30 Questions
What are the advantages of plain radiography?
Low cost and minimally invasive
How many views are usually needed to identify bone and soft tissue on plain radiography?
2
What is the systematic approach to reading and interpreting an x-ray?
Identify the bone and soft tissue
Which imaging modality is appropriate for investigating soft tissue injuries?
MRI
What is the purpose of relating x-ray findings to the aetiology, mechanism of injury, and clinical decisions?
To determine appropriate treatment
Which of the following can be considered as soft tissue in the knee?
Muscles
What are some of the degenerative changes that can be revealed in the knee joint?
Mechanical interference
What are some of the descriptive terms used to locate bone abnormalities in the knee?
Shaft, end, growth plate, outgrowth
Why might more than two images be needed for suspected scaphoid fracture?
To compare to the other side
What can affect the acquisition of images in radiology?
Pain or co-operation
Which imaging technique is best for assessing bony abnormalities such as fractures and subluxation?
Plain Radiography
Which imaging technique is not great for soft tissue differentiation if similar radiodensity?
Computed Tomography (CT)
Which imaging technique is sensitive to detecting changes and variations in bone marrow, such as bone tumors and stress fractures?
Magnetic Resonance Imaging (MRI)
Which imaging technique is contra-indicated for patients with metal implants, pacemakers, or claustrophobia?
Magnetic Resonance Imaging (MRI)
Which imaging technique is best for excellent soft tissue differentiation, such as partial vs complete tears of tendon or ligament?
Magnetic Resonance Imaging (MRI)
What is the potential consequence of a large disc protrusion in the spinal canal or neural foramina?
It can cause significant neurological symptoms by compressing the cord
What is the primary role of a physiotherapist in interpreting x-rays?
To recognize x-ray features of traumatic injuries and other rheumatological conditions
What should a physiotherapist check before interpreting an x-ray?
Patient name, DOB, and date of investigation
What does the 'ABCs' of musculoskeletal films stand for?
Alignment, Bone appearance, Cartilage, Soft tissue
What does bone appearance on an x-ray reveal?
Bone density changes, necrotic/lytic areas, chronic/degenerative changes, tumors, foreign bodies
What is the advantage of using ultrasound in imaging muscles, tendons, ligaments, and nerves?
It is noninvasive and safe
What is the Ottawa rule for ankle x-rays?
Ankle x-ray is required if there is pain in the malleolar zone and bone tenderness in the posterior fibular or tip lateral malleolus
What is the main use of real-time ultrasound imaging in physiotherapy?
To provide biofeedback
When is imaging needed?
If the results of imaging would change the course of treatment or understand the prognosis
What are the risks of diagnostic imaging tests?
Cost, radiation exposure, incidental findings, anxiety and fear
What is the most appropriate imaging test for a bimalleolar ankle fracture and why?
X-ray to confirm the fracture and assess alignment
What is the most likely diagnosis for a 13-year-old athlete presenting with heel pain that is not settling?
Retrocalcaneal bursitis
What is the most appropriate imaging test for a 40-year-old male patient with suspected spinal stenosis and nerve root impingement?
MRI to evaluate spinal stenosis and nerve root impingement
What is the most likely differential diagnosis for a hockey player complaining of knee instability and swelling with multiple prior injuries?
ACL rupture
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)?
MRI to evaluate spinal stenosis and nerve root impingement
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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