Week 5 Imaging
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Questions and Answers

What are the advantages of plain radiography?

  • Low cost and minimally invasive (correct)
  • High cost and minimally invasive
  • High cost and invasive
  • Low cost and invasive

    • How many views are usually needed to identify bone and soft tissue on plain radiography?

  • 1
  • 4
  • 3
  • 2 (correct)

    • What is the systematic approach to reading and interpreting an x-ray?

  • Identify the fat
  • Identify the metal
  • Identify the air and gas
  • Identify the bone and soft tissue (correct)

    • Which imaging modality is appropriate for investigating soft tissue injuries?

    <p>MRI</p> Signup and view all the answers

    What is the purpose of relating x-ray findings to the aetiology, mechanism of injury, and clinical decisions?

    <p>To determine appropriate treatment</p> Signup and view all the answers

    Which of the following can be considered as soft tissue in the knee?

    <p>Muscles</p> Signup and view all the answers

    What are some of the degenerative changes that can be revealed in the knee joint?

    <p>Mechanical interference</p> Signup and view all the answers

    What are some of the descriptive terms used to locate bone abnormalities in the knee?

    <p>Shaft, end, growth plate, outgrowth</p> Signup and view all the answers

    Why might more than two images be needed for suspected scaphoid fracture?

    <p>To compare to the other side</p> Signup and view all the answers

    What can affect the acquisition of images in radiology?

    <p>Pain or co-operation</p> Signup and view all the answers

    Which imaging technique is best for assessing bony abnormalities such as fractures and subluxation?

    <p>Plain Radiography</p> Signup and view all the answers

    Which imaging technique is not great for soft tissue differentiation if similar radiodensity?

    <p>Computed Tomography (CT)</p> Signup and view all the answers

    Which imaging technique is sensitive to detecting changes and variations in bone marrow, such as bone tumors and stress fractures?

    <p>Magnetic Resonance Imaging (MRI)</p> Signup and view all the answers

    Which imaging technique is contra-indicated for patients with metal implants, pacemakers, or claustrophobia?

    <p>Magnetic Resonance Imaging (MRI)</p> Signup and view all the answers

    Which imaging technique is best for excellent soft tissue differentiation, such as partial vs complete tears of tendon or ligament?

    <p>Magnetic Resonance Imaging (MRI)</p> Signup and view all the answers

    What is the potential consequence of a large disc protrusion in the spinal canal or neural foramina?

    <p>It can cause significant neurological symptoms by compressing the cord</p> Signup and view all the answers

    What is the primary role of a physiotherapist in interpreting x-rays?

    <p>To recognize x-ray features of traumatic injuries and other rheumatological conditions</p> Signup and view all the answers

    What should a physiotherapist check before interpreting an x-ray?

    <p>Patient name, DOB, and date of investigation</p> Signup and view all the answers

    What does the 'ABCs' of musculoskeletal films stand for?

    <p>Alignment, Bone appearance, Cartilage, Soft tissue</p> Signup and view all the answers

    What does bone appearance on an x-ray reveal?

    <p>Bone density changes, necrotic/lytic areas, chronic/degenerative changes, tumors, foreign bodies</p> Signup and view all the answers

    What is the advantage of using ultrasound in imaging muscles, tendons, ligaments, and nerves?

    <p>It is noninvasive and safe</p> Signup and view all the answers

    What is the Ottawa rule for ankle x-rays?

    <p>Ankle x-ray is required if there is pain in the malleolar zone and bone tenderness in the posterior fibular or tip lateral malleolus</p> Signup and view all the answers

    What is the main use of real-time ultrasound imaging in physiotherapy?

    <p>To provide biofeedback</p> Signup and view all the answers

    When is imaging needed?

    <p>If the results of imaging would change the course of treatment or understand the prognosis</p> Signup and view all the answers

    What are the risks of diagnostic imaging tests?

    <p>Cost, radiation exposure, incidental findings, anxiety and fear</p> Signup and view all the answers

    What is the most appropriate imaging test for a bimalleolar ankle fracture and why?

    <p>X-ray to confirm the fracture and assess alignment</p> Signup and view all the answers

    What is the most likely diagnosis for a 13-year-old athlete presenting with heel pain that is not settling?

    <p>Retrocalcaneal bursitis</p> Signup and view all the answers

    What is the most appropriate imaging test for a 40-year-old male patient with suspected spinal stenosis and nerve root impingement?

    <p>MRI to evaluate spinal stenosis and nerve root impingement</p> Signup and view all the answers

    What is the most likely differential diagnosis for a hockey player complaining of knee instability and swelling with multiple prior injuries?

    <p>ACL rupture</p> Signup and view all the answers

    What is the most appropriate imaging test for a patient with low back pain, right-sided leg pain, and pins and needles on their lateral foot, with a suspected spinal stenosis with nerve root impingement (radiculopathy)?

