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Bone
Joint
Soft tissues
Radiograph
MR
CT
Advantages and disadvantages
in
Musculoskeletal 、 Soft tissues
Plain X-ray film
Rich experiences
Best resolution in bone
Economic
Two dimension
Overlap
Limitation in soft tissues
CT
Good axis view
Irregular bone
Good density resolution
Good 3-D reconstruction imaging
Radiation
Limitation in joint
MR
High sensitivity
Multi-plane
Good resolution (soft tissues 、 joint
)
Functional imaging (diffusion)
Calcification
Osteoperiosteal reaction
ECT
Skeleton
Function (metabolic 、 physiological)
AP
lateral
CT MR
Summary B
Experiences : Plain>CT>ECT>MR
Sensitivity : MR>ECT>CT>Plain
Skeleton : MR=ECT>CT and plain
Fracture : plain—CT—MR
Shortness : MR<CT 、 ECT<plain
IMAGING
OF
BONE
Imaging of bone
Growth plate
diaphysis
Anatomic terms (normal sign)
Metaphysis
Cartilagenous
Epiphysis Epiphyseal plate
Cartilagenous
Epiphyseal plate
Epiphysis
Diaphysis
6ys Metaphysis
Growth plate
Joint space
diaphysis
End of bone
18ys
3m
3ys
6ys
10ys
Bone
maturation
13ys
18ys
Imaging of bone
lesion
Increase in bone density
Basic pathological changes
All kinds of lesions in bone
Sclerotic lesion / new bone
Localized / Diffused / Generalized
Change of density or signal
represent
bone destruction
Signs of bone diseases
Decrease in bone density or signal
Increase in bone density or signal
Periosteal reaction
Alteration in structure or shape
Alteration in bone age
Periosteal reaction
Periosteum -- invisible
Reaction to pathology
Several patterns
Not specific
Periosteal reaction
Periosteum -- invisible
Reaction to pathology
Several patterns
Not specific
Excess bone
Periosteal reaction
Lamellar
Periosteal reaction
Codman’s triangle
Signs of bone diseases
Decrease in bone density or signal
Increase in bone density or signal
Periosteal reaction
Alteration in structure or shape
Alteration in bone age
Alteration in structure or shape
congenital
Alteration in structure or shape
exostoses
Alteration in structure or shape
Alteration in structure or shape
Signs of bone diseases
Decrease in bone density or signal
Increase in bone density or signal
Periosteal reaction
Alteration in structure or shape
Alteration in bone age
Alteration in bone age.
Bone age
epiphyseal centers
fusion
indication of maturation.
Measurement
hand / wrist
Alteration in bone age
Carpal bones
Commonly Encountered
Bone Diseases
Tumor
Infection -- Osteomyelitis
Metabolic
Bone tumor
Benign
Malignant
Solitary
Multiple
Benign bone tumor
Fibrous dysplasia
Osteoid osteoma
En/Chondroma
Osteochondroma
Cyst
Giant cell tumor
Sclerotic
metastasis
Metastasis
Nasopharyngeal Cancer
Myeloma
Solitary (plasmacytoma)
Lytic bone destruction (metastasis)
Diffuse (osteoporosis)
Better defined deposit
Increased activity on radionuclide
Metaphyses widened/cupped
Plate widen
Deformities
Greenstick fracture
looser zone
Rickets and osteomalacia
Poor mineralization of osteoid
Acromegaly
Overgrowth of articular cartilage
Adolescence – Gigantism
Adult –acromegaly