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Musculoskeletal system > Lecture 2- MSK radiology > Flashcards

Lecture 2- MSK radiology Flashcards

1
Q

How is an X-ray produced

A

a projectional image generated. by passage of x-rays through an object

the iamge is generated on a detector plate called an x-ray detector

when the x-ray hits the plarte, it turns black- the amount of blackned depends on the number of x-rays penetrating the object and hitting the plate

x-rays only travel in srraight lines- no deflection by bones or metalwork

X-ryas are absrbed by dense materials

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2
Q

if X-ray white

A

ense

◦X-rays are absorbed by dense materials - wont hit the plate ‣ Bones

‣ Metals

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3
Q

if x-ray dark

A

If darker

◦Less dense
‣ Adipose

‣ Air

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4
Q
A
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5
Q

advantage of x-ray

A
  • quick
  • Available
  • Inexpensive
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6
Q

disadvantage of x-ray

A

involve radiation

Poor soft tissue contrast resolution

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7
Q

role of radiographs

A
  1. Initially imaging of choice for skeletal trauma/acute bone or joint injury:
  • Fracture
  • Joint dislocation
  1. Also used for initial evaluation of chronic bone or joint pathoglogies
  • Chronic osteomyelitis
  • Chronic arthritis e.g. osteoarthritis, rheumatoid arthritis
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8
Q

which x-ray view is normal

A

posterior anterior

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9
Q

medullary bone found

A

in the diaphysis centre

  • less dense
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10
Q

cortex

A

made of cortical comapct bone

  • thick and dense
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11
Q

outermost layer of bone

A

periosteum

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12
Q

undispalced fracture of the tibia

A
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13
Q

a fracture is

A

complete or incomplete break in the cortex or continuity if the bone

Sometimes nutrient vessels look like fracture

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14
Q

Displacement

A
  • out of line slightly
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15
Q

cartilage is

A

radiolucent so appears as joint space

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16
Q

types of fractures (7)

A
  1. transverse
  2. linear
  3. oblique nondisplaced
  4. oblique displaced
  5. spiral
  6. greenstick
  7. comminuted
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17
Q

most fractures look like a

A

lucent line

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18
Q

fractur

A
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19
Q

always describe

A

which side you are looking at

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20
Q

draw transverse

A
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21
Q

draw linear

A
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22
Q

draw oblique nondisplaced

A
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23
Q

draw oblique discplaced

A
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24
Q

spiral

A
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25
draw greenstick
like a twig being bent in half
26
draw comminuted
27
fracture displacement
28
compression fracture
29
if a fracture is hard to see, what may make it clearer
a CT
30
radiogrpahic changes seen during childhood
31
ossification
bone growth
32
calcification
deposition
33
normal paediatrics x-ray
34
what occurs to the bone during childhood to puberty
ossification of epiphysis
35
ossification of carpal bones
36
basic fracture healing process
1) haematoma formation 2) procallus formation 3) bony callus formation 4) bone remodelling
37
the inflammatory phases of fracture healing
* haematoma formation * tissue death * inflammation/ cellular proliferation * hours to days
38
reperative phase of fracture healing
* angiogenesis/ granulation tissue/ procallus * soft (fibrocartilaginous) callus formation * consolidation/ hard callus formation
39
remodelling phase
duration- months to years * remodelling of the callus so that the fracture line becomes completely obscured (radiographic union)
40
x-ray of bone repair
41
CT scans use
radiation to build cross sectional images of the body - thin slices give detailed info about the bone structure and pathology Soft tissue detail is better than plain X-ray
42
How long does a CT take
Whole body CT can be performed in a short time to look for bone or soft tissue injury ◦Slower than x ray
43
what type of fractures are better to view on a CT than x-ray
Subtitle in-displaced fractures are better visualised on CT scan than plain x-ray Spinal fractures and other complex rate like pelvic fractures can be seen in great detail- aid pre- operative planning Slices can be reformatted to create multiple planar and 3D images
44
disadvantages of CT
* radiation higher than x-ray * Motion artefact if patient moves - elderly confused * Poor soft tissue detail compared with MRI (but better than x-ray)
45
in CT scans the density of body tissues is emasured in
hounsfield units (HU)
46
tissue \<0 HU
appear dark e.g. air, fat and water
47
tissue with 0- + 40 HU
shades of grey- soft tissue
48
tissue of \>100 HU
appears white - trabecular and cortical bone
49
CT great at looking at different tissues in different concentrations
window can be selected e.g. can see lungs or soft tissue
50
MRI
Utilises magnetic resonance of the hydrogen nuclei o produce high quality cross-sectional images of the body in any plane no use of ionising radiation Utilises radiofrequency pulses in presence of carefully- controlled magnetic field
51
musculoskeletal MRI fundamental objectives
◦Define normal anatomy ◦Detection of pathology
52
MRI is betetr than CT and X-ray at
assessing soft tissue
53
MRI can also be used in assessment of
MSK infection- osetomyelitits
54
MRi poor at showing
micro-architecture of the bone
55
two tyoes of sequences in MRI
T1 and T2
56
T1
Anatomy defining sequences
57
T2
fluid sensitive - most MSK pathologies appear bright on fluid-sensitive sequences
58
advantages of MRI
* good detail: ligaments,tendons and muscle * Excellent for bone marrow imaging
59
Disadvantages of MRI
scan are long time (45-60 mins) Noisy Claustrophobic Non compatible with metallic/ electronic devices like pacemaker
60
advantages of ultrasound MSK imaging
* no radiation involved * Excellent soft tissue resolution for superficial soft tissue * Excellent imaging modality for assessment of tendons a nd peripheral nerves * Fluid collection * Superficial foreign bodies * Dynamic imaging * Excellent for image guided MSK intervention
61
disadvantages of ultrasound
* operator dependent * Poor deep tissue resolution * Limited bone and intra-articulation imaging
62
example of ultrasound
63
nuclear imaging
Radioisotope-labelled, biologically actve drugs that are administered to the patient to serve as a marker of biological activity
64
why is nuclear imagibng used
They are used to assess areas of metabolically active bone such as when trying to localise ◦Bone forming metastatic lesions ◦Healing fracture ◦Area of osteomyelitis

Musculoskeletal system (7 decks)

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