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1、RADIOLOGICAL ANATOMY OF THE UPPER AND THE LOWER LIMBS MODALITIES o CONVENTIONAL RADIOGRAPHY (X-RAY) o ULTRASOUND o COMPUTED TOMOGRAPHY (CT) o MAGNETIC RESONANCE IMAGING (MRI) o ANGIOGRAPHY CONVENTIONAL RADIOGRAPHY IMAGES PRODUCED THROUGH THE USE OF IONIZING RADIATION, I.E. X-RAY. INEXPENSIVE TO PROD
2、UCE, CAN BE OBTAINED ALMOST ANYWHERE USING PORTABLE MACHINES. IT IS USED AS VIRTUALLY EVERY INITIAL IMAGE OF THE SKELETAL SYSTEM. IONIZING RADIATION IN LARGE DOSES IS KNOWN TO PRODUCE CELL MUTATIONS THAT CAN LEAD TO MANY FORMS OF CANCER OR ANOMALIES. ONLY MEDICALLY NECESSARY DIAGNOSTIC EXAMINATIONS
3、SHOULD BE PERFORMED AND THAT STUDIES USING X-RAYS SHOULD BE AVOIDED DURING POTENTIALLY TERATOGENIC TIMES, SUCH AS PREGNANCY. WILHELM CONRAD R NTGEN 18451923 NOBEL PRICE IN PHYSICS 1901 THE SHOULDER THREE BONES: SCAPULA (SHOULDER BLADE) CLAVICLE (COLLAR BONE) HUMERUS (ARM BONE) THREE JOINTS: GLENOHUM
4、ERAL JOINT ACROMIOCLAVICULAR JOINT STERNOCLAVICULAR JOINT THE SHOULDER THE ARM THE ELBOW FOREARM WRIST HAND HIPS AND PELVIS SIJ STRUCTURE THE SACROILIAC JOINT IS FORMED BY THE IRREGULARLY-SHAPED AURICULAR SURFACES OF THE SACRUM AND THE ILIUM THE UPPER THIRD IS A SYNDESMOSIS. THE LOWER TWO THIRDS ARE
5、 LINED BY ARTICULAR CARTILAGE THE THIGH THE KNEE THE FOOT COMPUTED TOMOGRAPHY (CT OR CAT SCANS) o FIRST INTRODUCED IN THE 1970S. o CT SCANS, ARE THE CORNERSTONE OF CROSS-SECTIONAL IMAGING AND ARE WIDELY AVAILABLE, ALTHOUGH NOT AS YET TRULY PORTABLE. o CT SCANNERS ARE MORE EXPENSIVE TO ACQUIRE AND OP
6、ERATE THAN CONVENTIONAL RADIOGRAPHIC UNITS AND, LIKE THEM, STILL UTILIZE IONIZING RADIATION (X-RAYS) TO PRODUCE THEIR IMAGES. o FAST, RELIABLE METHOD, WIDELY USED IN TRAUMA CASES. SUPERIOR BONE RESOLUTION. o EMI (stands for ELECTRICAL AND MUSICAL INDUSTRIES), A RECORD COMPANY FOR THE BAND “BEATLES”,
7、 EMPLOYED GODFRAY HOUNSFELD, WHO WITH THE HELP OF THE FUNDING FROM BEATLES MASSIVE SUCCESSES, INVENTED THE CT AND RECEIVED A 1979 NOBEL PRIZE FOR MEDICINE. ULTRASOUND ULTRASOUND UTILIZES ACOUSTICAL ENERGY ABOVE THE AUDIBLE FREQUENCY OF HUMAN HEARING TO PRODUCE IMAGES, INSTEAD OF USING X-RAYS AS BOTH
8、 CONVENTIONAL RADIOGRAPHY AND CT SCANS DO. IT EMPLOYS A TRANSDUCER, WHICH BOTH PRODUCES THE ULTRASONIC SIGNAL AND RECORDS IT. THE SIGNAL IS PROCESSED FOR ITS CHARACTERISTICS BY AN ONBOARD COMPUTER. ULTRASOUND IMAGES ARE RECORDED DIGITALLY AND ARE EASILY STORED. ULTRASOUND SCANNERS ARE RELATIVELY INE
9、XPENSIVE COMPARED TO CT AND MRI SCANNERS. THEY ARE WIDELY AVAILABLE AND CAN BE MADE PORTABLE TO THE POINT OF BEING HANDHELD. BECAUSE ULTRASOUND UTILIZES NO IONIZING RADIATION, IT IS PARTICULARLY USEFUL IN IMAGING WOMEN OF CHILD-BEARING AGE, PREGNANT WOMEN, AND CHILDREN. ULTRASOUND IS ESPECIALLY USEF
10、UL IN IMAGING SOFT TISSUES AND FOR DELINEATING SOLID FROM CYSTIC STRUCTURES. IT IS ALSO WIDELY USED FOR IMAGE-GUIDED BIOPSIES AND IS A NONINVASIVE MEANS OF STUDYING BLOOD FLOW. ULTRASOUND IS GENERALLY CONSIDERED TO BE A VERY SAFE IMAGING MODALITY WITHOUT ANY KNOWN MAJOR SIDE EFFECTS WHEN USED AT MED
11、ICALLY DIAGNOSTIC LEVELS. Long biceps tendon MRI (MAGNETIC RESONANCE IMAGING) MRI SCANNERS ARE NOT AS WIDELY AVAILABLE AS CT SCANNERS; THEY ARE EXPENSIVE TO ACQUIRE AND REQUIRE CAREFUL SITE CONSTRUCTION TO OPERATE PROPERLY. IN GENERAL, THEY ALSO HAVE A RELATIVELY HIGH, ONGOING OPERATING COST. SCANNING TIMES ARE MUCH LONGER RELATIVELY TO THE CAT SCAN. AN AVERAGE MRI SCAN WILL TAKE 20-30 MIN (VS 2-3 MIN CAT SCAN). HOWEVER, THEY UTILIZE NO IONIZING RADIATION AND PRODUCE MUCH HIGHER CONTRAST BETWEEN DIFFERENT TYPES OF SOFT TISSUES THAN
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