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Ortho Imaging 1
Orthopedics
| Question | Answer |
|---|---|
| Burst Jefferson fx Radiology: | C1 lat masses not line up vertly w/ C2 sup articular facets; distance btw dens & C1 lat masses is asymmetric |
| Hangmans Fx: alignment: | vert body of C2 is normally aligned w/ C1 & dens; post elements of C2 are normally aligned w/ C3 |
| Wrist Radiographs | AP, Lateral, Oblique |
| Wrist Radiographs: clenched fist: to see: | Scapholunate dissociation |
| Wrist Radiographs: Scaphoid | Ulnar deviation |
| Wrist Radiographs: Carpal Tunnel: may see: | Hamate, pisiform injuries |
| Wrist Radiographs: Comparison views to see | Growth plate injuries |
| Wrist Radiographs: Lateral View: | Check 2-20 degree palmar tilt of articular surface of radius; dorsal aspect of distal radius is smooth; capitate sits in lunate |
| Wrist Radiographs: PA View: | Check radius lies distal to ulna; radial border of Scaphoid is intact; No more than 2mm of intercarpal joint space; no abnormalities of radius or ulna cortex; |
| Wrist Radiographs (PA): Impact fx may only show: | increased density at radial metaphysis |
| Wrist Radiographs: beak, bulge or density at fused epiphyseal line is: | not a fracture; IS a physeal scar |
| CTS: Anatomy: | 10 structures pass through carpal tunnel (9 tendons, 1 (median) n.) |
| Scaphoid Fx: Imaging: | AP, Lat, oblique, scaphoid views; MRI; Bone scan 72 hrs post injury |
| Knee Films (views) | AP, Lateral; Merchant; Tunnel view (look for OCD) |
| Knee Films: AP/ Lateral: can show: | Tumors; Fx; DJD; Surgeries/ Hardware |
| Knee Films: Merchant view | Patella (Instability; DJD; Chondral lesions) |
| Knee DJD: Fairbanks Changes | Flattened tibial plateau; decreased joint space; osteophytes; subchondral cysts |
| MRI: excellent for: | soft tissue |
| MRI in ortho: for: | ACL ( >95%); Menisc (>85%); chondral lesion (cannot quantify size); MCL,LCL,PLC,PCL; Bone Contusions/ Edema; tumors; fx? |
| CT: excellent for: | fracture characterization |
| CT: not good for: | evaluating soft tissue injuries |
| Patellar Dislocation: Radiographs: | AP/Lat, Merchant view |
| ACL: dx tests (imaging) | MRI to R/O other injuries |
| HNP: Evaluation: | MRI / CT |
| HNP: MRI/CT: asymptomatic disc herniation found in what percentage? | 17-36% |
| Lumbar Spinal Stenosis: Xray: may show: | narrowing of the IVD, old burst fx; MRI demonstrates stenosis |
| Spondylolisthesis: xray shows: | Lateral film shows slip |
| Osteoarthritis: X-ray shows: | joint narrowing, sclerosis, osteophytes |
| Ankylosing Spondylitis: X-ray shows: | Erosion & sclerosis on plain films |
| LBP: Imaging: when | Plain films approp: trauma/ longstanding sx ; if conservative Rx fails |
| LBP: Imaging: Order: | AP / Lateral; Obliques; Flex & Ext |
| LBP: MRI study of choice for: | discopathy |
| LBP: Tc 99m bone scan for: | primary tumors, metastatic disease, or infection |
| Reading Spine Films: looking for: | Fx; Disc space changes; Arthritic changes; Listhesis; Tumors |
| Spine Film: Frontal View: each vert resembles: | an owls head, straight on; each eye = pedicle; beak = spinous process |
| Spine Films/ Frontal: Horizontal displacement may = | fx or dislocation |
| Spine Films/ Frontal: Decreased intervertebral space = | Fx, DDD, HNP |
| Spine Films/ Frontal: Vert body (owl head) for: | Missing eye (destrn); pedicle |
| Spine Films/ Frontal: Vert body: crack in owls eye: in = | Chance fx (seat belt fx) |
| Spine Films/ Frontal: Vert body: increased space btw owls eyes: in = | Burst fx |
| Shoulder imaging: Standard views: | AP and axillary |
| Imaging: Can get Y view if: | suspected dislocation or scapular fx (trauma) |
| Best imaging for RCT | CT arthrogram good, but MRI is better (invasive) |
| CT is good for: | bone abnormality; tumors |
| MRI for RCT: S&S | 95% sensitivity & specificity in detecting RCT |
| MRI good for: | RCT; SLAP lesions (Arthrogram); Soft tissue |
| Clavicle Imaging | AP, 45 degree cephalic tilt |
| Clavicle Fx: MOA | FOOSH, onto shoulder, direct trauma |
| Nexus criteria for spinal imaging | Image spine if: midline C-spine TTP; AMS +/- EtOH; neuro sx/sx; distracting painful injury |
Created by:
Abarnard
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