    <p>MRI to evaluate spinal stenosis and nerve root impingement</p> Signup and view all the answers

    Study Notes

    Advantages of Plain Radiography

    • Quick and cost-effective imaging technique
    • Widely available and easy to perform
    • Good for initial assessment of bone fractures and alignments

    Imaging Views for Bone and Soft Tissue

    • Typically more than one view is needed to assess bone and soft tissue comprehensively
    • Standard views include anteroposterior (AP) and lateral

    Systematic Approach to x-ray Interpretation

    • Follow the ABCs method: Alignment, Bone density, Cartilage spaces
    • Evaluate soft tissues for abnormalities as well

    Imaging Modality for Soft Tissue Injuries

    • MRI is the preferred choice for investigating soft tissue injuries
    • Provides excellent visualization of ligaments, tendons, and other soft structures

    Relating Findings to Aetiology and Clinical Decisions

    • Important to correlate x-ray results with the mechanism of injury
    • Guides clinical management and treatment decisions based on injury context

    Soft Tissue in the Knee

    • Includes ligaments (ACL, PCL), tendons (quadriceps, patellar), and muscles around the knee

    Degenerative Changes in the Knee Joint

    • Common changes include osteophyte formation, joint space narrowing, and subchondral sclerosis

    Descriptive Terms for Bone Abnormalities in the Knee

    • Terms include effusion, deformity, and malalignment for clear communication of findings

    Additional Images for Suspected Scaphoid Fracture

    • More than two images may be needed due to the scaphoid's complex anatomy and potential for occult fractures

    Factors Affecting Image Acquisition in Radiology

    • Patient movement, positioning, and equipment calibration can influence image quality

    Best Imaging Technique for Bone Abnormalities

    • X-ray is optimal for assessing fractures and dislocations due to its ability to show bony structures clearly

    Imaging Technique for Soft Tissue Differentiation

    • X-ray has limitations in differentiating soft tissues when densities are similar

    Technique Sensitive to Bone Marrow Changes

    • MRI is sensitive to changes in bone marrow, effective for identifying tumors and stress fractures

    Contraindications for Imaging Techniques

    • MRI is not suitable for patients with metallic implants, pacemakers, or severe claustrophobia

    Best Imaging for Soft Tissue Differentiation

    • MRI excels in differentiating between partial and complete tears in tendons and ligaments

    Consequence of Large Disc Protrusion

    • May lead to spinal canal or neural foramina compression, causing nerve root impingement

    Physiotherapist's Role in X-ray Interpretation

    • Interpret x-rays within the context of clinical findings and treatment planning

    Physiotherapist Checks Before Interpretation

    • Verify proper imaging quality and clarity of the x-ray prior to interpretation

    ABCs of Musculoskeletal Films

    • Stands for Alignment, Bone integrity, and Cartilage condition

    Bone Appearance on X-ray

    • Reveals information about bone density, structure, and potential fractures or lesions

    Advantages of Ultrasound in Imaging

    • Provides real-time imaging and is excellent for assessing soft tissues like muscles and tendons

    Ottawa Rule for Ankle X-rays

    • Guidelines to determine the need for x-rays based on specific criteria following ankle injuries

    Main Use of Real-time Ultrasound in Physiotherapy

    • Assessing dynamic movements and guiding therapeutic interventions in soft tissue injuries

    When Imaging is Needed

    • Imaging is indicated for suspected fractures, unresolving pain, or significant functional impairment

    Risks of Diagnostic Imaging Tests

    • Exposure to radiation, potential allergic reactions to contrast materials, and invasiveness in some procedures

    Most Appropriate Imaging Test for Bimalleolar Ankle Fracture

    • X-ray is preferred for clear visualization of fractures in the ankle due to its rapid turnaround time

    Likely Diagnosis for Heel Pain in Young Athlete

    • Possible diagnosis could be Sever's disease (calcaneal apophysitis), common in active adolescents

    Most Appropriate Imaging for Suspected Spinal Stenosis

    • MRI provides detailed views of spinal structures and can identify nerve root impingement

    Differential Diagnosis for Knee Instability in Hockey Player

    • Consider ligament injuries, such as ACL or MCL tears, especially with a history of previous injuries

    Imaging for Low Back Pain with Radicular Symptoms

    • MRI is the most appropriate test to assess for spinal stenosis and nerve root impingement in this context

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    Related Documents

    Lecture W5 Diagnostic Imaging For Musculoskeletal System PDF

    Description

    Test your knowledge on appropriate imaging tests for ankle injuries in two case scenarios. Case 1 covers an inversion injury resulting in a bimalleolar ankle fracture, while Case 2 involves being a sports physiotherapist for an elite athlete with ankle pain. Learn which imaging tests are best suited for each scenario.

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