Radiography and Radiology

Question 1

Name the 3 aims of radiography in the horse

Answer 1

• Minimal exposure / risk to staff
• Good, diagnostic films of region of interest
• As little repetition of views as possible – minimum number of exposures possible

Question 2

How do we acheive: (4)

• Minimal exposure / risk to staff
• Good, diagnostic films of region of interest
• As little repetition of views as possible – minimum number of exposures possible

Answer 2

• Careful attention to protocols and safety
• Good selection of cases for radiography (no safaris!)
• Careful positioning and technique
• Accurate records of exposures and equipment settings

Question 3

We beam should we consier using? (especially on a yard)

Answer 3

Horizontal beam

Question 4

What is the inverse square law?

Answer 4

Double the distance = 4 x less exposure

Question 5

Who should be around when radiographing.. who shouldn’t?

Answer 5

Minimum number of staff (>18, not pregnant)

Question 6

What do we ned to set up when radiographing on a yard?

Answer 6

Temporary controlled area

Question 7

What do we use to centre the beam?

Answer 7

Markers on the horse

Question 8

What do we need to measure for horse x-ray? What is this?

Answer 8

•Careful measuring of fim focal distance (plate to X-ray head)

Question 9

What 3 things should we write down?

Answer 9

• Record case details, exposures and outcome
• Clearly label radiographs (patient, date and leg)
• Careful storage of radiographs (legal records)

Question 10

What 4 things do we need to desrcibe about radiograph films when interpreting?

Answer 10

• Animal
• Region
• Views
• Film faults

Question 11

When interpreting radiographs what 5 things do we Describe the lesion?

(Roentgen signs?)

Answer 11

• Position
• Number
• Size
• Shape
• Radiopacity

Question 12

After interpreting a rdiograph, what are the next 3 steps?

Answer 12

Develop a list of differential diagnoses

Decide any further diagnostic tests

Arrive at the most likely diagnosis

Question 13

How do you interpret bone on radiographs?

Answer 13

• Sharp vs. Fuzzy = inactive vs. active, acute vs. chronic
• Smooth vs. irregular = acute vs. chronic
• Mineralised opacities with medullary pattern = fractures
• Subchondral bone defects = osteochondrosis, fracture bed

Question 14

What may a cystic lesion be on a bone? (2)

Answer 14

• Osteochondrosis
• Subchondral bone cyst

Question 15

What may a bone radiolucent line be on radiograph? (2)

Answer 15

• Fracture
• Artefact

Question 16

What changes would you be able to see with soft tissue on radiographs? (3)

Answer 16

• Swelling
• Presence of air or foreign body - puncture wound
• Mineralisation - dystrophic calcification

Question 17

How many views must an abnormality be seen on equine radiograph?

Answer 17

2

Question 18

Why is it so important to evaluate areas with a high prevalence of certain disease with equine?

Answer 18

As the performance demands on animals mean that we may be looking for early and subtle changes

Question 19

What are the potential causes of radiographic changes? (5)

Answer 19

• Trauma
• Infection
• Degeneration
• Developmental
• Neoplasia

Question 20

What does DLPMO oblique highlight?

Answer 20

Dorsomedial and palmarolateral aspect

Question 21

What does the DMPLO oblique view highlight?

Answer 21

Dorsolateral and palmaromedial aspect

Question 22

What view is this?

Answer 22

Upright oblique view of the pedal bone

Question 23

Which palmar process if fractured?

Answer 23

Lateral palmar process

Question 24

What is this a radiograph of?

Answer 24

Hock

Question 25

What does a DLPMO view of the hock highlight?

Answer 25

The dorsomedial aspect and the plantarolateral aspect

Question 26

What is visible on the DLPMO view of the hock: A) Dorsally? (4) B) Plantar? (3)

Answer 26

A) Medial trochlear of talus, central tarsal bone, third tarsal bone and third metatarsal bone B) Calcaneus, 4th tarsal bone and 4th metatarsal bone

Question 27

What does the DMPLO view of the hock highlight?

