[11.06] Radiopathologic Imaging of the Musculoskeletal System V2.1.pdf

ionizing radiation

What utilizes ionizing radiation and generally differentiates structures based on densities?

stochastic effects

Statistically, small doses of radiation still have the potential to cause what effects?

good

How is the spatial resolution of a radiograph described?

very poor

How is the soft tissue resolution of a radiograph described?

hyperdense, hypodense, and isodense

What are the terms used to describe radiographic lesions in relation to the predominant background?

axial

In what plane is a CT scan primarily acquired?

computational techniques

What does a CT scan use to generate 3D images from 360 degree views?

sagittal, axial, coronal, and oblique

What are four common planes of evaluation in a CT scan?

fast

How is the speed of a CT scan examination described?

excellent

How is the spatial resolution of a CT scan described?

moderate

How is the soft tissue resolution of a CT scan described?

hyperdense, hypodense, and isodense

What terms are used to describe CT scan lesions?

magnetic resonance

MRI utilizes what principle to produce images?

t1 and t2 properties

MRI generally differentiates structures based on which two magnetic properties?

directly acquired in different planes

Unlike CT, how are MRI planes acquired?

takes more time

How does the imaging acquisition time of MRI compare to CT?

excellent

How is the soft tissue resolution of an MRI described?

relatively poorer

How does the spatial resolution of MRI compare to CT?

intensity or whiteness of signals

MRI differentiates structures based on what?

hyperintense, hypointense, and isointense

What terms describe the signals or whiteness of findings in an MRI?

ultrasound waves

What does an ultrasound use to form images?

echogenicity

Ultrasound differentiates structures based on what tissue property?

multiplanar

What type of evaluation involves the operator choosing the plane, such as axial or sagittal?

limited field of view

What is the number one limitation of ultrasound?

excellent

How is the spatial resolution of an ultrasound described?

machine and operator dependent

What two factors are critical for the quality of ultrasound imaging?

echoes, hyperechoic, hypoechoic, and isoechoic

What terms are used to describe lesions in ultrasound?

projectional views

While CT and MRI use multiplanar evaluation, what does X-ray use to evaluate extremities?

cortex and medulla/marrow

When evaluating bone on imaging, what two specific parts are examined?

space, cartilage, and ligaments

When evaluating a joint on imaging, what three components are checked?

contralateral or adjacent normal

What should imaging be compared with to ensure systematic evaluation?

clinical data

Imaging findings must be correlated with what to generate differential diagnoses?

radiograph / x-ray

What is the initial modality requested when evaluating the possibility of fractures or dislocation?

radiolucent/lucent

What term describes a structure that appears black or dark on a radiograph?

radiodense/dense

What term describes a structure that appears white or light on a radiograph?

sclerotic

What refers to radiodense new or reactive bone that appears as white spots or areas?

lytic

What refers to radiolucent areas implying destroyed or resorbed bone?

blastic

What refers to radiodense lesions implying pathology or neoplasm?

ill-defined

What term describes poor marginal/border definition where the interface with adjacent tissue cannot be pinpointed?

well-defined

What term describes an interface with adjacent tissue that is readily defined and easily outlined?

zone of transition

What refers to the border of a lesion with the normal bone?

multiple myeloma

What is a classic example of lytic black focal areas in the bone?

healing non-ossifying fibroma

What is an example of a sclerotic or blastic white focal area in the bone?

mixed

What type of lesion shows both lytic black and sclerotic white areas?

accumulation of calcium

Calcified lesions on a radiograph indicate what in specific areas?

chondrosarcoma

Which tumor is a typical example of a calcified lesion with lytic components?

expansile

What term describes a lesion that distorts the normal contour of the bone by bulging or pushing out the cortex?

non-expansile

What term describes a focal hypodense lesion that does not alter the contour of the bone?

narrow zone of transition

If a lesion is well-defined enough that its borders can be drawn with a fine-point pen, it is a what?

non-aggressive process

What does a narrow zone of transition suggest?

wide zone of transition

If the margins of a lesion are imperceptible and cannot be clearly identified, it is a what?

