TOPIC OUTLINEI. RadiologyII. Musculoskeletal SystemIII. Radiologic Modalities
I. RADIOLOGY
Multimodality imaging specialty Logarithmic development Often diagnostic, sometimes therapeutic Can be categorized into diagnostic radiology, interventional
radiology, or radiotherapy
II. MUSCULOSKELETAL SYSTEM
A. FUNCTION
Ambulation Protection of Vital Organs Hematopoeisis Calcium and Phosphate Metabolism
B. EMBRYOLOGY
Intramembranous ossification Enchondral ossification Mixed type of ossification
C. HISTOLOGY
Cellso Osteoprogenitor cellso Osteoblastso Osteoclastso Osteocytes
Bony matrixo Organic – collageno Inorganic – calcium and phosphates
D. PARTS OF A LONG BONE
Epiphysis Epiphyseal Plate Metaphysis Diaphysis Apophysis
Figure 1. R tibia & fibula
III. DIFFERENT RADIOLOGIC MODALITIES USED IN MUSCULOSKELETAL IMAGING
Plain radiographs Skeletal scintigraphy Ultrasound CT scan MRI
A. PLAIN RADIOGRAPHS
Uses x-rays to produce images Often the initial modality requested Sometimes the imaging modality of choice
Figure 2. X-ray machines
Figure 3. Lower ex polydactyly
Figure 4. Injuries
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Figure 5. Various pathologiesB. SKELETAL SCINTIGRAPHY
Bone-seeking radionuclides taken up in areas of increase bone turnover
Normal growth plate of children Tumors, infections, and fractures More sensitive but less specific than radiograph Correlation with clinical findings and other imaging modalities
Figure 6. Skeletal scintigraphyC. ULTRASOUND
Use of high frequency sound waves to produce images Application limited by poor penetration of sound waves through bone Pediatric patients - joint effusion and subperiosteal fluid collections Adults – Cellulitis, soft tissue abscesses, ligament and tendon tears
Figure 7. UTZ
Figure 8. R supraspinatus
Figure 9. R biceps
D. CT SCAN
Uses x-rays to produce images
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Visualization not only of bone but adjacent soft tissues and marrow in medullary cavity
Allows multiplanar imaging More superior than MRI in evaluation of cortical bone Bone and soft tissue windows Inject contrast material to visualize vascular structures
Figure 10. CT scan
Figure 11. CT scan findingsE. MAGNETIC RESONANCE IMAGING
Uses electromagnetic radiation to produce images Imaging modality of choice in the study of the soft tissues and bone
marrow Not as sensitive as CT scan for evaluation of cortical bone Multiplanar imaging Does not require contrast media to visualize vascular structures
Figure 12. MRI
Figure 13. X-ray vs MRI; R knee
Figure 14. CT scan vs MRI; spine
Figure 15. CT scan vs MRI; vertebra
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