - expensive - ferromagnetic implants - claustrophobia