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Radiologic Review of Common <= b>Musculoskeletal Disorders
Jeanne Cavalier= i, MPAS, RPAC
Clinical Assist= ant Professor
Department of PA Education
Stony Brook University
3Daboutus
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Diagnostic Imaging in Musculoskeletal Disorders
nConventional, “plain” xray
–= Used in almost all circumstances = for the initial evaluation of musculoskeletal complaints
nCT
<= span style=3D'font-family:"Times New Roman"'>–Aids in the further evaluation of:
<= span style=3D'font-family:"Times New Roman"'>•complex fractures
•= certain fractures (glenoid, acetabular, tibial plateau, calcaneal or other complex fractures)
<= span style=3D'font-family:"Times New Roman"'>•bone tumors
<= span style=3D'font-family:"Times New Roman"'>•vertebral column
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nMRI
–= Occult fractures – see marrow edema
–= Assists in the investigation of:&= #13;
•= spinal column (discs, ligaments, cord)
•= osteomyelitis <= /div>
•= bone tumors
•= soft tissue masses
–= Used to evaluate joints, ligament= s, menisci
–
–
•
–
Diagnostic Imaging in Musculoskeletal Disorders
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Diagnostic Imaging in Musculoskeletal Disorders
nBone Scan
–= Used for detecting areas of abnor= mal metabolic activity within bone (infection, inflammation, metastatic disease, areas of  rapid turnover of bone)
<= span style=3D'font-family:"Times New Roman"'>–Sensitive, but not specific
<= span style=3D'font-family:"Times New Roman"'>–Allows for screening of entire skeleton
– <= /span>
nUltrasound
–= Assessment of soft tissue lesions, abscesses & masses, joint effusions, congenital hip dislocation in infants
n<= span style=3D'font-family:"Times New Roman";mso-ascii-font-family:"Times New Ro= man"; mso-hansi-font-family:"Times New Roman";display:none'> <= /div>
<= span style=3D'font-family:"Times New Roman";visibility:hidden'>–= <= /div>
<= span style=3D'font-family:"Times New Roman";visibility:hidden'>–= <= /div>
<= span style=3D'font-family:"Times New Roman";visibility:hidden'>–=
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Imag= ing Studies of Choice
nTrauma/fracture (fx)
nOccult hip fx
nOccult knee fx
nStress fx
nMetastatic disease
nOsteomyelitis
nInternal derangemen= t of k= nee
nLow back pain
n
n <= /div>
aPlain x-ray
aMRI
aMRI
aMRI/bone scan
aPlain x-ray/bone scan
aPlain x-ray/MRI/bone scan
aMRI
a
aDepends!
n <= /div>
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Interpreting Musculoskeletal Radiographs
nAlways get at least= 2 views: AP, lateral
nAlways check patient ID
nMake sure marked correctly (R or L)
nAssess film quality
nMake sure all structures are on film
nLook at entire film!!
nCompare with old films
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Syst= ematic Approach - ABCs
nAdequacy/Anatomy/Alignment
nBone
nCartilage/joint
nSoft tissues
nCompare sides
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3Dbone 3DHumeruspathfxprior
Bone Anatomy
3D"Radiograph:
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