Intro to Diagnostic Imaging lecture 2

ABCS search pattern

a- alignment

b- bone density

c- cartilage spaces

s- soft tissues

when evaluating alignment, look for:

alignment of bones, general contour of bones, general skeletal architecture

cortical fx

• older adults

• fall, evulsion of humerus

heel spur

a bony calcium deposit that forms a protrusion on the underside or back of the heel bone

impaction fx

hard ends of a broken bone are jammed or driven into each other by a strong force

things to look out for when looking at bone density:

general bone density, textural abnormalities, local bone density

“fluffy” appearance =

decalcification

sclerosis

reaction of bone to trauma or growth - healing

things to look for when assessing cartilage spaces:

joint space, subchondral bone, epiphyseal plates

SALTR - classification of pediatric fx

S - straight across

A - above

L - lower

T - through

R - rammed/crushed

grade I epiphyseal plate fx

fx through physis

grade II epiphyseal plate fx

fx through physis and metaphysis

grade III epiphyseal plate fx

fx through physis and epiphysis

grade IV epiphyseal plate fx

fx through physis, metaphysis, epiphysis

grade V epiphyseal plate fx

crush/compression to physis

things to look for when evaluating soft tissue:

fat, joint capsule, periosteum, other

fat pad/sail sign

abnormal finding on an elbow X-ray that shows a joint swelling or bleeding inside the joint

FBI sign

Fat-Blood-Interface

presence of a lipohemarthrosis (fat and blood mixed in a joint)

periosteal reactions

new bone formation that happens when the outer membrane of a bone (the periosteum) is irritated, damaged, or lifted

solid periosteal reaction

benign

lamellated periosteal reaction

agressive

spiculated periosteal reaction

agressive

codman’s periosteal reaction

very agressive

heterotrophic ossification

bone is laid down into muscle

gangrene

body tissue dies due to a lack of blood supply or a severe bacterial infection

gold-standard imaging for osteoporosis

DEXA scan

DEXA scan - t-score

compares your results to a healthy young adult ages 20-35

DEXA scan - z-score

compares your results to a person of the same age/gender

t-score -1.5 to -2.4

may indicate osteopenia

z-score less than -2.5

may indicate osteoporosis

osteomyelitis

bone infection

septic arthritis

joint infection

cellulitis/myositis

infection of soft tissue