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Lec 10: MSK Radiology

1
December 1,
2014

TOPIC OUTLINE
I. Radiology
II. Musculoskeletal System
III. 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

Cells
o Osteoprogenitor cells
o Osteoblasts
o Osteoclasts
o Osteocytes
Bony matrix
o Organic collagen
o Inorganic calcium and phosphates
D. PARTS OF A LONG BONE

Figure 2. X-ray machines

Figure 3. Lower ex polydactyly

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

Dan, Bryan

Figure 4. Injuries

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Lec 10: MSK Radiology

RAD 250

Figure 6. Skeletal scintigraphy


C. 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 5. Various pathologies


B. 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

Dan, Bryan

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Lec 10: MSK Radiology

RAD 250

Figure 9. R biceps

D. CT SCAN

Figure 12. MRI

Uses x-rays to produce images


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 13. X-ray vs MRI; R knee

Figure 10. CT scan

Figure 14. CT scan vs MRI; spine

Figure 15. CT scan vs MRI; vertebra


END OF TRANSCRIPTION

Figure 11. CT scan findings


E. 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

Dan, Bryan

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