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• Cover
• Title Page
• Copyright Page
• Foreword
• Preface
• Contributors
• Reviewers
• Acknowledgments
• Contents in Brief
• Table of Contents
• Chapter 1 General Principles of Musculoskeletal Imaging
• Why Study Imaging?
• What Is Radiology?
• What Is Musculoskeletal Imaging?
• Historical Perspective
• Turn-of-the-Century Sensationalism
• The 1910s and 1920s
• The 1930s and 1940s
• The 1950s and 1960s
• The 1970s and 1980s
• The 1990s and into the 21st Century
• Essential Science
• What Is a Radiograph?
• What Is Radiation?
• What Are X-rays?
• Image Receptors: Different Ways to Capture the X-Rays
• The Gold Standard: Film/Screen Radiography
• Fluoroscopy
• Computed Radiography
• Digital Radiography
• Understanding the Image
• What Is Radiodensity?
• Radiodensity as a Function of Composition: Anatomy in Four Shades of Gray
• Radiodensity as a Function of Thickness
• How Many Dimensions Can You See?
• Radiodensity in a Rose
• More to the Radiograph
• Radiographic Terminology
• Anteroposterior, Lateral, and Oblique Projections
• Viewing Radiographs
• Identification Markers
• Image Quality Factors
• The Routine Radiographic Examination
• The Radiologist as the Imaging Specialist
• Other Common Studies in Musculoskeletal Imaging
• Contrast-Enhanced Radiographs
• Conventional Tomography
• Computed Tomography
• Nuclear Imaging
• Magnetic Resonance Imaging
• Ultrasonography
• Interventional Techniques
• Epidural Steroid Injections
• Spinal Nerve Blocks
• Radiofrequency Ablation
• Diskography
• Percutaneous Needle Biopsy of the Spine
• Percutaneous Vertebroplasty, Kyphoplasty, and Cementoplasty
• Automated Percutaneous Lumbar Diskectomy
• Intradiscal Electrothermal Therapy
• The Imaging Chain
• Summary of Key Points
• Self-Test
• Chapter 2 Radiologic Evaluation, Search Patterns, and Diagnosis
• Where Does Radiologic Image Interpretation Begin?
• What Are the Pitfalls of Image Interpretation?
• What Can the Nonradiologist Offer to Image Interpretation?
• Search Pattern: The ABCS of Radiologic Analysis
• A: Alignment
• B: Bone Density
• C: Cartilage Spaces
• S: Soft Tissues
• Radiologic Diagnosis of Skeletal Pathology
• Categories of Skeletal Pathology
• Distribution of the Lesion
• Predictor Variables
• Radiologic Characteristics of Common Pathologies
• Adult Rheumatoid Arthritis
• Osteoarthritis (Degenerative Joint Disease)
• Osteoporosis
• Musculoskeletal Infections
• Bone Tumors
• The Radiologic Report
• Heading
• Clinical Information
• Findings
• Conclusions
• Recommendations
• Signature
• Radiologic Report Example
• Summary of Key Points
• Self-Test
• Chapter 3 Radiologic Evaluation of Fracture
• Trauma, the Most Common Disorder
• Trauma Radiology
• What Is a Fracture?
• Biomechanics of Bone
• Definition of Fracture
• Elements of Fracture Description
• Anatomic Site and Extent of the Fracture
• Type of Fracture: Complete or Incomplete
• Alignment of Fracture Fragments
• Direction of Fracture Lines
• Presence of Special Features
• Associated Abnormalities
• Fractures Caused by Abnormal Stresses or Pathological Processes
• Fractures in Children
• Location Description
• Difficulties in Assessment of Immature Bone
• Elements of Fracture Description
• Healing Factors
• Reduction and Fixation of Fractures
• Reduction
• Fixation
• Fracture Healing
• Cortical Bone Healing
• Cancellous Bone Healing
• Surgically Compressed Bone Healing
• Radiologic Evaluation of Healing
• Time Frame for Fracture Healing
• Factors That Influence Rate of Fracture Healing
• Radiologic Examination Intervals During Fracture Healing
• Complications in Fracture Healing
• Complications at Fracture Site
• Late-Effect Complications of Fracture
• Associated Complications in Other Tissues
• Life-Threatening Complications
• Commonly Missed Fractures
• Why Are Fractures Missed on Radiographs?