Answer 27

The dorsolateral aspect and the plantaromedial aspect

Question 28

What is seen on the DMPLO view of the hock: A) Dorsally? (4) B) Plantar? (3)

Answer 28

A) Lateral trochlear of talus, central tarsal bone, third tarsal bone and third metatarsal bone ## Footnote B) Calcaneus, 2nd tarsal bone and 2nd metatarsal bone

Question 29

What view is this and what is wrong?

Answer 29

Upright navicular view Radiolucent line proximal to distal border -# Multiple, variable size and shape areas of sclerosis

Question 30

What view is this? what is wrong?

Answer 30

CdCr view Cystic lesion

Question 31

What is a mach line?

Answer 31

Bone overlying another line = artefact

Question 32

What should we be aware of when radiographing after a nerve block?

Answer 32

Gas pocket artefact

Question 33

Whats the matter here?

Answer 33

Large swelling on back of pastern

Question 34

Whats the matter here?

Answer 34

Irregular new bone on dorsal aspect = fracture

Question 35

What is the matter here?

Answer 35

Irregular new bone on dorsal aspect = infection

Question 36

What view is this?

Answer 36

Dorsoplantar view (as you can see splint bones)

Question 37

What view is this?

Answer 37

DLPlMO

Question 38

Which view is this?

Answer 38

DMPlLO (PlLDMO)

Question 39

A) Which view? B) Outline the 4 main joints C) Which joints communicate?

Answer 39

A) Latermedial B) * Tarsocrural joint * Distal intertarsal joint * Proximal intertarsal joint * Tarometarsal joint C) Distal intertarsal and tarsometatarsal communicate only in some horses

Question 40

What view is this of the carpus and why?

Answer 40

2 splint bones Dorsopalmar Accessory carpal bone is lateral

Question 41

DLPaMO view highlights the dorsomedial aspect and the palmarolateral aspect: A) What is seen dorsally? (3) B) What is seen on the palmar aspect? (4)

Answer 41

A) Radial carpal bone, 3rd carpal bone and 3rd metacarpal bone B) Accessory carpal bone, ulnar carpal bone, 4th carpal bone and 4th metacarpal bone

Question 42

PaLDMO (DMPaLO) view highlights the dorsolateral aspect and the palmaroromedial aspect: A) What is seen dorsally? (3) B) What is on the palmar aspect? (4)

Answer 42

A) Intermediate carpal bone, third carpal bone and third metacarpal bone B) Part of accessory carpal bone, radial carpal bone, 1st and 2nd carpal bones and 2nd metacarpal bone

Question 43

What view of the carpus is this?

Answer 43

* This view highlights the accessory carpal bone (ACB) * ACB is palmar and lateral * This is therefore a DLPaMO

Question 44

A) Outline the 3 main joints of the carpus B) Which joints communicate?

Answer 44

A) * Radiocarapl * Medial carpal * Carpo metacarpal B) Carpometacrarpal and middle carpal

Question 45

Describe and interpret this radiograph. Give the most likely differential diagnosis. History: Older horse Responded to abaxial nerve block and positive response Horse

Answer 45

Lateral medial image of the foot No artefact Soft tissue – see the capsule and pastern Long toe; low heel toe confirmation Lucent areas in hoof capsule – nails and have air artefact Joints – line distal P1 and distal P2 – bit of Proximal distal rotation. Had to interpret bone Bone – P2 has a smooth new bone on dorsal aspect of P2. The lip is normal Extensor process – new bone formation on P3. Radiolucency Palmar processes are heading down –they should never do this and should be 3-10 degrees the other way NB – kind of normal but heading into distal extension Distal sesamoid lig originates here – may be Smooth new bone on proximal aspect of the NB Cortex, subchrondral area etc normal Top D/Dx = OA/DJD of DIP Prognosis – not great

Question 46

Describe and interpret this radiograph. Give the most likely differential diagnosis. History: Horse was kicked

Answer 46

LF DLPaMO horse ## Footnote Highlights DM and PaL Soft tissue swelling Joints – normal Bones – Palmar lateral surface = 4th metacarpal bone Irregular new bone on proximal pal lat aspect. Radiolucency and increased opacity with it D/Dx – fracture of splint bone with bridging callus

Question 47

What is the difference between radiography and radiology?

Answer 47

Radiography – taking x-ray Radiology - interpreting