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Flashcards in Musculoskeletal Imaging Deck (22)
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1

What are some criteria that help you decide on the appropriate imaging modality?

  • Body part of interest
  • Differential diagnosis consideration
  • Age of patient
  • Patient history
  • Cost of exam
  • Radiation dose
  • Availability

2

Guidelines for Choosing a Modality:

1. What is the clinical question?

2. What test is most likely to answer this question? (Which are available?)

3. If more than one test will work -- think about safety for the patient first, then think about cost of the procedure

3

What a is good way to approach an imaging study? 

Develop a consistent search pattern for evaluation 

4

What is a reformated image? 

Technology takes the image and reforms it to make it more anatomically relevant 

5

How many views do you need in radiographs? 

At least two!

One view is NO view. 

6

What are some pitfalls of radiography? 

Inappropriate projection -- pathology may be seen only on one view  

Poor quality exam 

Satisfaction of search

Timing of exam

Lack of correlation between imaging findings and clincial findings 

Specifics: Vascular channels, accessory bones, developmental abnormalities 

7

What imaging modality uses radioactive isotopes? 

Nuclear medicine 

8

What are sesamoid bones? What is the largest sesamoid bone in the body 

Bone embedded wtihin a tendon where the tendon passes over a joint. 

Patella.

9

What are a couple of examples of developmental anomalies that are seen on x-ray? 

Sacral Agenesis

Marfan's 

Limbus vertebral body 

10

Pneumonic for going through possible differentials when imaging:

VINDICATE

  • Vascular
  • Infection
  • Neoplasm
  • Drugs
  • Inflammatory/idiopathic
  • Congenital 
  • Autoimmune
  • Trauma
  • Endocrine/metabolic 

11

What sign can a periosteal reaction around a tumor cause? 

Codman's Triangle 

12

What are some examples of abnormal calcifications? 

Crest Syndrome

Soft Tissue Hemangiomas 

13

What is a helpful sign of injury but doesn't always manifest radiographically? 

Effusions

In knee, elbow, ankle, wrist, fingers 

14

What is lipohemarthrosis? 

Mixture of fat and blood in joint capsule following trauma -- can be seen in radiograph 

15

What characteristics should you use to describe a fracture? 

  • Location
  • Orientation
  • Displacement
  • Apposition
  • Angulation
  • Intraarticular involvement 
  • Comminution
  • Open vs. closed
  • Associated injuries 

16

What is a Jone's Fracture? 

Fracture at the base of the 5th metatarsal 

Likelihood of non-union needs to be followed 

17

What is a Rolando fracture? 

A cominuted intra-articular fracture through the base of the 5th metatarsal 

18

What is an avulsion fracture? 

When a fragment of bone tears away from main mass of bone due to physical trauma (with ligament) 

19

What is a Segond fracture? What injury is likely to accompany it? 

Avulsion fracture of the knee that involves lateral aspect of the tibial plateau. Frequently associated with ACL tear. 

20

What are some radiographic findings with osteoarthritis? 

  • Osteophytes
  • Asymmetric joint loss
  • Predictable pattern

21

What are some types of inflammatory arthritis to watch out for?

  • Rheumatoid arthritis
  • Seronegative syndromes: ankylosing spondylitis, reactive arthritis, psoriatic arthritis 
  • Deposition diseases: gout, pseudogout

22

Age vs. appearance

When the images do not fit the patient's age, must consider an alternative diagnosis.