Imaging of Musculoskeletal System

Imaging Techniques

• Conventional Radiography-corner StoneZ
• Fluoroscopy; MRI is generally superior
• Computed Tomography
• Magnetic Resonance Imaging
• Ultrasound
• Angiography
• Nuclear Medicine

Where to look and what to look for

• Important Site
• Boone density, texture
• Distortions
• Displacement of normal structure

Common Fractures

• Supracondylar Fractures
• Galeazzi Fracture (Radial shaft with disruption  _distal radioulnar joint)
• Monteggia fracture (proximal or middle ulna w/ concomitant dislocation of the radial head)
• Boxer’s Fracture (4th or 5th metacarpal neck)
• Pelvic Fractures CT with IV contrast - 3D surgical plan

Ligament Tears - MRI best modality

• Menisci Ligament
• Cruciate Ligament

METABOLIC AND ENDOCRINE BONE DISORDERS

• Osteoporosis (DEXA) cortical outline of each vertebra appears accentuated.
  abnormal trabecular pattern & biconcave/compressed vertebral configuration.
• Osteomalacia - Thinning of the trabeculae and cortex., Looser’s ones (pseudo fractures)., Rickettsia in children
• Hyperparathyroidism (sub-periosteal bone, Terminal tuft erosion, Salt and pepper skull, Ruger Jersey Spine - changes due renal dystrophy)

Bone related pathologies

• Thalassemia widening of the diploë (hair on appearance)

• Sickle cell Disease

• Paget’s Disease of Bone

• Osteopetrosis (marble bone disease).

• Rheumatoid Arthritis

• Ankylosing spondylitis

• Osteoarthritis

• Gouty Arthritis

• Avascular (aseptic) necrosis

• Idiopathic avascular necrosis (Perthes disease)

• Osteomyelitis

• Bone infarction

MUSCULOSKELATAL TUMORS

• OSSEOUS:

  • Osteoma, osteoid osteoma and
  • Osteosarcoma

• CHONDRAL: flecks of calcium

  • Enchondroma ,
  • Chondrosarcoma

• FIBROUS:

  • Fibrous dysplasia ,
  • fibroma ,
  • fibrosarcoma

• SOFT TISSUE:

  • Lipoma

• Others:

  • Aneurysmal bone cyst fluid
  • giant cell tumors expansile eccentric

Further readings (Diagnostic Imaging by Andrea G. Rockall, 7th edition) - From Page 399 - 404Z Bone tumors : From Page 320 - 325Z