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35 Cards in this Set
- Front
- Back
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imaging options
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1. xrays
2. CT 3. MRI 4. nuclear studies 5. bone density scans 6. vascular studies 7. discogram 8. arthrogram 9. PET scans |
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plain x-ray pros
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1. readily available
2. non invasive 3. relative low cost 4. minimal risk 5. rapid 6. often diagnostic |
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xrays cons `
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1. poor soft tissue image
2. uniplanar 3. low radiation 4. chemicals 5. storage |
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xray basics
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-min 2 views AP and lat
-shielding -in trauma: must see joint above and below -assess technique and quality -when unsure..comparison views! |
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MRI pros
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1. excellent soft tissue
2. no radiation 3. safe 4. multiplanar 5. non invasive |
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MRI cons
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1. not always available
2. expensive 3. slow 4. pt must be still (prob for elderly/kids) 5. claustrophobia 6. poor image of articular cartilage, cortical bone, Ca+ deposits |
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MRI absolute C/I
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-poorly fixed metallics: vascular clips, FBs in eye
-electronic devices |
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MRI relative contraindications
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-early preg (1-2 trimester)
-middle ear prosthesis -penile prosthesis |
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CT pros
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1. available
2. fast 3. safe 4. excellent bone images** 5. 3D reconstructions |
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CT cons
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1. radiation
2. moderately expensive 3. poor soft tissue images |
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Pilon fracture
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-smashed into pieces
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Radionuclide bone scan
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-Administer radioactive labeled phosphonate( 99mTc) intravenously and measure uptake in soft tissue and bone.
-Phosphate uptakes normally in bone and concentrates in areas of increased bone activity. |
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bone scan pros
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1. very sensitive
2. relatively inexpensive 3. whole body scan or focus on one part (SPECT) |
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bone scan cons
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1. poorly specific
2. scheduled availability 3. invasive 4. false neg in elderly 5. tough with peds 6. false negative with myeloma!!! |
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Arthrogram
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-Inject radio opaque dye in joint to check for leaks(tears) and to outline structures for better visualization.
-Often used now in conjunction with CT or MRI |
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Fluoroscopy
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-"live" running xray
-useful in guidance of needles, tools, biopises, etc -Useful in retrieving metallic foreign bodies intraoperatively. |
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bone density scan
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-A method to assess bone mineral density
-Correlates with risk of fracture -Does not measure anything else!! |
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PET scan
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-radioactive sugar molecule
-absorbed sugar emits positron -detects biochemical activity prior to anatomical changes -cancer, brain, heart |
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Cervical spine views
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-standard: AP, lateral, open mouth
-additional views: obliques, swimmers, flexion/extension |
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shoulder views
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-standard: AP, Y view
-additional: axillary, transthoracic, int/ext rotation, others prn |
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Elbow views
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-standard: AP, Lat
-additional views: radial head, others |
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fat pad
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-fluid in elbow
-typically blood |
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wrist/hand views
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-standard: AP, lat
-additional: navicular |
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Colle's fracture
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-fx of distal radius
-silver fork deformity |
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Torus fx
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-swelling/bump
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lumbar spine views
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-standard: AP, lat
-additional: obliques, standing spot lateral, flexion/extension |
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spondylolysis
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-fx of spine
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spodylolithesis
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?
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pelvis views
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-AP
-obliques -inlet/outlet |
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hip views
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-AP
-lateral: cross table, frog |
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knee views
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-AP, lat
-skyline patella -notch virew -obliques -wt bearing |
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ankle views
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-AP
-lat -mortise -stress views |
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foot
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-AP, lat, obliquea
-axial heel |
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jones fx
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-fx in 5th metacarpal
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lisfranc fx
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-midfoot
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