Spine and upper extremity imaging

What are some indications for x-ray of MSK

First line for evaluating bony anatomy

Pain

Following injury or trauma

Suspect fracture or foreign body

Surgical planning

Post surgical changes

Post fracture healing

Osteomyelitis

Indications of MSK CT

intra-articular fractures

Bony recon

Surgical planning

Presence of metallic implants

MRI MSK indications

Soft tissue

Tumors

Surgical planning

Osteomyelitis

indications for imaging of cervical spine

Trauma

Infection

Atypical pain

Limb pain

Osteoporosis

Degenerative changes

Unique views of cervical spine

odontoid-AP w. open mouth, oblique to show narrowing or impingement of neural foramina

indications for thoracic spine imaging

Fall from height

MVA

Neuro deficits

Post-op imaging

Assess for metastasis

Curvature like scoliosis

what can be seen on oblique view of lumbar spine xray

pars defect or fracture-scotty dog

what can be seen on flexion and extension views of lumbar spine x-ray

spondylolisthesis(anterior vertebral displacement)

Indications for lumbar spine CT

s/p trauma

Fractures

Seat belt injury

MRI contraindicated

Spinal injections

spondylolisthesis(fracture w/ movement) and spondylolysis(pars articularis)

indications for lumbar spine MRI

Low back pain

DDD/DJD

Herniated disc

Spinal stenosis

tumors

Metastases

Indications for shoulder, humerus, elbow, forearm, wrist imaging

Pain

Trauma

Assess healing of fracture

Post op

Indications for hand and finger imaging

Pain

Trauma

Assess healing of fracture

Post op

Suspect foreign bodies

Deformity

What views used for shoulder

AP, scap Y, axillary

what views used for elbow

AP elbow in extension

lateral flexed at 90 degrees

Oblique elbow in extension

Fat pad/sail sign -found after trauma or injury, pad gets pushed up by effusion

What views used for wrist

AP, lateral, oblique

Scaphoid view for presence of anatomical snuff box pain