Radiology Review

Question 1

What are the different image modalities?

Answer 1

X-ray
CT
MRI
US
Nuc Med

Question 2

Which modality uses a single pulse of ionizing radiation?

Answer 2

X-ray

Question 3

X-ray is good for? bad for?

Answer 3

Good-Bones and airspaces

Bad-Soft tissue and overlapping structures

Question 4

X-ray film starts what color?

Answer 4

White

Question 5

After being hit with ionizing radiation, x-ray turns what?

Answer 5

dark

Question 6

What are the five basic radiographic densities?

Answer 6

Air (darkest)
Fat (less dark)
Fluid/blood/soft tissue (gray)
Bone (white)
Metal/contrast (most white)

Question 7

Because x-rays are two dimensional views of a three dimensional object it is important to get what?

Answer 7

multiple views

Question 8

What are the x-ray views?

Answer 8

Anteroposterior (AP)
Lateral (LAT)
Oblique (OBL)
Posteroanterior (PA)

Question 9

Anteroposterior is for what?

Answer 9

Used for patients unable to stand or sit

Question 10

Is the PA or AP view higher quality?

Answer 10

PA

Question 11

Which view magnifies the heart and makes borders fuzzy when doing a chest x-ray?

Answer 11

AP

Question 12

Which x-ray view is usually taken in conjunction with PA view and gives three dimension to objects?

Answer 12

Lateral

Question 13

Oblique is at an angle and mostly used on what body parts?

Answer 13

limbs

Question 14

Which modality uses multiple pulses of ionizing radiation?

Answer 14

CT

Question 15

CT is good for? bad for?

Answer 15

Good- Bone, airspace, some soft tissue and overlapping structures
Bad-Some soft tissues, nerves, muscles, connective tissues

Question 16

What are the CT Views?

Answer 16

Sagittal or median
coronal
axial or transverse or cross-sectional

Question 17

MRI uses what to image?

Answer 17

electromagnetism and radio frequency

Question 18

MRI is good for? bad for?

Answer 18

Good- Soft tissue(nerves, muscles, connective tissue, brain and joints)
Bad-People who cannot hold still or have ferrous metals in the body

Question 19

what are the views of MRI?

Answer 19

same as CT

Question 20

What modality uses sound waves and does not use radiation?

Answer 20

US

Question 21

US is good for? bad for?

Answer 21

Good-determine fluid vs solid, abdominopelvic, blood flow (doppler)
Bad-Things under bones and air filled chambers, deep objects

Question 22

What are the US views?

Answer 22

Longitudinal (sagittal)

Transverse (axial)

Question 23

Which modality is used with a radioactive agent and participates in the physiologic processes?

Answer 23

Nuclear Medicine

Question 24

Nuc med is good for? bad for?

Answer 24

Good-Detecting normal or abnormal physiologic process

Bad-Showing less anatomic detail

Question 25

What is the pre-read criteria for a film?

Answer 25

``` Correct patient correct date correct body part correct type number of views expected do comparison films exist ```

Question 26

What is the RIP technique for?

Answer 26

Assessing technical adequacy

Question 27

What is the RIP criteria?

Answer 27

Rotation Inspiration Penetration

Question 28

What is looked for under rotation in the RIP technique?

Answer 28

Clavicles relative to vertebral column and equally spaced

Question 29

What is examined on inspiration of the RIP technique?

Answer 29

Rib count is 9-10

Question 30

What is looked for in penetration using the RIP technique?

Answer 30

See ribs through heart barely see spine through heart see pulmonary vessels near the edges of the lungs

Question 31

What is happening if a film shows lung fields almost completely black or a lung field (one or both) shows black with changes in pulmonary vessels?

Answer 31

Over-penetrated film *over-penetration of one side could suggest pneumothorax

Question 32

When soft tissue structures are obscured or image appears bright what happened?

Answer 32

under-penetration

Question 33

In a lung fields with some brighter areas (unilateral or bilat) and no evidence of under penetration, indicating consolidation. You could suspect what diagnosis?

Answer 33

pneumonia

Question 34

What are the broad steps to reading a chest x-ray?

Answer 34

Pre-read RIP technique ABCDE method

Question 34

What are the broad steps to reading a chest x-ray?

Answer 34

Pre-read RIP technique ABCDE method

Question 35

What is the systematic method (ABCDE) to reading a chest film?

Answer 35

``` A-airway/airspaces B-bones/soft tissue C-Cardiac shadow D-Diaphragm E-Everything else ```

Question 36

What are you looking for in the A of ABCDE? (detail)

Answer 36

Trachea midline and patent Blood vessels all the way to edges are there patches of white?

