Radiology exam 2, spine,msk,brain

baisilar a

gray is gray, white is darker than gray

what is the normal appearance of gray and white matter

subdural hemorrhage

dura; brain; sutures; midline

subdural hemorrhage is bleeding between _______ and ______; it crosses _______, but not _______

epidural hemorrhage

dura; skull; midline; sutures

epidural hemorrhage is bleeding between ________ and ________; it crosses __________ but not _________

subarachnoid hemorrhage

subarachnoid hemorrhage

subarachnoid hemorrhage

lobes

subarachnoid hemorrhage is bleeding between _______

mass effect and midline shift

dense middle cerebral artery; early sign of stroke

what is this and what does it suggest?

hemorrhagic stroke

middle cerebral artery

most common artery involved in a stroke

dwi; new cva's look bright

_______ mri is the best for stroke identification; what is a key finding?

DWI (diffusion weighted image) of stroke that occurred 10-14 days ago

core: where the brain died; penumbra: area of the brain where there is not enough blood flow but if clot is dissolved quickly, brain can be salvaged and deficits resolved

what is penumbra and core in CVA

DWI (diffusion weighted image) of stroke that occurred 10-14 days ago

cerebral aneurysm via angiogram

cerebral clot on angiogram

intracranial hemorrhage

amyloid angiopathy, hypertension, trauma

a common cause of this hemorrhage in the brain is:

CT; MRI

____ is used for acute intracranial bleed/hemorrhage, while ____ is used for everything else

true

T/F: contrast is not necessary most of the time, but is used for a suspected tumor or infection

intracranial hemorrhage; without

CT is the best test for acute ______________ _____________ and is ordered with/without contrast 99% of the time

mri

an ______ is best to view strokes, MS, malignancy, infection, or a non-emergent seizure workup

darker; brighter

white matter is ________ on CT while gray matter is __________ on CT

parenchymal, subarachnoid, subdural, epidural, intraventricular

there are 5 types of intracranial hemorrhage:

acute stroke

an ______ _____ is associated with mass effect

ruptured cerebral (intracranial) aneurysm

is the most common cause of non-traumatic subarachnoid hemorrhage

left:

- trauma (finger-like projections between gyri)

right:

- aneurysm

left vs. right

CT

best initial test for evaluating bleeding in the brain

CT

____ is first line for spinal trauma

spinal trauma imaging criteria

anterior longitudinal ligament, anterior 2/3 vertebral body and disc

anterior column of spine (contents)

posterior longitudinal ligament, posterior 1/3 vertebral body and disc

middle column of spine contents

articular facets, lamina, spinous process, ligamentum flavum, interspinous ligament

posterior column of spine contents

spondylosis

- osteophytes

this is _________, which is what?

spondylolithesis

- translation

this is _________, which is what?

spondylolysis

- defect thru pars interarticularis

image: normal pars articularis, broken pars articularis

this is ______, which is what?

degenerative disc (characteristic finding: dark discs on mri)

what is this?

disc bulge

herniation (protrusion)

disc herniation

disc herniation (extrusion)

- protrusion: a little bit is coming out

- extrusion: comes out and it starts to go up or down

extrusion vs. protrusion disc herniation?

a- protrusion

b- extrusion

c- extrusion

bulging gets wider, but herniated has a "mickey mouse ear" coming out of the intervertebral disc space

herniated vs. bulging discs

1- compression fracture

2- normal disc

3- abnormal disc

the area between the superior and inferior articulations of the vertebrae; common site of fractures due to spondylolysis

pars interarticularis

compression fracture

compression fracture

compression fracture with edema

typically a loss of height in the vertebral body, and a wedge-shaped or collapsed appearance

how to identify a compression fracture

x-ray

image modality of choice in msk trauma

epiphysis

metaphysis

diaphysis

scaphoid and navicular fracture

osteonecrosis

complication that can arise from a scaphoid/navicular fracture

7-10 days

(for persistent pain & point tenderness ---> CT & MRI for further evaluation; MRI for ligament or tendon injuries)

when to do follow up with x-ray in patients

open fracture

when a fracture extends through the skin

comminuted

more than two fragments

interarticular fracture

cartilage involvement of fracture

displacement fracture

distal fragment will move relative to proximal fragment in _______ _______

lateral displacement of distal fracture fragment

posterior displacement of distal fracture fragment

anterior displacement of distal fracture fragment

1. ulnar styloid fracture

2. torus/buckle fracture at radius

torus/buckle fracture

common pediatric long bone fracture:

salter harris

use what to describe pediatric fractures:

fracture through physeal (growth) plate only

with metaphyseal fracture

with epiphyseal fracture

with metaphyseal and epiphyseal fracture

crush injury

type 1 salter harris

type 2 salter harris

a shoulder dislocation occurs between the glenohumeral joint;

a shoulder separation occurs between the acromioclavicular joint

shoulder separation vs. dislocation

shoulder dislocation

shoulder dislocation

separated AC joint, normal AC joint

lisfranc fracture

fracture-dislocation of the tarsometatarsal joint/ midfoot

can slide laterally or "split in half" if left untreated

why lisfranc fractures are so important to catch

lisfranc fracture