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Differential Diagnosis & Med Screening > STAATS- US Imaging in the PT Practice > Flashcards

STAATS- US Imaging in the PT Practice Flashcards

(51 cards)

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1
Q

Ultrasound Imagining aka

A

Ultrasonography, Medical Ultrasound, Diagnostic Ultrasound imagining, Real Time Ultrasound Imagining (RUSI), Rehabilitative Ultrasound Imaging (RUSI)

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2
Q

Use of sound waves to generate an image done thru echo interpretation

A

US imaging

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3
Q

US Imagining

what is it?

A

Use of sound waves to gen. image done thru echo interpretation

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4
Q

US imagining predominantly used to what?

A
  1. R/O blood clots (doppler)
  2. ID organs
  3. Sonograms to monitor fetal dev.
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5
Q

Sonar/Echolocation

A

Dolphins, bats, submarines

  • To detect objs in distance
  • Returning echoes give fb on size, structure and distance
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6
Q

How US works

A

Time elapsed bw sound waves sent and echo returned AND the freq of waves returning to the sound head is interpreted and a grey scale img produced

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7
Q

US Image ex.

A

NOTE: patella, patellar tendon, tibia

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8
Q

US Terminology:

ALL First

A
  • HypERechoic/echogenic=> LOTS of echoes, BRIGHT
    • Ex’s: MOST bright: bone, calcific deposits, fascia, tendon, lig: LEAST bright
  • HypOechoic= LOW echogenicity, fewer echoes, DARK
    • Ex’s: Muscle, fat, cartilage, organs, nerve (honey comb, starry night, little bright specks)
  • Anechoic (think TEARS)= means devoid of echoes, BLACK
    • Ex. Fluid/gas
  • Isoechoic= used when two structures look similar due to similar echoes
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9
Q

Objects INFERIOR to BRIGHT hypERechoic objs will appear

A

DARK or ANechoic

makes assess. of these structures diff. ***

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10
Q

US Terminology

HypERechoic/echogenic==>

A

BRIGHT

  • LOTS of echoes
  • Exs from MOST bright to LEAST bright:
    • bone, calcific deposits, fascia, tendon, ligament
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11
Q

US Terminology

HypOechoic==

A

DARK

  • LOW echogenicity, fewer echoes
  • EX’s:
    • Muscle, fat, cartilage, organs, Nerve (honeycomb/starry night/little white specks)
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12
Q

US Terminology

Anechoic==

A

THINK “TEARS”

BLACK

  • Devoid of echoes
  • Ex: Fluid/Gas
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13
Q

US physics

ALL FIRST

A
  • HIGHER Freq==> CLEARER, but only Superficial***
  • LOWER Freq==> LESS clear, penetrates Deeper***
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14
Q

US Physics

HIGHER FREQ==>

A

CLEARER PIC but penetrate superficially

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15
Q

US Physics

LOWER FREQ==>

A

LESS clear pic, but penetrates Deeper*

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16
Q

Types of Probes for MSK purposes

A
  1. Linear
  2. Curvilinear

*NOTE: SMALLER footprint== higher freq==more superf penetration==clearer pic

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17
Q

Probes

SMALLER footprint== higher freq==more superf penetration==clearer pic

A

Linear

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18
Q

Probes

Curvilinear

A

LOWER freq, wider, curved footprint

Penetrate deeper==LESS clear img

*piriformis, TrA, Multifidi

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19
Q

MSK RUSI in PT Practice

USES:

A

See List

Be familiar!!!

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20
Q

RUSI for Shoulder Exam

A
  • Structures ID’d:
    • LHB→ SAX (Short axis horizontal) and LAX (Long axis vertical) (in relation to body)
    • Suprasp, Subscap, SubAC bursa, Infrasp, Articular cart. below SSP
    • AHI→ Acromio-Humeral Interval
    • Labrum→ diff to img
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21
Q

SAX view ex

Study These Flashcards
A

Short-Axis, Horizontal

see pics

22
Q

US Imaginng:

RTC Tear Validity

23
Q

Left Oblique SAX

RTC Bird Beak

24
Q

RTC Tear Ex.

