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USAHS Imaging Questions and Answers 100% Pass

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USAHS Imaging Questions and Answers 100% Pass When something is ______________ it appears to be black because the X-rays are able to pass through with little resistance. Radiolucent When something is ___________ it appears to be white/light grey because the X-rays are blocked. Radiodense When something is _____________ it appears white because no X-rays can pass through. Examples include metals/ injected dyes. Radio-opaque What is more radio-dense cortical bone or cancellous bone? Cortical What is more radio-dense bone or muscle? Bone What is more radio-dense muscle or fat? Muscle What is more radio-dense water or fat? Water Short exposure time and low milliamperes on an X-ray _______________ radiodensity. Increase Standard distances from the X-ray tube for the best quality are ____ inches for skeletal and ____ inches for the chest. 40, 72 ______ is the modality of choice for viewing bone, the best for evaluating loose bodies and subtle/complex fractures. Also the best for the evaluation of spinal degeneration. CT ______ does not use radiation. This is the superior method for soft tissue detail and certain bone pathologies. MRI How does MRI produce images? From the emission of energy from the protons in the body (NOT from the absorption of X-rays) T1 imaging signal is caught ______ emphasizing fat. Early T2 imaging signal is caught ______ emphasizing fluid. Late In a T1 MRI the ______ is bright Fat (in T2 the fluid is bright) How can you use the cortex of a bone to determine if it is a CT scan or MRI? If they cortex of the bone is bright it is a CT scan What is the difference between T1 and T2 weighted images? Time to echo (TE) and time to repetition (TR) On an MRI cortical bone has a very _____ signal T1 & T2. Low On an MRI red bone marrow has an ____________ signal on T1. Intermediate On an MRI yellow bone marrow has a _________ signal intensity on T1. High On an MRI bone marrow comes out _______ on T2. Dark On an MRI muscles have an ___________ signal intensity on both T1 and T2; slightly darker on T2. Intermediate On an MRI tendons/ligs/menisci will have a ______ signal on T1 and T2 if healthy. Low On an MRI cartilage has an ___________ signal on T1 and T2. Intermediate A T1 weighted image is made by employing a short TE and TR, fat releases energy _______ than water therefore fat appears white. Faster In both T1 and T2 dense structures such as cortical bones, tendons, and ligaments appear _________. Dark In regards to ultrasound, hyperechoic tissues appear _______ than surrounding tissues. Brighter In regards to ultrasound, hypoechoic tissues appear ______ ______ than the surrounding tissues. Less bright In regards to ultrasound, anechoid tissues appear _______ because there is so signal. Black (bone > lig > tendon > nerve > fat > muscles > water) Ultrasound is best for _________ and _________. Ligaments and tendons (dynamic imagining is a plus as well) In regards to ultrasound the higher the frequency the ________ the image. Better Explain curvilinear transducers. Used for abdomen and pelvis, images are angled because the beam diverges, this divergence causes the deepest structures are seen as proportionally larger Osteophytes, sclerosis, subchondrial cysts, joint space narrowing, effusion, erosions, deformities, fusion, bone marrow edema. One joint inflamed = _____________ Infection Two joints inflamed is ___________ _____________ Inflammatory arthritis Proximal joints of hand, no bony proliferation, and more than one joint involved is _____________ ____________. Rheumatoid arthritis Distal joints of hand, bony proliferation, and greater than one joint involved is what? Seronegative spondyloarthropathy _____________ narrowing = osteophytes and sclerosis Asymmetric Neuropathic hemophilia is linked to ___________ ____________. Atypical arthritis Osteophytes are one of the hallmarks of OA, what causes them? Forces pulling on bone, capsular/lig. Attachments also at direct bony contacts _________ is increased bone density adjacent to joint surfaces. Sclerosis (due to loss of cartilage) ____________ __________ are more common in OA than RA, due to increased fluid pressure, fissuring of cartilage. Subchondral cysts Uniform joint space narrowing in __________ arthritis. RA Effusion is a hallmark of ____________ arthritis. Inflammatory (synovial hypertrophy is associated with synovitis; proliferation of pannus destroys cartilage. Trophi specific to gout. Erosions are a sign of inflammatory arthritis due to ________ _____________. Synovial proliferation (RA) or crystal deposits, other causes are post trauma and chronic overload True or false: Deformities are a hallmark of inflammatory arthritis and late stage OA. True Joint surface/ margin changes OA and RA? OA- heberdens RA- psoriatic arthritis (pencil in cup) __________ is the end product of many forms initially fibrous and results in ossesous formations. Fusion __________ __________ ___________ happens in all forms of arthritis and can explain sx and guide POC. Bone marrow edema (seen as increased density on radiograph, best diagnosed with MRI) areas of increased signal intensity on T2 and decreased on T1 80% of all arthritis is _____. OA Osteophytes = _____, erosions = ______. Osteo= OA Erosions= ra true or false: RA erosions are NOT the result of joint loading or articular stresses. True (found in joint areas not covered by cartilage and the product of pannus formation _______ appear as radiolucent circles deep to articular surfaces. Cysts What are Greenspan's 7? Site and extent of fracture (open or closed) Complete or incomplete Relationship of fragments Direction of the fracture line Special features (impaction, avulsion) Associated abnormalities (joint dislocations) Special types (stress, pathological) In regards to relationship of fragments the __________ is the degree of opposition at osseous ends. Abnormal = displacement. Position In regards to relationship of fragments the _____________ is the angular relationship; one fragment relative to another; the distal end relative to the proximal. Abnormal = deviation. Alignment Examples of pathologies that weaken bones? Tumors, osteoporosis, Paget's disease, infections ___________ fractures typically occur in patients with a history of activity induced symptoms, a standard radiograph initially shows as normal. MRI shows abnormality much sooner (band low signal on T1 or T2; or high T2 signal) Stress Type 1 epiphyseal fracture Through the physis (good prognosis; hard to see) Type 2 epiphyseal fracture Involves the physis and the metaphysis (most common) Type 3 epiphyseal fracture Physis and epiphysis (may be possible to experience partial growth arrest) Type 4 epiphyseal fracture physis, metaphysis, and epiphysis (may be possible to experience partial growth arrest) Type 5 epiphyseal fracture Crushed physis (easily missed; arrested growth may be the first sign)

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