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Flashcards in 1. Roentgen Signs Deck (136)
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1

Advantages of conventional radiography

– Inexpensive
– Easily obtained
– Non-invasive
– Demonstrates anatomy and osseous/ articular
relationships

2

Disadvantages of conventional radiography

– Poor soft tissue discrimination
– Change in bone density difficult to assess
– Poorly defines small lesions
– Exposure differences between facilities
– Technical and processing artifacts
– Ionizing radiation

3

decrease in bone density needed to see lesion on conventional radiography

at least 30-50% and 1-5cm in size

4

examples of underlying disease not detected on radiograph

Metastatic Disease, Multiple Myeloma, Lymphoma, Fracture,

5

Time until a lesion is seen by plain film radiography

Radiographic Latent Period

6

Radiographic Latent Period for Osteomyelitis in peripheral bone

10-14 days

7

Radiographic Latent Period for Spinal osteomyelitis

21 days

8

Radiographic Latent Period for Aggressive Tumors

4-6 weeks

9

evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision
for a specific clinical condition.

ACR Appropriateness Criteria (AC)

10

Injection of water soluble iodinated contrast into IVD’s nucleus pulposus via fluoroscopic control in order to determine pain
generator

Discography

11

a provocational study for discogenic pain and guide for surgical intervention

Discography

12

Pattern of Distribution of Contrast during discography

fissuring, extravasation and pooling

13

Performed to visualize internal disc derangement
patterns (annular tears) that are not seen with MRI

CT Discography

14

Disadvantages of discography

– Fluoroscopy increases radiation dose
– Risk of infection (0.1-0.2%)
– Risk of nerve root damage
– Risk of dural trauma and tear
– Chemical meningitis
– Increased pain or exacerbation of pain
– Allergic reactions to contrast (iodine)
– Patient awake during
procedure to give responses to physician performing examination

15

Inject 15-20mCi of Technitium-99m-Methylene Diphosphate
(99mTc-MDP) intravenously and wait
30 min - 2 hours

Radionuclide Imaging (Bone Scan)

16

3-Phase Bone Scan

1. Blood Pool Phase
2. Delayed Phase
3. Delayed/delayed Phase

17

Bone scan: scan 5 minutes after injection

Blood Pool Phase

18

bone scan: scan 2-4 hours after injection

Delayed Phase

19

bone scan: scan 24 hours after injection

Delayed/delayed Phase

20

Isotope half-life for bone scan is _____ and is excreted by the _____

6 hours, kidneys

21

View areas of bone where bones overlap e.g. pars
interarticularis

SPECT Scan: (Single-Photon Emission Computed Tomography)

22

Takes about 45 – 60 minutes

SPECT Scan

23

Bone Scan Applications:

Detection of:
- Metastatic disease
- Tumors
- Infection
- Arthritis
- Fracture (occult, stress, recent fx)
- Avascular Necrosis (AVN)
- Normal plain film but pain of
unknown origin

24

Bone Scan Advantages

– can detect 3-5% bone destruction/production
– 10x more sensitive than plain film
– Great for early detection of many disease processes

25

Bone Scan Disadvantages:

– Measure of activity, quantitative image
– Sensitive, but not specific
– No uptake in Multiple Myeloma unless pathological
fx
– Tracer excreted within 1-3 days
– must stop breast feeding for 24 hours after tracer injection

26

(Bone Scan)
Multiple “Hot Spots” are seen on bone scan
throughout the skeleton
indicating

Metastatic Disease

27

uniform uptake of the tracer

normal bone scan

28

After you receive an injection of radioactive
tracer, a machine containing a ________
passes slowly over your body, recording the
pattern of tracer absorption in your bones.

gamma camera

29

bone scan takes about

30 minutes

30

Advantages of Diagnostic Ultrasound

– Abdominal and Pelvic imaging
– display of vascular
integrity/flow velocity
– MSK disorders
– masses (cystic,
solid, or mixed matrix)
– Guiding biopsy and joint aspiration
techniques