Diagnostic Imaging Exam 1

Why should PTs learn about radiology

-Pt will bring x-rays with them to their PT visits

-better understand anatomy and pathology

-helps PTs know what the joint looks like postoperatively

-helps PTs to communicate with referring provider

-allows PTs to set realistic goals and have a better idea of prognosis

-educate patients on the extent of the injury

True/False: Military PTs can not order imaging

False

True/False: The diagnostic accuracy by PTs is equal to that of an orthopedic surgeon when comparing exams to MRI

True

what states clearly allow PTs to order imaging?

-Wisconsin

-DC

-Colorado

-Maryland

-New Jersey

-Utah

what states clearly prohibit PTs to order imaging?

-South Carolina

-New York

-Mississippi

define radiology

a branch of medicine concerned with radiant energy in radioactive substance, such as x-rays, isotope, and ionizing radiation, and the application of this information to prevention, diagnosis, and treatment of disease

define radiologists

physicians specializing in radiology

define radiographers

professional technicians who produce the images

types of diagnostic imaging

-plain radiograph

-MRI/MRA/fMRI/dMRI

-CT Scan

-Bone Scan

-PET Scan

-Ultrasound

-Arthrograms

-Myelograms

what is interventional radiology

the use of radiological modalities for the treatment of disease

what is an example of interventional radiology

radiation therapy used for cancer

what are the 3 requirements for a radiograph

-x-ray beam source

-patient

-x-ray film or other image receptor

what is x-ray film/plate

the physical material on which the image is exposed

what are x-rays?

a form of radiant energy with shorter wavelengths of visible light

how do radiolucent objects appear?

less dense and appear darker

how do radiopaque objects appear?

denser and appear lighter

what does radiodensity refer to?

how many x-rays are absorbed, with more x-rays being absorbed will result in a whiter structure

what determines the rate at which material will absorb the x-ray?

-atomic number/density of tissue

-tissue thickness

what is a conventional radiograph

-also called a plain film

-radiograph made without contrast enhancement or other modifications

what is a projection

the path of the x ray beam

what is the view

processed x-ray film/image

what are the advantages of conventional radiographs

-inexpensive relative to other imaging methods

-rapid evaluation

-demonstrates fine detail bone

what are the disadvantages of conventional radiographs

-ionizing source of radiation

-does not demonstrate soft tissue well

-low sensitivity changes in bone mineral density

what is needed to create an xray?

-source of electrons

-a force to move them rapidly

-something to stop them

what are the two ways a patient is exposed to ionizing radiation in imaging?

-ionizing radiation transmitted through tissue

-ionizing radiation emitted after injection or ingestion

what types of imaging transmit ionizing radiation through tissue?

-conventional radiographs

-fluoroscopy

-conventional tomography

-mammography

-contrast studies

-arthrograms

-myelograms

-computerized axial tomography

what types of imaging emit ionizing radiation after injection/ingestion?

-scintigraphy/bone scan

-positive emission tomography

what are the non-ionizing methods of imaging

-MRI

-Diagnostic US

how is radiation dosage measured?

effective dose which is measured in a millisievert

what is the effective does for a CT of the abdomen and pelvis?

10 mSv

a CT scan of the abdomen and pelvis is comparable to how much natural background radiation?

3 years

a CT scan of the abdomen and pelvis repeated with and without contrast material has what approximate effective dose?

20 mSv

a CT scan of the abdomen and pelvis repeated with and without contrast material is comparable to natural background radiation for how long?

7 years

what is the approximate effective dose of a spine x-ray?

1.5 mSv

a spine x-ray is comparable to natural background radiation of how long?

6 months

what is the approximate effective dose of an extremity x ray

0.001 mSv

an extremity x-ray is comparable to the background radiation of how long?

3 hours

what is the approximate effective dose of a dental x ray

0.005 mSv

a dental x ray is comparable to what natural background radiation timeframe?

1 day

what is the approximate effective dose of a bone densitometry (DEXA)

0.001 mSv

what is the approximate effective dose of a mammography

0.4 mSv

what is the comparable natural background radiation to mammography

7 weeks

what does ALARA mean

As Low As Reasonably Achievable

what population is the MOST sensitive to the effects of radiation?

unborn children of a pregnant person

what types of cancer are females at greater risk for when exposed to radiation?

-Thyroid

-Breast

-Lung

Which of the following lists materials in order to radiopaque to radiolucent?

a. Air-Fat-Water-Bone-Metal

b. Air-Water-Fat-Bone-Metal

c. Metal-Bone-Water-Fat-Air

d. Metal-Bone-Fat-Water-Air

Metal-Bone-Water-Fat-Air

what is an example of a contrast media?

barium sulfate

Anteroposterior

What type of projection is this?

a. Posteroanterior

b. Anteroposterior

c. Left Lateral

d. AP oblique

Posteroanterior

what type of projection is this?

a. Posteroanterior

b. Anteroposterior

c. Left Lateral

d. AP oblique

Left Lateral

what type of projection is this?

a. Left lateral

b. Right Lateral

c. Left AP Oblique

c. Right AP Oblique

Right Lateral

what type of projection is this?

a. Left lateral

b. Right Lateral

c. Left AP Oblique

c. Right AP Oblique

Left AP Oblique

what type of projection is this?

a. Left lateral

b. Right Lateral

c. Left AP Oblique

c. Right AP Oblique

Right AP Oblique

what type of projection is this?

