SM_226a: MSK Imaging Flashcards

1
Q

_____ is initial test of choice to assess the MSK system

A

Radiography is the initial test of choice to assess the MSK system

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2
Q

Advantages of radiography are that it is _____, _____, and _____

A

Advantages of radiography are that it is inexpensive, reproducible, and has minimal radiation

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3
Q

Limitations of radiography are _____, _____, and _____

A

Limitations of radiography are occult fractures, limited evaluation of soft tissues, and the need to get at least 2 views

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4
Q

Radiography is used for evaluation of _____, _____, and _____

A

Radiography is used for evaluation of trauma, infection, and arthritis

(can indicate mechanism of injury and suggest underlying soft tissue injury)

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5
Q

Radiography can suggest _____

A

Radiography can suggest underlying soft tissue injury

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6
Q

CT is excellent for answering a specific question, such as _____, _____, and _____

A

CT is excellent for answering a specific question, such as preoperative planning, fracture detail, and occult fracture

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7
Q

Advantages of CT are _____, _____, _____, and _____

A

Advantages of CT are superior spatial resolution, ability to obtain multi-planar reformatted images, wide availability, and rapid exam time

(better resolution for bone than soft tissue)

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8
Q

Limitations of CT are _____, _____, and _____

A

Limitations of CT are moderately expensive, ionizing radiation, and artifact with metal

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9
Q

MRI is superior for evaluation of _____, _____, and _____

A

MRI is superior for evaluation of joints, soft tissue, and cartilage

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10
Q

Advantages of MRI are _____, _____, and _____

A

Advantages of MRI are superior contrast resolution, no radiation, and multi-planar imaging

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11
Q

Limitations of MRI are _____, _____, _____, and _____

A

Limitations of MRI are expensive, not patient friendly, longer scan times, and contraindications

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12
Q

Absolute contraindications to MRI are _____, _____, _____, and _____

A

Absolute contraindications to MRI are pacemakers, stimulators, metal in the orbit, and weight limit

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13
Q

Relative contraindications to MRI are _____ and _____

A

Relative contraindications to MRI are aneurysm clips and metal

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14
Q

Ultrasound is excellent for viewing _____, such as _____, _____, and _____

A

Ultrasound is excellent for viewing superficial soft tissues, such as tendons, ligaments, and nerves

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15
Q

Advantages of ultrasound are _____, _____, and _____

A

Advantages of ultrasound are patient friendly, dynamic imaging, and inexpensive

(no radiation, no contrast)

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16
Q

Limitations of ultrasound are _____ and _____

A

Limitations of ultrasound are user dependent and limited evaluation of bone

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17
Q

Dual X-ray absorptiometry is used to measure _____ and detect _____

A

Dual X-ray absorptiometry is used to measure bone density and detect osteoporosis and fracture risk

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18
Q

Dual X-ray absorptiometry is used to image the _____ and _____

A

Dual X-ray absorptiometry is used to image the lumbar spine and proximal femur

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19
Q

Advantages of dual X-ray absorptiometry are _____, _____, and _____

A

Advantages of dual X-eray absorptiometry are short exam time, widely available, and inexpensive

20
Q

Limitations of dual X-ray absorptiometry are _____ and _____

A

Limitations of dual X-ray absorptiometry are overlying calcifications and compression fractures

21
Q

T-score of a DXA study is the difference between _____ and _____

A

T-score of a DXA study is the difference between the bone mineral density of patient and standard young adult population

22
Q

Describe the scroing of a DXA study

A

DXA study

T-score: difference between the bone mineral density of patient and standard young adult population

  • < 1 SD: normal
  • 1-2.4 SD: osteopenia
  • >2.5 SD: osteoporosis
  • >2.5 + ≥1 low-trauma fractures: severe osteoporosis
23
Q

Bone scintigraphy is _____ but not _____

A

Bone scinitigraphy is sensitive but not specific

(normal is usually normal, further imaging to determine the specific pathology)

