special views xray

What is arthrography and which contrast media are commonly used?

Arthrography is imaging of a joint after injection of contrast. Common contrasts are iodinated contrast (positive), air (negative), or both (double contrast).

What are the indications for shoulder arthrography?

Rotator cuff tears, labral tears, joint instability, and adhesive capsulitis.

Describe the procedure for knee arthrography.

Under aseptic conditions, contrast is injected into the knee joint using fluoroscopic guidance, followed by imaging in multiple projections.

What patient preparation is required before arthrography?

Consent, allergy check (iodine), aseptic prep, explanation of procedure, and removal of jewelry.

What are the contraindications for arthrography?

Joint infection, severe contrast allergy, bleeding disorders.

What complications can arise from arthrography?

Infection, allergic reaction, pain, swelling.

How does CT arthrography differ from conventional arthrography?

CT arthrography provides cross-sectional, more detailed images, especially of bone and soft tissue.

What structures are best visualized in hip arthrography?

Labrum, cartilage, joint capsule.

What positioning is used for shoulder arthrogram imaging?

AP views with internal and external rotation.

What is the role of fluoroscopy in arthrography?

Guides needle placement and monitors contrast distribution.

What is cholangiography?

Imaging of the bile ducts using contrast media.

Differentiate between ERCP and PTC.

ERCP is endoscopic via the duodenum; PTC is percutaneous through the liver.

What are the indications for biliary imaging?

Obstructive jaundice, gallstones, tumors, strictures.

What contrast agents are used in cholangiography?

Iodinated contrast media.

What patient preparation is required for ERCP?

Fasting, consent, sedation prep, allergy check.

What are the risks of biliary duct procedures?

Pancreatitis, infection, bleeding, perforation.

How is obstructive jaundice evaluated radiographically?

Ultrasound first, followed by ERCP or PTC if needed.

What is intraoperative cholangiography?

Imaging of bile ducts during surgery to detect stones or injury.

What are normal vs abnormal findings in bile ducts?

Normal: smooth ducts; Abnormal: dilation, filling defects, strictures.

What role does ultrasound play before cholangiography?

First-line screening for stones and duct dilation.

What is hysterosalpingography used for?

Evaluation of uterus and fallopian tubes, mainly infertility.

What is the best timing in the menstrual cycle for HSG?

Day 7–10 (post-menstrual, pre-ovulation).

What contrast media are used in HSG?

Water-soluble iodinated contrast.

What are the indications for HSG?

Infertility, recurrent miscarriage, uterine abnormalities.

What are contraindications of HSG?

Pregnancy, pelvic infection, heavy bleeding.

Describe the procedure for performing HSG.

Contrast is injected into the uterus via cervix and images are taken under fluoroscopy.

What complications may occur during HSG?

Pain, infection, allergic reaction.

What are normal findings in HSG?

Normal uterine cavity and free spill of contrast from tubes.

How is tubal patency assessed?

By observing contrast spill into the peritoneal cavity.

What patient instructions are given after HSG?

Expect mild cramping, report severe pain/fever, avoid intercourse briefly if advised.

What is myelography?

Imaging of the spinal cord using contrast in the subarachnoid space.

What contrast media are used in modern myelography?

Non-ionic, water-soluble iodinated contrast.

What are the indications for myelography?

Disc herniation, spinal stenosis, tumors.

Describe lumbar puncture technique in myelography.

Needle inserted into lumbar subarachnoid space under sterile conditions to inject contrast.

What positioning is required post-procedure?

Head elevated to prevent contrast entering brain.

What complications can occur after myelography?

Headache, nausea, infection.

What is the role of CT myelography?

Provides detailed cross-sectional images of spinal canal.

What are contraindications of myelography?

Increased intracranial pressure, infection at puncture site.

How does myelography help detect disc herniation?

Shows indentation or blockage of contrast column.

What precautions are taken to prevent CSF leakage?

Proper needle technique and post-procedure rest.

What are standard projections for long bone imaging?

AP and lateral views.

How do you identify fractures on X-ray?

Break in cortex, lucent line, displacement.

What are the types of fractures?

Transverse, oblique, spiral, comminuted.

What is the importance of two-view imaging?

Prevents missed fractures and shows true alignment.

Describe radiographic features of osteoporosis.

Reduced bone density and thinning of cortex.

What is the role of X-ray in joint dislocations?

Confirms displacement and checks for associated fractures.

What are common positioning techniques for trauma patients?

Minimal movement, cross-table lateral views.

How is bone infection (osteomyelitis) identified?

Bone destruction, periosteal reaction.

What are growth plate injuries and how are they classified?

Injuries to epiphyseal plate; classified by Salter-Harris system.

What radiation protection measures are used?

Shielding, collimation, minimal exposure.

When is arthrography preferred over MRI for joint pain?

When MRI is contraindicated or unavailable.

Why is HSG indicated in infertility?

To assess uterine shape and tubal patency.

First imaging choice for jaundice and why?

Ultrasound—non-invasive and detects obstruction.

When is myelography used in spinal trauma?

When MRI is contraindicated or inconclusive.

How do you differentiate soft tissue vs bone injury on X-ray?

Bone injuries show fractures; soft tissue shows swelling or may need other imaging.