tailieunhanh - Ebook Imaging for students (4/E): Part 2

Part 2 book “Imaging for students” has contents: Musculoskeletal system, spine, central nervous system, head and neck, endocrine system, paediatrics, imaging in oncology. Invite reference. | 8 Musculoskeletal system Imaging investigation of the musculoskeletal system 147 How to look at a skeletal radiograph 148 Fractures and dislocations: general principles 150 Fractures and dislocations: specific areas 157 IMAGING INVESTIGATION OF THE MUSCULOSKELETAL SYSTEM Radiographs Radiographs are indicated in all fractures and dislocations. Radiographs are often sufficient for diagnosis in general bone conditions such as Paget’s disease. Most bone tumours and other focal bone lesions are characterized by clinical history and plain radiographs. MRI and CT are used for staging or to assess specific complications of these lesions, but usually add little to the diagnostic specificity of radiographs. A major limitation of radiography is insensitivity for early bony changes in conditions such as osteomyelitis and stress fractures. CT Multidetector CT is used for further delineation of complex fractures. Common indications include depressed fracture of the tibial plateau, comminuted fracture of the calcaneus, and fractures involving articular surfaces. CT may also be used to diagnose complications of fractures such as nonunion. CT may assist in staging bone tumours by demonstrating specific features, such as soft tissue extension and cortical destruction. Scintigraphy Bone scintigraphy, commonly known as ‘bone scan’, is performed with diphosphonate-based radiopharmaceuticals such as 99mTc-MDP. Bone scintigraphy is highly sensitive and therefore able to Internal joint derangement: methods of investigation Approach to arthropathies Approach to primary bone tumours Miscellaneous common bone conditions 173 176 179 181 demonstrate pathologies such as subtle undisplaced fractures, stress fractures and osteomyelitis prior to radiographic changes becoming apparent. Scintigraphy is also able to image the entire skeleton and is therefore the investigation of choice for screening for skeletal metastases and other .