25
Tear Ex.
see pics
26
Large Calcific Deposit ex.
see pics
27
Ex. **Measuring calcific deposit**
see pics
28
Measuring AHI and **note sound head angle\*\*\***
see pics
29
R. Bicep **LAX view for LHB tendon**
see pics
30
R. Bicep **Calcific deposit in LAX view (LONG-AXIS, VERTICAL)**
see pics
31
Ulna view
see pics
32
Fx of Ulna
see pics **(same view to view Ulna as previously seen) \*\*\***
33
LAX view medial aspect of knee ## Footnote **MCL Tear**
see pics
34
LAX View medial aspect of knee ## Footnote **Medial meniscus**
see pics
35
Displaced meniscus ## Footnote **NOTE: Femur, tibia and how displaced Medial Meniscus displays along MCL**
see pics
36
Posterior aspect of knee (**SAX, HORIZONTAL)** ## Footnote **NOTE: Baker's Cyst,**
see pics
37
Left Long Bakers ## Footnote **Most likely from Posterior aspect of knee (SAX, Horizontal)**
see pics
38
Anterior aspect of distal wrist (**SAX, HORIZ)** ## Footnote **Looking into Carpal Tunnel** **NOTE: Median N.**
see pics
39
More on Median N. @ Carpal Tunnel w/ **SAX, HORIZ.** ## Footnote **Measured out here**
see pics
40
\>\_\_\_\_\_\_\_\_\_\_\_ CSA (Cross-sectional Area) @ wrist crease indicates\_\_\_\_\_\_\_\_\_
\>10mm CSA indicates **CTS**
41
**WFR (Wrist:Forearm Ratio) to Dx CTS** Median N. progression pics to check for **CTS** **NOTE: FDP, FDS**
* **\>1.4 Wrist measurement to Forearm measurement is _indicative of CTS_\*** * **NOTE IN PICTURES:** * Distal R. wrist crease measurement**==\> 18mm2** * R. Median N. **4in. PROX==\> 6mm2** * **THEREFORE→** 18mm2/6mm2==\> 3! * **So…YES CTS!!!**
42
Posterior aspect of Gastroc (**LAX, VERT.)** ## Footnote **Gastroc tear**
see pics
43
Post-Gastroc tear ## Footnote **2wks later** **~4wks later**
see pics
44
Lateral aspect of R. ankle (**SAX, Horizontal)** ## Footnote **NOTE: ATFL ligament the _partial tear_**
see pics
45
Achilles Tendon view (**LAX, Vertical) L think L**ongways think VERTICAL\*\*\*
**NOTE:** Partial Tear vs. Tendinosis\*
46
Lateral portion of abdomen (**SAX, HORIZ) SAX think "short view, hOrizontal rhymes w/ shOrt\*\*\***
**NOTE: TrA and then “shortened” TrA and see it _visibly shortens_!!!!**
47
**Dry needling** can be done **under RUSI\*\*\***
see pics
48
**Beneftis** of **RUSI**
* Painless, **NO iodizing radiation\*,** LESS expensive, Accessible, \***Efficient (included in PT exam),** Improved quality of care
49
**Limitations** of **RUSI**
* Cannot see **deep structures** well or those **deep to hypERechoic structures** * **\*Operator dependent**
50
**Reimbursement** for **RUSI** ## Footnote **In general…**
* Ongoing battle in state of NJ * **Aetna and Meritian** reimburse RUSI done **by a PT**
51
Some states (Mass, NY, Oklahoma, Washington)→ **RUSI by a PT is reimbursed** ## Footnote **How?**
* Have to **_educate_ third party payers** * AIUM and APCA physician alignment should help * PT's have **directed 6 webinars on RMSK on the AIUM website** * May 2016 Hazle, Kirsch, White and Keil **clearly states APTA support of imagining privileges\*\*\***

Differential Diagnosis & Med Screening (12 decks)

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