Investigation Flashcards

1
Q

things to consider before imagine bone?

A

flat/long?
diaphysis/metaphysis/ epiphysis?
medulla/cortex / trabecular?
diffuse/local?

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2
Q

diffuse bone disease?

A

brittle bones- osteoporosis

soft bones- rickets/ osteomalacia, paget’s

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3
Q

local bone disease?

A

trauma, neoplastic, inflammatory, degenerative

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4
Q

a bone scan is…

A

a map of osteoblastic activity

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5
Q

3 spinal deviations from normal?

A

lordosis- cervical deviation
kyphosis- thoracic deviation
lordosis- lumbar deviation

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6
Q

a normal vertebrae (C3-L5) is made up of?

A

vertebral body with posterior arch (have 2 pedicles), laminae, 1 spinous process and 2 transverses processes
neural foramen
facet joints superiorly and inferiorly

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7
Q

what are 2 abnormal vertebrae?

A

C1 and C2

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8
Q

how does C1 differ from the normal vertebra?

A

has no vertebral body- only anterior and posterior arches

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9
Q

how does C2 differ from the normal vertebra?

A

has an odontoid process that projects superiorly into C1

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10
Q

what mode of imaging is used for fractures?

A

CT

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11
Q

what mode of imaging is used for ligamental damage?

A

MRI- ligament damage appears light

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12
Q

what is a diagnostic MRI findings to indicate spinal ligament damage?

A

abnormal vertebral alignment

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13
Q

explain the use of different imaging techniques for the identification of bone tumours?

A

Xray & CT: shows bone sclerosis

MRI: shows bone marrow infiltration, extradural mass and spinal cord compression

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14
Q

what are intra-vertebral discs?

A

they cushion the vertebras

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15
Q

what imaging is used for IV disc disease e.g. disc prolapse or herniation?

A

MRI- disc prolapses

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16
Q

what is disc dehydration?

A

it commonly precedes disc prolapse

17
Q

what imaging is used for spinal cord?

A

MRI

18
Q

what are the tell tale signs of osteoarthritis?

A
  • asymmetric jt space reduction
  • sclerosis (dense bone)
  • cysts
  • osteophyte formation
19
Q

what are tell tale signs of RA?

A
  • jt involvement is symmetrical
  • soft tissue swelling
  • periarticular osteoporosis
  • marginal erosion*
20
Q

what does periarticular osteoporosis look like on x-ray?

A

appears less white

21
Q

what are tell-tale signs of seronegative arthritides?

A

synovitis, enthesitis
sacroiliac jt and spine involvement
ill defined periarticular new bone formation
ossification of ligaments/ bone fusion across jts

22
Q

what does isotope bone scan show?

A

inc vascularity around inflamed joints

23
Q

what does doppler USS show?

A

thickening of synovium and inc blood flow

24
Q

which x-rays should you get with trauma presentation?

A

AP, horizontal beam

25
Q

things to remember when doing x-rays…

A
fracture appearance variable 
always assess bony alignment 
check for soft tissue abnormalities
look for other fractures
some FBs don't show on x-ray
26
Q

which fractures should you be extra aware of?

A

posterior shoulder dislocation, supracondylar fracture (brachial artery), scaphoid fracture (AVN), Bennett’s fracture

27
Q

how do children have different bones?

A

bend more (plastic bowing fracture)
greenstick (incomplete) fracture
soft tissue injuries more common
salter-harris fractures

28
Q

what are salter-harris fractures?

A

epiphysis fracture

29
Q

which x-ray should you get to diagnose posterior shoulder dislocation?

A

oblique view

30
Q

MRI used to assess…

A

deep soft tissue

31
Q

USS used to assess…

A

superficial soft tissue

32
Q

CT good for…

A

resolves many x-ray limitations- good to further assess bones

33
Q

what are the 4 accessory ossification centres in young

A

5th MT, calcaneus, fabella (sesamoid bone in gastrocnemius), rounded sesamoid bone in 1st MT head