Radiology Techniques Overview

X-ray

• Multiple views are needed for full assessment of the structure being examined.
• Serial x-rays can determine the status of the healing process.
• X-rays are ordered with specific desired positioning.

Computed Tomography (CT)

• With or without contrast enhancement, CT scans provide detailed views of a specific plane of the bone.
• Can identify soft tissue tumors or injuries to ligaments and tendons.
• Used to pinpoint the location and extent of fractures in challenging areas for evaluation.

Magnetic Resonance Imagining (MRI)

• Uses magnetic fields, radio waves, and computers to depict changes in soft tissues like muscles, tendons, cartilage, nerves, and fat.
• Contrast material can be used to enhance the visibility of anatomical structures.

Arthrography

• Imaging of joints to visualize internal structures.
• Contrast is injected into the joint space to highlight any irregularities.
• ROM exercises are performed during the imaging process.

Bone Densitometry

• Utilizes X-rays or ultrasound to assess bone strength.
• Measures the degree of osteoporosis and monitors response to treatment.

Bone Scan

• Detects metastatic and primary bone tumors, osteomyelitis, and some fractures and aseptic necrosis.
• A bone-seeking isotope is injected 2-3 hours before the scan.
• The scan measures the distribution of the isotope, revealing bone metabolism.
• Increased uptake indicates primary skeletal disease (osteosarcoma), metastatic bone disease, inflammatory skeletal disease (osteomyelitis), and fractures that are not healing as expected.

Arthroscopy

• Direct visualization of joints for diagnosis and treatment of tears, defects, and disease processes.
• Performed in the Operating Room under local or general anesthesia.
• Saline is injected to enlarge the joint space for better visualization.
• Symptoms: pain, joint contour changes, limb length alterations, and loss of range of motion.

Sports-Related Injuries

• Can be acute (sprains, strains, dislocations, fractures) or chronic and gradual from repetitive use (tendinitis, stress fractures).

Fractures

• Complete or incomplete disruption in the continuity of bone structure.
• Defined by type, extent, and appearance.
• Occur when bone is subjected to stress exceeding its capacity.
• Can affect adjacent structures, leading to soft tissue edema, hemorrhage, joint dislocations, ruptured tendons, severed nerves, damaged blood vessels, and organ damage.

Fracture Classification

• Based on location (proximal, midshaft, distal), type, degree of break, appearance, position and alignment of fragments, stability, and open or closed nature.

Fracture Types

• Avulsion: bone fracture resulting from strong tendon or ligament pulling.
• Spiral: fracture twisting around the bone shaft.
• Depressed: fragments driven inward, common in skull and facial bone fractures.
• Impacted: one bone fragment driven into another.
• Pathologic: fracture through diseased bone, occurring spontaneously or with minimal trauma.
• Simple: contained fracture, no skin disruption.
• Stress: fracture caused by repeated loading of bone and muscle.

Fracture Signs and Symptoms

• Immediate localized pain.
• Edema and swelling.
• Decreased function.
• Inability to bear weight or use affected part.
• Guarding.
• Crepitation (crackling sound).
• Ecchymosis (discoloration due to bleeding under the skin).

Goal of Fracture Treatment

• Anatomic realignment of bone fragments (reduction).
• Immobilization to maintain alignment.
• Restoration of normal function.

Emergency Fracture Management

• Immobilization of the limb (support above and below the fracture).
• Splints minimize soft tissue damage, pain, and bleeding from fragment movement.
• Open fracture: cover the wound with a sterile dressing, do not attempt reduction.
• Handle fractured extremity minimally.

Medical Fracture Management

• Reduction: restoration of bone fragments to correct alignment and position.
• Closed Reduction: non-surgical manual realignment, immobilized by traction, casting, external fixation, splints or braces.
• Open Reduction: surgical correction with incision, uses internal fixation (ORIF) like wires, screws, pins, plates, rods, or nails.
• Immobilization: after reduction, to maintain the alignment until union occurs.
• External Immobilization: bandages, casts, splints, continuous traction, external fixators.
• Internal Immobilization: metal implants.
• Traction: devices applying pulling force on the fractured extremity for realignment with counter-traction in the opposite direction.
  • Skin Traction: short-term, for 48-72 hours until skeletal traction or surgery. Tape, boots, splints applied directly to the skin with 5-10 pounds of weight.

Amputation Levels

• Performed at the most distal point with successful healing potential.
• Determined by adequate circulation and functional usefulness.
• Doppler, blood pressure, and transcutaneous PaO2 aid in level determination.
• Goal is to conserve as much extremity as possible, with preservation of knee and elbow joints preferred.

Amputation Complications

• Hemorrhage
• Infection
• Skin breakdown
• Phantom limb pain
• Joint contracture

Medical Amputation Management

• Focus on wound healing to achieve a nontender residual limb with healthy skin for prosthetic attachment.
• Gentle handling, compression dressings to manage edema, and aseptic techniques are crucial for healing.

Amputation Dressings

• Compression bandage applied after surgery for soft tissue support, edema reduction, faster healing, pain management, and residual limb shrinkage.
• Proper stump bandaging shapes the limb for prosthesis fitting.

Amputation Nursing Diagnosis

• Disturbed body image due to amputation and impaired mobility.
• Impaired skin integrity due to immobility and improperly fitting prosthesis.
• Chronic pain related to amputation.
• Impaired physical mobility due to amputation.
• Risk for infection due to amputation.
• Risk for sensory perception alterations due to amputation.

Amputation Nursing Interventions

• Pain management.
• Minimizing altered sensory perceptions.
• Promoting wound healing.
• Enhancing body image.
• Facilitating grief resolution.
• Promoting independent self-care.
• Achieving physical mobility.
• Monitoring and managing potential complications.
• Supporting home, community-based, and transitional care.

Amputation Nursing Care

• Preoperative:
  • Reinforce already taught information to patient and family.
  • Understand amputation level, dressing type, and planned prosthesis.
  • Educate about post-operative exercises, including upper extremity exercises.
  • Discuss post-operative nursing care and expectations.
  • Explain phantom limb sensation and pain.
• Postoperative:
  • Very individualized based on health, reasons for amputation, and age.
  • Emphasis on prevention and detection of complications.
  • Monitor for signs and symptoms of hemorrhage, including vital signs and dressing assessment.
  • Employ sterile technique to minimize infection risk.

This quiz covers various radiology techniques including X-rays, CT scans, MRIs, and arthrography. Understand the applications and importance of each imaging modality in diagnosing and evaluating injuries and conditions. Test your knowledge on how these technologies visualize different anatomical structures.