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85 Cards in this Set
- Front
- Back
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A change in soft tissue size would indicate what three things?
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(1) atrophy
(2) FOCAL increase (3) DIFFUSE increase |
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What are two causes of soft tissue atropy?
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(1) Disuse
(2) Neurogenic |
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What are two causes of a focal increase in soft tissue?
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(2) Intra-capsular soft tissue swelling
(2) Extra-capsular soft tissue swelling |
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What are three causes of intra-capsular soft tissue swelling?
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(1) effusion
(2) Synovitis (3) Joint Associated Tumor |
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What are three causes of extra-capsular soft tissue swelling?
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(1) trauma
(2) neoplasia (3) cellulitis |
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What are four causes of diffuse soft tissue swelling?
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(1) trauma
(2) impaired lymphatics (3) vasculitis (4) cellulitis |
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Where is intracapsular ST swelling always centered over?
What about extracapsular ST swelling? |
-A joint
-NOT centered over a joint |
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What are the three main soft tissue opacity abnormalities?
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(1) gas
(2) mineral (3) bone |
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Gas is a soft tissue is called emphysema. What are the five causes of this?
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(1) puncture
(2) iatrogenic (3) gas producing organism (4) vacuum phenomena (5) tracheal/esophageal perforation |
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Fat inside of a soft tissue is most likely a lipoma. What two types of lipoma could it be?
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(1) infiltrative lipoma
(2) liposarcoma |
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There are three types of mineral soft tissue abnormalities. What are they?
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(1) intra-articular
(2) structured (3) unstructured |
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What are the four causes of INTRA-ARTICULAR mineral soft tissue abnormalities?
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(1) joint mouse
(2) avulsion fragment (3) synovial osteochondroma (3) chondrocalcinosis |
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What are the four causes of STRUCTURED mineral soft tissue abnormalities?
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(1) normal (sesamoid)
(2) fracture fragment (3) myositis ossificans (hematoma in a muscle that mineralizes) (4) neoplasia |
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What are the four causes of UNSTRUCTURED mineral soft tissue abnormalities?
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(1) dystrophic mineralization
(2) neoplasia (3) calcinosis cutis/circumscripta (mineralization of the skin) (4) metastatic mineralization (increased Ca/P ratio) |
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What percentage of bone is lost before a lesion is seen on radiographs?
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30-60%
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Is focal or generalize bone loss easier to see?
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focal - due to contrast with adjacent bone
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Bone loss is either characterized as one of two things. What are they?
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(1) osteopenia
(2) focal (osteolysis) |
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What are the three types of osteolysis in order of least aggressive to most agressive?
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(1) geographic
(2) moth eaten (3) permeative |
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What are the two categories of osteopenia?
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(1) generalized
(2) limb/distal extremity = disuse (osteoporosis) |
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What are the two types of generalized osteopenia?
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(1) osteoporosis
(2) osteomalacia |
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Which is more aggressive - cortical geographic lysis or expansion of the cortex?
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cortical
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Is it better for the patient if margins are distinct or indistinct in the case of geographic lysis?
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distinct
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What is permeative lysis?
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pinpoint areas of lysis which are indistinct and fade into normal bone; no apparent zone of transition
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What is the degree lysis characterized by?
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the most aggressive lesion
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What does the zone of transition tell you?
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- helps to assess the aggressiveness
-a wide zone of transition is more agressive |
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When looking at focal bone loss, what are local mediators?
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-up-regulation of osteoclasts
-down regulation (+/-) of osteoblasts |
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What will you evaluate when looking at focal bone loss?
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(1) type (geographic, moth-eaten, permeative)
(2) zone of transition (3) cortical destruction |
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When classify zones of transition, list them from the most to least aggressive.
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short, intermediate, long
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What does cortical destruction mean for the patient?
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agressive
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Agressiveness is characterized by the most aggressive lesion - what are the four factors you should consider?
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(1) osteolysis
(2) margins (3) osteogenesis (4) zone of transition |
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What is the length of time it will take to visualize periosteal reactions on a radiograph?
-bone lysis? |
-10-14 days
-3-5 days |
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What are the two major categories of osteogenesis?
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(1) generalized (osteopetrosis)
(2) focal |
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What are the two categories of focal osteogenesis?
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(1) Endosteal (sclerosis)
(2) Periosteal reactions (the MAJORITY |
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What are the three major categories of periosteal reactions and list them from least aggressive to most aggressive.
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(1) Solid
(2) lamellar (onion skin) (3) Interupted |
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What are the two patterns of solid periosteal reactions?
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(1) smooth
(2) irregular |
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What are the three patterns of interrupted periosteal reactions?
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(1) Spiculated
(2) sunburst (3) amorphous |
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What is more aggressive in a periosteal reaction - well defined margins or poorly defined margins?
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poorpy defined are active lesions
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What are three rule-outs for endosteal sclerosis?
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(1) panosteitis
(2) Infarct (3) Trauma (4) Neoplasia |
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What is the cause of a periosteal reaction?
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occurs by stimulation or elevation of the periosteum from the cortex (periosteum is attached to the cortex via sharpey's fibers)
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Periosteal reactions are characterized in terms of what?
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(1) aggressiveness: solid/interupted
(2) Activity: margins (3) duration: degree of mineralization |
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What does it mean when a periosteal reaction is more opaque?
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it is older
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What are four rule-outs for solid periosteal reactions?
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(1) trauma
(2) osteomyelitis (3) HOD (4) Neoplasia |
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What does a lamellated periosteal reaction mean?
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there is a cyclic or intermittent process
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Are long, thin spicules or short thick spicules more aggressive in a periosteal reaction?
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long, thin spicules
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What does a sunburst, spiculated periosteal reaction look like?
