Imaging

Question 1

What are the advantages of conventional radiography for imaging of MSK?

Answer 1

• widely available
• reproducible
• inexpensive
• minimal ionizing radiation

Question 2

What are the disadvantages of conventional radiography for imaging of MSK?

Answer 2

• fractures may be occult if not displaced
• importance of more than 1 view
• complex bones and superimposed structures
• soft tissues are poorly evaluated with x-ray

Question 3

What is conventional radiography most useful for in MSK?

Answer 3

Evaluation of bones mostly, not as good at imaging soft tissues

Question 4

What are the main uses of CT in MSK?

Answer 4

More detailed evaluation of fractures, preoperative planning, assessment of healing

Question 5

What are the main advantages of CT for MSK?

Answer 5

• widely available, quick imaging
• good spatial resolution
• with or without contrast
• can reformat images
• alternative for MRIs if they are contraindicated

Question 6

What are the main limitations of CT for MSK?

Answer 6

• ionizing radiation
• cost
• soft tissue evaluation is inferior to MRI
• metal causes artifact

Question 7

What are the main uses of MRI in MSK?

Answer 7

Best at evaluation of joints and soft tissues

Question 8

What are the main advantages of MRI for MSK?

Answer 8

• high contrast resolution
• can see changes earlier than x-ray
• no radiation
• widely available
• many techniques

Question 9

What are the main disadvantages of MRI for MSK?

Answer 9

• expensive
• not patient friendly
• variable quality
• metal causes artifacts
• many contraindications

Question 10

What are the main uses of fluoroscopy in MSK?

Answer 10

Used in procedures or for dynamic imaging

Question 11

What are the main advantages of fluoroscopy for MSK?

Answer 11

• widely available

- dynamic imaging

Question 12

What are the main disadvantages of fluoroscopy for MSK?

Answer 12

• ionizing radiation to patient and operator

Question 13

What are the main uses of ultrasound for MSK?

Answer 13

Good for superficial soft tissue structures (tendons, muscles), some ability to evaluate bone surfaces

Question 14

What are the main advantages of ultrasound for MSK?

Answer 14

• patient friendly
• reproducible
• small/moderate expense
• widely available
• dynamic imaging

Question 15

What are the main disadvantages of ultrasound for MSK?

Answer 15

• user/operator dependent

- cannot go through cortical bone

Question 16

What is dual x-ray absorptiometry?

Answer 16

A type of X-ray that evaluates bone density relative to others of the same sex/ethnicity/demographics

Question 17

What is bone scintigraphy?

Answer 17

A sensitive but nonspecific way to evaluate bone density

Question 18

What is bone scintigraphy sensitive for?

Answer 18

Conditions with bone turnover and increased blood flow, specifically fracture, infection, and blastic metastases

Question 19

What is an arthrography used for?

Answer 19

A technique to introduce contrast into joints to evaluate joints

Question 20

What is myelography used for?

Answer 20

A technique to introduce contrast into the central canal of bone

Question 21

What imaging techniques are used for chronic back pain in adults?

Answer 21

• plain radiographs

- MRI

Question 22

What imaging techniques are used for chronic back pain in children?

Answer 22

• plain radiographs

- nuclear medicine exam

Question 23

What imaging techniques are used for acute back pain?

Answer 23

• plain radiographs

- consider CT or MRI

Question 24

What imaging techniques are used for neck pain?

Answer 24

• plain radiographs

Question 25

What imaging techniques are used for joint pain?

Answer 25

Plain radiographs, consider MRI

Question 26

What imaging techniques are used for neoplasm?

Answer 26

Plain radiograph, MRI with contrast, CT, nuclear medicine study

Question 27

What imaging techniques are used for occult fractures?

Answer 27

Plain radiographs, CT/MRI/nuclear medicine if x-ray is normal

Question 28

What imaging techniques are used for osteomyelitis in diabetic patients?

Answer 28

- plain radiograph - MRI - nuclear medicine study

Question 29

What imaging techniques are used for osteomyelitis in non-diabetic patients?

Answer 29

- plain radiograph | - MRI with contrast