aggressive lesion

What does a wide zone of transition suggest?

infection and eosinophilic granuloma

What are two examples of conditions that can present with a wide zone of transition?

central

What is the term for a lesion located in the center of the bone, such as a solitary bone cyst?

eccentric

What is the term for a lesion located at the periphery of the bone, such as a giant cell tumor?

epiphysis, metaphysis, and diaphysis

What are the three main anatomic locations used to describe bone lesions?

chondroblastoma

What is a lucent lesion typically found in the greater tuberosity/epiphysis?

non-ossifying fibroma

What is a lucent lesion typically found in the distal tibia/metaphysis?

brown tumor

What is a lucent lesion typically found in the tibia/diaphysis?

eosinophilic granuloma

What is an example of a solitary lucent hypodense lesion?

multiple myeloma

What is an example of multiple smaller lucent lesions found in the calvarium?

behavior of the lesion

The terms aggressive and non-aggressive describe what, rather than just malignancy?

geographic

What pattern of bone destruction is characteristic of a non-aggressive tumor?

permeative

What pattern of bone destruction is characteristic of an aggressive tumor?

none / cortex preserved

What is the status of cortical disruption in non-aggressive tumors?

cortex is broken or not seen

What is the status of cortical disruption in aggressive tumors?

sharp and short

How is the zone of transition described for non-aggressive tumors?

indistinct and long

How is the zone of transition described for aggressive tumors?

smooth and continuous

How is the periosteal reaction described for non-aggressive tumors?

interrupted or lifted

How is the periosteal reaction described for aggressive tumors?

almost none

What is the rate of change over 10 days for a non-aggressive tumor?

marked changes

What is the rate of change over 10 days for an aggressive tumor?

periosteum

What is the thin layer in the outer portion of the bone called?

transverse, oblique, spiral, and comminuted

What are the four main types of fractures named in the sources?

complete fracture

What involves a complete interruption of the cortex in at least two views?

incomplete fracture

What is a fracture that does not have a complete interruption of the cortex?

asking laterality

Because symptoms are not always available on imaging, what is necessary for a complete report?

open fracture

What is already considered if a wound or skin interruption is directly adjacent to or on top of a fracture?

distal portion relative to the proximal portion

Displacement describes the location where which part of the bone went?

angulation

What refers to deviation introducing an angle from the zero degree long axis of a bone?

rotation

What refers to relative clockwise or counterclockwise rotation of a fragment or bone?

override

What is the displacement of the distal portion onto the more proximal portion resulting in one being on top of the other?

telescoping

What is the term for when one bone segment goes inside another segment?

shortening

What is the term for the shortening of a limb due to impaction?

comminuted

What term describes a fracture with 3 or more fragments?

it has an implication on management

A fracture is specifically called comminuted only if what?

pathologic fracture

What type of fracture occurs through a pre-existing bony abnormality like a tumor or metabolic lesion?

stress fracture

What results from repetitive forces on a normal bone that are not enough to break the entire integrity at once?

greenstick fracture

What is an incomplete, single-cortex, or bowing deformity seen in the elastic bones of children?

rolando

What is the proper name for a comminuted fracture that includes the articular surfaces?

bennett

What is the proper name for a non-comminuted fracture that includes the articular surfaces?

transcervical neck and intertrochanteric fractures

Which two femoral neck fractures are more likely to displace due to muscle group attachment?

dorsal and ventral

What are the two types of angulation mentioned for distal radius fractures?

colles fracture

What results from a fall leading to dorsal angulation of the distal radius?

smith fracture

What results from ventral or palmar angulation of the distal radius?

plastic bowing deformity

What is it called when a bone bends toward a particular direction without breaking due to malleability?

subtle sclerotic lines

What radiographic finding denotes changes in areas of repetitive stress as the bone tries to repair?

chronic process

The fact that a bone has time to deposit more calcium at a stress fracture site implies what kind of process?

anterior dislocation

In what condition does the humeral head lie medial to the glenoid and inferior to the coracoid process?

90 percent

What percentage of shoulder dislocations are anterior?