a. Left lateral

b. Right Lateral

c. Left AP Oblique

c. Right AP Oblique

Right PA Oblique

What type of projection is this?

a. Right AP Oblique

b. Right PA Oblique

c. Left AP Oblique

d. Left PA Oblique

Left PA Oblique

What type of projection is this?

a. Right AP Oblique

b. Right PA Oblique

c. Left AP Oblique

d. Left PA Oblique

underexposed

Which of the following would be used to describe this radiograph?

a. Underexposed

b. Correctly Exposed

c. Overexposed

correctly exposed

Which of the following would be used to describe this radiograph?

a. Underexposed

b. Correctly Exposed

c. Overexposed

overexposed

Which of the following would be used to describe this radiograph?

a. Underexposed

b. Correctly Exposed

c. Overexposed

when performing a chest x-ray, would you prefer a low or high contrast radiograph?

low contrast

what is recorded detail

geometric sharpness or accuracy of the structural lines on the radiograph

what is recorded distortion

difference between the object being evaluated and its recorded image

radiolucent objects are ______________, and will appear ____________ on imaging

a. more dense, darker

b. more dense, lighter

c. less dense, darker

d. less dense, lighter

less dense, darker

view

This is an example of a _______.

a. view

b. projection

c. conventional MRI

d. none of these

recorded detail

Motion was discussed to affect the ______ of an image

a. recorded distortion

b. radiographic density

c. recorded detail

d. radiographic contrast

what are the two pitfalls of image interpretation

-errors of observation

-errors of interpretation

what is an error of observation

incomplete or faulty search patterns

what is an error of interpretation

practitioners failure to link abnormal radiologic signs to relevant clinical date

what does ABCs stand for with radiologic analysis

-alignment

-bone density

-cartilage spaces

-soft tissues

what should you be looking at with alignment?

-general skeletal architecture

-general contour of bone

-alignment of bones to adjacent bone

what should you be looking at with bone?

-general bone density

-textural abnormalities

-local bone density changes

what should you be looking for with cartilage?

-joint space width

-subchondral bone

-epiphyseal plates

what should you be looking for with soft tissue?

-muscles

-fat pads and fat lines

-joint capsules

-periosteum

-misc soft-tissue findings

what are the components of a radiology report

-heading/type of exam

-technique/protocol

-clinical information

-findings/main report

-conclusions/impressions

-signature of radiologist

what are the possible complications of a spinal fracture?

neurological injury

what are the possible complication of a pelvic/femur fracture ?

hemorrhage

what is a possible for multiple or crushing type fractures

fat embolism

what is a possible complication for elbow fracture?

brachial artery injury

what is a possible complication for proximal humeral fracture?

axillary nerve injury

what are possible complications for shoulder dislocation?

-axillary artery injury

-brachial plexus injury

-axillary nerve injury

what are the possible complications for elbow dislocation

-brachial artery injury

-median nerve injury

-ulnar nerve injury

what are the possible complications of a hip dislocation

-femoral artery injury

-femoral nerve injury

what are the possible complications for knee dislocation

-popliteal artery injury

-peroneal nerve injury

define fracture

a break in the structural continuity of bone or cartilage

what is key factor for closed fracture

skin and overlying soft tissue is intact

what are the 7 elements of fracture description

-anatomic site and extent of fracture

-complete vs incomplete

-alignment of fracture fragments

-direction of fracture line

-presence of special features

-associated abnormalities like dislocation

-special types of fractures as a result of abnormal stress

nondisplaced

what type of alignment is seen with this fracture?

a. nondisplaced

b. medial displacement

c. lateral displacement

d. distracted

medial displacement

what type of alignment is seen with this fracture?

a. nondisplaced

b. medial displacement

c. lateral displacement

d. distracted

lateral displacement

what type of alignment is seen with this fracture?

a. nondisplaced

b. medial displacement

c. lateral displacement

d. distracted

distracted

what type of alignment is seen with this fracture?

a. nondisplaced

b. medial displacement

c. lateral displacement

d. distracted

overriding with posterior and superior displacement

what type of fracture is this

a. overriding with posterior and superior displacement

b. distracted

c. lateral displacement

d. distracted and rotated laterally

distracted and rotated laterally

what type of fracture is this

a. overriding with posterior and superior displacement

b. distracted

c. lateral displacement

d. distracted and rotated laterally

transverse

what is the direction of this fracture line?

a. transverse

b. longitudinal

c. oblique

d. spiral

longitudinal

what is the direction of this fracture line?

a. transverse

b. longitudinal

c. oblique

d. spiral

oblique

what is the direction of this fracture line?

a. transverse

b. longitudinal

c. oblique

d. spiral

spiral

what is the direction of this fracture line?

a. transverse

b. longitudinal

c. oblique

d. spiral

Type I

what type of Salter-Harris fracture is this?

a. Type I

b. Type III

c. Type IV

d. Type II

Type II

what type of Salter-Harris fracture is this?

a. Type I

b. Type III

c. Type IV

d. Type II

Type III

what type of Salter-Harris fracture is this?

a. Type I

b. Type III

c. Type IV

d. Type II

Type IV

what type of Salter-Harris fracture is this?

a. Type I

b. Type III

c. Type IV

d. Type II

Type V

what type of Salter-Harris fracture is this?

a. Type I

b. Type IV

c. Type V

d. Type II