24
Q

Bone scintigraphy provides _____

A

Bone scintigraphy provides physiologic information

25
Limitations of bone scintigraphy are _____ and \_\_\_\_\_
Limitations of bone scintigraphy are radiation and time intensive (4-6 hours/study)
26
Fluoroscopy is most commonly used \_\_\_\_\_
Fluoroscopy is most commonly used for/during procedures
27
Advantage of fluoroscopy is \_\_\_\_\_
Advantage of fluoroscopy is dynamic imaging
28
Limitation of fluoroscopy is \_\_\_\_\_
Limitation of fluoroscopy is radiation to patient and operator
29
Describe image guided procedures
Image guided procedures * Biopsy: bone or soft tissue * Arthrography: evaluation of joints and supporting structures * Myelogram: dynamic imaging, evaluation of bone * Therapy: corticosteroid injections, calcific tendinitis lavage, vertebroplasty, thermal ablation
30
Image guided biopsy is a safer alternative to \_\_\_\_\_
Image guided biopsy is a safer alternative to surgical/open biopsy (outpatient procedure)
31
Image guided biopsy is used for \_\_\_\_\_, \_\_\_\_\_, and \_\_\_\_\_
Image guided biopsy is used for lesion of unknown etiology, confirming diagnosis, and staging of disease
32
Arthrography is used to introduce _____ into a joint
Arthrography is used to introduce contrast into a joint (iodinated contrast, gadolinium based contrast)
33
Arthrography allows excellent evaluation of \_\_\_\_\_
Arthrography allows excellent evaluation of joints (labrum, cartilage, rotator cuff tendons, intrinsic ligaments)
34
Contraindications to arthrography are _____ and \_\_\_\_\_
Contraindications to arthrography are contrast allergy and contraindications to MRI
35
Myelogram is used to introduce _____ into the _____ and is visible with fluoroscopy and CT
Myelogram is used to introduce contrast into the thecal sac and is visible with fluoroscopy and CT
36
Advantages of myelogram are \_\_\_\_\_, \_\_\_\_\_, and \_\_\_\_\_
Advantages of myelogram are use if MRI is contraindicated, evaluation of bone, and dynamic imaging
37
Limitations of myelogram are \_\_\_\_\_, \_\_\_\_\_, \_\_\_\_\_, and \_\_\_\_\_
Limitations of myelogram are contrast allergy, ionizing radiation, invasive, and inferior to MRI for soft tissue evaluation
38
Image guided therapy includes \_\_\_\_\_, \_\_\_\_\_, \_\_\_\_\_, and \_\_\_\_\_
Image guided therapy includes corticosteroid injections, calcific tendinitis lavage, vertebroplasty, and thermal ablation
39
Chronic back pain in an adult is imaged with _____ and \_\_\_\_\_, while chronic back pain in a child is imaged with _____ and \_\_\_\_\_
Chronic back pain in an adult is imaged with radiographs and MRI, while chronic back pain in a child is imaged with radiographs and nuclear medicine exam
40
Acute back pain is imaged with \_\_\_\_\_, \_\_\_\_\_, and \_\_\_\_\_
Acute back pain is imaged with radiograph, CT if trauma, and MRI
41
Neck pain is imaged with \_\_\_\_\_
Neck pain is imaged with radiograph (if normal but significant pain/symptoms consider MRI)
42
Joint pain is imaged with _____ or \_\_\_\_\_
Joint pain is imaged with radiographs or MRI if soft tissue injury (soft tissue: ligament, cartilage, tendon, muscle)
43
Neoplasm is imaged with \_\_\_\_\_, \_\_\_\_\_, \_\_\_\_\_, or \_\_\_\_\_
Neoplasm is imaged with radiograph, MRI with contrast, CT, or nuclear medicine study * MRI with contrast: if osseous image joint to joint to evaluate for skip lesions * Nuclear medicine study: osseous metastasis
44
Occult fracture is imaged with \_\_\_\_\_
Occult fracture is imaged with radiographs (if X-ray normal then use CT, MRI, or nuclear medicine study)
45
Osteomyelitis is imaged with \_\_\_\_\_, \_\_\_\_\_, and _____ in a diabetic patient, while osteomyelitis is imaged with _____ and _____ in a non-diabetic patient
Osteomyelitis is imaged with radiograph, MRI, and nuclear medicine study in a diabetic patient, while osteomyelitis is imaged with radiograph and MRI with contrast in a non-diabetic patient