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spicules radiate from a central point and indicated a focal area where the tumor has broken out
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What is the most aggressive type of periosteal reactions?
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amorphous periosteal reaction - unorganized bone production
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What are two rule-outs for interrupted periosteal reactions?
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(1) neoplasia = primary bone tumor (osteosarcoma) OR metastatic (carcinoma)
(2) osteomyelitis = fungal or bacterial (direct inoculation) |
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What are rule-outs for mono-ostotic aggressive bone reactions?
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(1) neoplasia = metastatic (carcinoma, osteosarcoma, multiple myeloma)
(2) osteomyelitis = fungal (disseminated) OR bacterial (baceremia) |
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What are the three rule-outs for an aggressive joint lesion?
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(1) joint associated tumor (synovial cell sarcoma or histiocytic sarcoma)
(2) septic artritis (bacterial or fungal) (3) erosive polyarthritis (rheumatoid arthritis) |
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Why is the spinal cord not visible on survey radiographs?
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-low density
-surrounded by bone |
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What three general views are used when looking at the spinal column?
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(1) lateral
(2) VD - preferred (3) Oblique (45 and 20 degrees) |
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What happens when you don't get the spine parallel to the table?
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-you get artefactual narrowing of disk space and a more en-face projection of vertebral end plates
-esp. important in C spine |
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How do you differentiate between a true and oblique lateral?
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-comparing superimposition of right and left dorsal rib curvatures, transverse processes, articular processes and/or intervertebra foramina
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Why is a VD preferred?
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-better alignment
-better image detail (decreased SFD) |
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How do you tell a true VD?
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-assess whether spinous processes are projected end-on end and whether the sternum and spine are superimposed
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Why is a VD not great for assessing disk space?
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b/c of the normal curvature of the spine - BUT it can be done by angling the X-ray beam slightly from caudal to cranial
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What does a ventral-45-lateral oblique do for you?
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-can see inter vertebral foramina C2-3 thru C7-T1 without superimposition of articular processes
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Obliquity of 20 degrees from lateral allows you to see what?
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the dens
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What is the vertebral formula in the dog?
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C:7
T:13 L:7 S:3 Cdx |
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What tissue density is the inter vertebral disk space inter vertebral foramina?
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soft tissue
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Which intervertebral C disk spaces are usually a little narrower?
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C2-3 and
C 7 - T1 Especially |
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Where is the anitclinal space?
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T10-T11
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Which intervertebral T disk spaces are usually a little narrower?
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T10-T11 is the narrowest
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Which is the shortest lumbar vertebrae?
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L6 is shorter than L7 and spinous process of L7 is relatively short
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What is important to note when evaluating the spine?
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-note numbers (any asymmetry or abnormal structures
-alignment of vertebral bodies and vertebral canal -vertebral canal, disk space and foramina for changes in size, shape and opacity (compare with cranial and caudal) -end plates for morphology and opacity |
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What is myelography?
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spinal radiography following the introduction of CM into the spinal subarachnoid space; used to eval contour of spinal cord
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What is thinner, the ventral or dorsal column of the spinal cord?
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ventral and esp pronounced with flexion - and slight thinning between disk spaces of the ventral column
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Is myelography a useful technique for lesions past L6?
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NO b.c ventral and lateral columns converge as one
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What are the three abnormal patterns of myelography interpretation?
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(1) Extradural - narrowing
(2) Intramedulary - focal enlargement (3) Intradural-Extramedullarry |
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Give examples of an extradural lesion.
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(1) herneated disk
(2) hyperplastic ligaments (3) vertebral neoplasia (4) hematoma |
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Give an example of a intramedullary lesion.
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(1) Cord neoplasia
(2) Cord edema |
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What is an epidurography?
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Spinal radiography following introduction of contrast media into the spinal epidural space; used to evaluated compressive lesions withing the vertebral canal from L6 caudally since the subarachnoid space moves away from the lateral and ventral margins of the vertebral canal
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What is percutaneous puncture used for?
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needle is placed into a disk space or vertebral body - primarily for aspiration of material (sometime biopsy)
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T or F. Lateral vertebral foramen are incomplete in the young horse (C2).
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True
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T or F. A milk, stair-step may be present between adjacent vertebra in the horse with flexion.
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True
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Why are minimum values important in the horse?
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-may help indicate spinal cord compression due to narrowing of vertebral canal
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What is MSD?
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Minimum Sagital Diameter = narrowest dimension between dorsal and ventral margins of vertebral foramen within each vertebral canal
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What is MFD?
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Minimum Flexion Diameter =
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Why are ratio used more now to measure values?
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-direct measurements do not account for geometric magnification or take into account variations in patient size
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What is the ratio of most importance when dealing with horses?
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Sagittal Diameter Ratio:
-intravertebral= (min. sagittal diameter of vertebral canal/max height of vertebral body) -intervertebral=(min height between 2 vertebra/max height of vertebral body) |
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What are 5 artifacts of myelography?
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(1) epidural contrast medium
(2) L Venous Sinuses (3) Central Canal (4) Air Bubbles (5) Incomplete Filling |
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What are common positions to radiograph the brain and skull?
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(1) Lateral
(2) VD/DV (3) Lateral Oblique - 20 degrees (4) Rostro Caudal (Open Mouth) (5) Fronto-Occipital - nose is 20 degrees from vertical beam (6) Foramen Magnum: same as above, BUT nose is 30-45 degress from vertical beam |
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What is important about the lateral oblique view?
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-projects the dependant tympanic bulla
-must take the other side for comparison |
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Which view can you see the tympanic bulla side by side and the dens of C2?
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ropen mouth rostro-caudal
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Which imaging modalities provide the most diagnostic information about a potential brain mass?
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(1) CT
(2) MRI (replacing CT for brain imaging) |
