How do bone scans work
- IV fluid injected into patient
- Injection selectively concentrated to areas that have increased osteoblastic activity
what is a major downfall of bone scans
Very sensitive but not specific between diffferent ailments
What are some normal hot areas on bone scans
- Ac joints
- sternoclavicular joint
- scap tips
- sternum
- costochondral junctions
- lower neck
- scaroiliac j
- Bladder
- Injection site
Advantsges of muskuloskelatal diagnostic ultrasound
- rapid
- non ionizing
- availible and cheap
- long structures can be viewed
disadvantages of muskuloskelatal diagnostic ultrasound
- deep structurees hard to see
- difficult to penetrate bone
conditions that can be found with muskuloskeletal diagnostic ultrasound
- Tendon tears
- Muscle tears
- Lig sprains/ tears
- Inflammation
- Nerve entrapment
- Joint changes
Advatages of Ct
- Fast
- Detailed bone
disadvantages of Ct
- ionizing radiation
- not good for soft tissue
- need contrast
Indications for a CT
- Spine trauma
- Osseous spinal stenosis
- Good for herniations
What is the hounsfield units for soft tissue and bone
closer to 0= soft tissue
closer to 1000= bone
what can you see at the lvl of the IVF in a CT
- disk
- vert body
- facets
- lig flavum
what can you see at the lvl of the pedicle in a CT
- pars interarticularis
- TVP
Adv of an MRI
- no ionizing rad
- images in any plane
- images larger section of body
- no contrast needed
T1- what is high signal + what can you see
- high signal is fat
- good for sub cut. fat and yellow marrow
T2- what is high signal + what can you see well
- high signal is water
- can really see CSF and normal disks, good for tumors, inflamation, infection
what cant MRIs
- cardiac pacemakers
- dorsal column stims
- prostetic heart valves
- any metal devices
Indications for MRI
- spinal cord absess
- lumbosacral rediculopothy
- spine inf
- stenosis
- tumors
- mylelopothy
- MS
What is the major pitfall of MR
high false positive rate
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Lumbar Spine- Normal19
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Thoracic Spine- Normal7
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cervical spine- normal25
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Pedriatric Patient- Normal10
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Congenital Anomolies- Lumbar/Thoracic14
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Congenital Anomalies- Cervical13
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Pelvis/Sacrum/Hips- Normal9
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Knee/Ankle/Foot- Normal9
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Normal Variants + Anomalies of the Extremities16
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Scoliosis9
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Spondyloytic Spondylolisthesis9
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Advanced Imaging18
