Orthopedics: Radiology intro

Question 1

Xrays: Form of ___________ radiation

Answer 1

Electromagnetic

Question 2

Density Principle: Thicker the object —> ________ penentrability

Answer 2

less

Question 3

Components of xray

Answer 3

Xray tube, beam and film plate

Question 4

Shape idea

Answer 4

3D –> 2D based on shape and density

Question 5

Radiopaque vs Radiolucent

Answer 5

Radiopaque (i.e. bone) - relative impenetrability to X rays

Radiolucent (i.e. air) - relative penetrability to X rays

Question 6

An x-ray (or any test) is only as good as the _______________

Answer 6

History and Physical

Question 7

Treat _____, not xrays

Answer 7

people

Question 8

Understand the test you order and its ____________

Answer 8

potential outcomes

Question 9

Understand ________ and ________ of x rays

Answer 9

Strengths and weaknesses

Question 10

Metaphysis vs. Diaphysis

Answer 10

Metaphysis - region next to joint

Diaphysis - long part of bone

Question 11

Epiphysis

Epiphyseal Plate

Answer 11

Epiphyseal plate - growth plate

Epiphysis - bone part distal to growth plate

Question 12

Apophyseal plate

Apophysis

Answer 12

Growth plate w/ tension from tendon (i.e. elbow)

Distal area

Question 13

Reasons to get Xrays

Answer 13

Pain - traumatic or nontraumatic

Miscellaneous (congenital, endocrine)

Question 14

Complete disrupption in the continuity of bone

Answer 14

Fracture

Question 15

Fracture shows up as ________ on Xray

Answer 15

radiolucent line

Question 16

Fractures: Obtain ________ views (ideally in ________ planes) of involved bones

Answer 16

AT least 2 views, perpendicular

Question 17

Obtain X ray of joint _______ and ________ fracture

Answer 17

above and below

Question 18

Consider ________ views in children

Answer 18

contralateral

Question 19

Look for __________ of fracture

Answer 19

indirect signs

Question 20

Indirect signs of a fracture

Answer 20

• Soft-tissue swelling
• Obliteration or displacement of fat stripes
• Periosteal and endosteal reaction
• Buckling of the cortex
• Double cortical line

Question 21

Which is fracture?

Answer 21

One on left - look at thicker soft-tissue (swelling)

Question 22

Answer 22

Periosteal reaction - healing

Question 23

Answer 23

Buckling of cortex

Question 24

Answer 24

Double cortical line

Question 25

Describing X ray of fracture

Answer 25

View Soft tissue abnormalities Fracture description

Question 26

Fracture description

Answer 26

Anatomic location Type of fracture Direction of the fracture line Alignment of the fracture Special features Associated abnormalities (i.e. tumor)

Question 27

Simple vs. comminuted

Answer 27

Simple - one line Comminuted - multiple fracture lines

Question 28

Displacement vs Angulation

Answer 28

D - movement away from midline A - angled away from midline (typically in terms of distal fragment)

Question 29

Valgas vs varus

Answer 29

Valgus - knock-kneed (Gum between) Varus - in

Question 30

Answer 30

Foreshortened, distracted

Question 31

Answer 31

Compacted

Question 32

Directions of fracture line

Answer 32

Transverse, oblique, spiral, longitudinal

Question 33

Site and Extent of Fracture

Answer 33

Jct middle/distal third Supracondylar Intraarticular

Question 34

Fracture Type

Answer 34

Buckle (torus) Greenstick

Question 35

Differential Dx/Classification of Arthritis (not on test... but good to know)

Answer 35

* Osteoarthritis * Inflammatory arthritis (RA, SLE, scleroderma, etc.) * Seronegative spondyloarthropathies (Reiter’s, ankylosing spondylitis, psoriatic, reactive arthritides) * Crystal deposition arthropathy (Gout, pseudogout) * Metabolic / endocrine * Infectious

Question 36

Radiographic dx of arthritis is based on:

Answer 36

The morphology of an articular lesion Its distribution in the skeleton

Question 37

\_\_\_\_\_\_\_ most important radiologic imaging modality of arthritis

Answer 37

x rays

Question 38

RAdiographic features of arthritis

Answer 38

Periarticular osteoporosis, subchondral sclerosis, soft tissue swelling, subchondral erosion, narrowing of joint space, joint effusion, osteophyte formation, subchondral cystlike lesions

Question 39

Xray appearance of osteoarthritis

Answer 39

* Marginal osteophytes * Cortical irregularity * Subchondral sclerosis * Subchondral cysts * Joint space narrowing

Question 40

RA appearance on xrays

Answer 40

* Periarticular osteoporosis * Joint effusion * Joint space narrowing * Articular erosions/destruction * Synovial cysts * Deformities