MSK

Answer 1

distal proximal mid shaft
-turned/rotated internally/externally
-anterior/posterior dislocation

Question 2

CT

Answer 2

-greater detail
-large joint spaces and bones
-vertebral columns- small bones
-trauma

Question 3

MRI

Answer 3

-ateriography
-cons- metals, its long process, if you position the pt wrong you need to repeat

Question 4

bone scan

Answer 4

-3 phases
-radiotracer injected into vascular system
-take image 30 mins after
-and then again after
-4-5 hour exam
-pt must be STABLE
-metabolic activity at the level of the bone
-cell turnover
-very sensitive
-picks up osteomyelitis way earlier than anything else
-MUST CONFIRM via bone bx

Question 5

order of imaging

Answer 5

-ALWAYS NO MATTER WHAT 2D XRAY
-then if you suspect soft tissue injury go for MRI
-then if you suspect bone injury go to CT for details
-if you suspect osteomyelitis/infection (and pt is stable) -> go for bone scan

Question 6

70 year old female with foot ulcer, fever, 21,000 WBC, glucose 300, a1c 12.2, left foot

Answer 6

-1st- x-ray, PA and lateral -> everything looks good
-2nd- bone scan (bc you thinking infection)
-gold standard- biopsy

Question 7

child abuse

Answer 7

-rib fractures
-femur, humoral
-head trauma
-suspect abuse
-MC- long bones
-spiral fractures- require a lot of force