Question 37

What are you looking for in B of ABCDE? (details)

Answer 37

Clavicle, ribs, pectoral girdle and spine alignment, symmetry and fractures

Question 38

What are you looking for in C of ABCDE? (details)

Answer 38

Transverse diameter of the silhouette should not exceed 50% of the transverse diameter of the thoracic cage (PA only) Cardiac borders

Question 38

What are you looking for in C of ABCDE? (details)

Answer 38

Transverse diameter of the silhouette should not exceed 50% of the transverse diameter of the thoracic cage (PA only) Cardiac borders

Question 39

What are you looking for in D of ABCDE? (details)

Answer 39

``` Diaphragm should be dome shaped right hemidiaphragm is higher or same level as left costophrenic angles (sulcus) - dark and sharp points ```

Question 40

What does E for ABCDE include? (details)

Answer 40

Gastric bubble | Check for EKG leads, equipment

Question 41

Imaging should be ordered to do what?

Answer 41

confirm a suspicion or diagnosis

Question 42

Examples of common issues in primary care that receive imaging are?

Answer 42

``` acute foot pain acute ankle pain acute knee pain low back pain HA ```

Question 43

Acute ankle pain ottawa rules are?

Answer 43

Pain in malleolar zone Tenderness to posterior edge (6cm) of lateral/medial malleolus Inability to bear weight both immediately and four steps at evaluation

Question 44

Acute foot pain ottawa rules are?

Answer 44

Pain in midfoot Bone tenderness at the base of the 5th metatarsal or navicular Inability to bear weight immediately or for four steps in evaluation

Question 45

What are the steps if suspicion of stress fracture?

Answer 45

X-ray Bone scan CT or MRI

Question 46

Acute knee pain ottawa rules are?

Answer 46

``` Age >55 tenderness of patella tenderness of head of fibula unable to flex knee 90 degrees Inability to bear weight immediately or for four steps in the evaluation ```

Question 47

If you suspect a ligamentous injury, what type of imaging should be used?

Answer 47

MRI

Question 48

If plain radiographs are negative what should you consider if you still suspect fracture?

Answer 48

CT

Question 49

What is the criteria to get imaging of shoulder?

Answer 49

Traumatic cause presence of pain loss of ROM

Question 50

Plain films of the shoulder should be able to identify what?

Answer 50

Fracture Dislocation Arthritis AC or SC joint injuries

Question 51

Tuft fractures refer to fractures involving what?

Answer 51

head of distal phalanx

Question 52

What is a complex synovial joint formed by the articulations of the humerus, the radius and the ulna?

Answer 52

The elbow

Question 53

What are the three articulations of the elbow?

Answer 53

radiohumeral -capitellum of the humeus with the radial head ulnohumeral -trochlea of the humerus with the trochlear notch of the ulna radioulnar -radial head with the radial notch of the ulna

Question 54

The presence of a joint effusion in adults on a elbow film should be treated as?

Answer 54

non-displaced radial head fracture

Question 55

What is the term for an elevated fat pad due to fluid in the joint capsule raising the pad?

Answer 55

sail sign

Question 56

Dislocations of the elbow are named how?

Answer 56

the direction the radius and ulna are in relation to the humerus

Question 57

The UCL and lateral epicondylitis would be best assessed using what imaging modality?

Answer 57

MRI

Question 58

Imaging of the back is generally not indicated for how long?

Answer 58

4-6 weeks

Question 59

Imaging of the back is indicated if a patient presents with what?

Answer 59

``` Neuro findings/cauda equina Constitutional findings traumatic cause current/history of malignancy Elderly (>50yo) Infectious risk chronic steroid use nerve root irritation post conservative management risk of osteoporosis ```

Question 60

Imaging of the head should be considered if a patient presents with?

Answer 60

``` head/neck trauma headache(new, worse, abrupt onset) Focal neuro sxs thunderclap HA radiating to neck positional HA temporal HA > 55 yo suspect infection ```

Question 61

What is the preferred imaging for trauma to rule out hemorrhage, bone abnormalities or prior lumbar puntcures?

Answer 61

CT

Question 62

What is preferred imaging for soft tissues such as tumors or vascular?

Answer 62

MRI

Question 63

What are the common fractures?

Answer 63

``` Oblique Transverse Spiral Overriding Distraction Torus Greenstick Comminuted ```

Question 64

what fractures has an angulated fracture line?

Answer 64

oblique

Question 65

what fracture runs perpendicular to the shaft of the bone?

Answer 65

transverse

Question 66

what fracture has a multiplanar and complex fracture line?

Answer 66

spiral

Question 67

what fracture has one bone displaced over another?

Answer 67

overriding

Question 68

what fracture has fragments separated by a gap?

Answer 68

distraction

Question 69

what fracture looks like a bump and is classified as an incomplete fracture in children?

Answer 69

torus

Question 70

what fracture is bending and is an incomplete fracture seen in children?

Answer 70

greenstick

Question 71

What fractures have more than two fracture fragments?

Answer 71

comminuted