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

Page 1 / 3Dan, Bryan

Lec 10: MSK Radiology1

December 1, 2014

Lec 10: MSK Radiology RAD 250

Page 3 / 3Dan, Bryan

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

Lec 10: MSK Radiology RAD 250

Page 3 / 3Dan, Bryan

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

END OF TRANSCRIPTION