Radiology for

1. BASICS OF MUSCULOSKELETAL
RADIOLOGIC IMAGING
FOR
PHYSIOTHERAPY STUDENT
dr umer radiologist

2. Objectives
• Review a systemic approach of radiologic interpretation
• Review the common orthopedic truma and MSK disease

3. Outline
• Introduction to radiology
• understand imaging modalities
• Principles of interpreting bone, joint
• Normal & abnormal bone density and soft tissue
• Joint alignment and abnormality
• Orthopedic related radiologic findings

4. Intr.
physical therapy component.
Diagnosis
Treat
Rehabilitate
Radiology
 Medical specialty that uses medical imaging to diagnose diseases and guide treatment, within
the bodies of humans and other animals.
….radiology take vital role for correct diagnosis

5. Imaging modalities include
• x ray based
Radiography(x ray)
computed tomography(CT)
mammography
fluoroscopy
• sonography (US)
• magnetic resonance imaging (MRI)

6. Plain radiography(x-ray)- baseline imaging
modality in most musculoskeletal problems.
 bones will appear white
 soft tissues will appear grey
 air/gas will appear black
Structures of high density (e.g. bones and
metal foreign bodies) will absorb (attenuate)
the X-ray
ADVANTAGE
• Quick
• Not expensive
• Relatively low radiation

7. computed tomography (CT)
 CT scan combines a series of X-ray images taken from
different angles around body and uses computer
processing to create cross-sectional images (slices) of
the bones, blood vessels and soft tissues inside body
organs.
CT
Expensive
More radiation
Often not necessary

8. Ultrasound
• Uses sound wave
• Has limited value in acute truma and ortho

9. MRI
MRI scanners use strong magnetic fields,
magnetic field gradients, and radio waves to
generate images of the organs in the body.
No value for acute trauma

10. MSK system
 includes bones, muscles, tendons,
ligaments and soft tissues.
 ligaments connecting bone to bone, and
tendons connecting muscle to bone
 Bone – axial and appendicular

15. • Bone cortex
 Outline of bone for continues –disruption on
fracture or bone tumor
 New bone formation or periosteal reaction –
infections or healing fracture
• Bone texture


18. soft tissue changes
Fat replacement of the muscle
muscle degeneration
muscular atrophy
Unilateral lower limb atrophy associated with glomus tumors

19. Normal x-ray appearance
and anatomy

33. 33

34. Orthopedic trauma imaging

35. • Fractures are either complete or incomplete
depending of the continuity of cortex
• According to the cause
• Acute traumatic
• Stress
• Pathologic #

36. 36

37. Stress fractures.
This type of fractures are a tiny cracks in the
bone (micro fractures) that develop gradually
overtime usually overuse ,repetitive activities
that reduce time of healing
Common location
• Sesamoid bone
• MT Head and shaft
CF
 pain, tenderness, swelling ,redness
Rx
 Early –radiolucent inter-cortices striation
 Late- endostea thickening

44. Skeletal deformity
• Incidence is around 1:1000 live births
• The 3 cardinal abnormalities are adducted
fore foot inversion of the foot plantar flexion
of the foot
Club foot deformity

45. • Radiologically medial displacement of the
navicular and the cuboid in relation to the
heads of the talus and calcaneus will be seen
• Calcaneus will rotate medially under the talus
• Plantar flexion will be seen by posterior
displacement of the calcaneus

46. thanks