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MRI Alignment
Disruption of bone, ligament, tendon, nerve
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MRI Bone signal
Bone bruise
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MRI eDema
inflammation of bone or soft tissue (tendinopathy)
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MRI soft tissue
disorders of synovium, fat pad, bursa, tendinopathy
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MRI advantages
- 1. multiple planes
- 2. no known health hazards
- 3. Good contrast for inflammation
- 4. Good for soft tissue
- 5. Good for neurologic tissue
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MRI disadvantages
- 1. Expensive
- 2. claustrophobic
- 3. limited availability
- 4. bad for bone trauma compared to CT
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MRI contraindications
- 1. pacemaker
- 2. Iron intracranial clip
- 3. non iron metal cause distortion
- 4. cochlear implant
- 5. large tattoos
- 6. 1st trimester
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MRI red flags
- 1. incontinence
- 2. pain below knee
- 3. constitutional symptoms
- 4. major trauma
- 5. Hx of CA
- 6. unrelenting agony
- 7. pain worse at night
- 8. pain > 6 wks age <18 or >50
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What can a CT myelogram dx?
- Excellent pre-op
- SC compression
- NR injury
- Stenosis
- Ruptured disc
- Intervertebral tumor
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Common causes for stenosis
- 1. disc lesion
- 2. spondylolisthesis
- 3. osteophyte
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CT advantages
- 1. Good for anatomy and pathology cross section (fx, stenosis, loose body, arthritis)
- 2. less time
- 3. less expensive
- 4. less claustrophobic
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CT disadvantages
- 1. radiation
- 2. bad for soft tissue
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CT search patterns
- A: Alignment
- B: Bone density
- C: cartilage, canal space
- S: soft tissue
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CT alignment
- 1. Congenital deformity
- 2. Fx
- 3. Spur
- 4. Sublux/dislocations
- 5. Supernumerary or absent bones
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