• Which Fractures Are Missed?
• Summary of Key Points
• Case Study
• Self-Test
• Appendix: Fracture Eponyms
• Chapter 4 Computed Tomography
• Computed Tomography
• History
• Principles of CT
• Elements of a CT Scanner
• Making the CT Image
• Different Forms of CT
• Three-Dimensional CT
• CT Myelogram
• Cone Beam CT
• Viewing CT Images
• Radiodensities
• The Image
• Viewing the Patient’s Images
• Selective Imaging—Windowing
• Quality of the Image
• Clinical Uses of CT
• What Does CT Image Best?
• What Are the Limitations of CT?
• Summary and Future Developments
• Neuroimaging
• History
• CT Versus MRI
• CT and MRI Characteristics of the Brain
• CT Exam: Six Brain Images
• Common Cerebral Pathological Conditions
• Summary of Key Points
• Self-Test
• Chapter 5 Magnetic Resonance Imaging
• Magnetic Resonance Imaging
• History
• Principles of MRI
• Image Information and Protocols
• Sequences
• Making the Magnetic Resonance Image
• The Elements of an MRI Scanner
• Viewing Magnetic Resonance Images
• Imaging Characteristics of Different Tissues
• Image Quality
• Clinical Uses of MRI
• What Does MRI Image Best?
• What Are the Limitations of MRI?
• Use of Contrasts
• Magnetic Resonance Arthrography
• Magnetic Resonance Myelography
• Comparison of MRI and CT
• Clinical Thinking Points
• Clinical Thinking Point 1: Bone Bruise—The Footprint of Injury
• Clinical Thinking Point 2: Magnetic Resonance Imaging of Stress Fractures
• Summary and Future Developments
• Summary of Key Points
• Self-Test
• Chapter 6 Ultrasound Imaging
• Ultrasound Imaging
• History
• Ultrasound in Rehabilitation
• Principles of Diagnostic Ultrasound
• Diagnostic Ultrasound Equipment
• The Pulser
• The Ultrasound Transducer
• The Scan Converter and Monitor
• Ultrasound Physics
• Production
• Reception
• The Ultrasound Beam
• Interaction Between Ultrasound and Tissues
• Absorption
• Reflection
• Refraction
• Scattering
• Doppler Ultrasound
• Power Doppler
• The Ultrasound Image
• Applying the Transducer
• Information Used to Create the Image
• Viewing the Ultrasound Image
• The Quality of the Image
• Artifacts
• Clinical Uses of Ultrasound
• General Advantages
• Imaging Characteristics—Comparison with MRI
• What Are the Limitations of Ultrasound?
• Future Developments
• Clinical Thinking Point—Musculoskeletal Ultrasound for the Nonradiologist
• Summary of Key Points
• Self-Test
• Chapter 7 Radiologic Evaluation of the Cervical Spine
• Review of Anatomy
• Osseous Anatomy
• Ligamentous Anatomy
• Joint Mobility
• Growth and Development
• Postural Development
• Routine Radiologic Evaluation
• Practice Parameters for Spine Radiography in Children and Adults
• Basic Projections and Radiologic Observations
• Advanced Imaging Evaluation
• Introduction to Interpreting Sectional Anatomy of CT/MRI
• Practice Parameters for Computed Tomography of the Spine
• Basic CT Protocol
• Practice Parameters for Magnetic Resonance Imaging of the Spine
• Basic MRI Protocol
• Trauma at the Cervical Spine
• Diagnostic Imaging for Trauma of the Cervical Spine
• Potential Injury to the Spinal Cord and Spinal Nerves
• SCIWORA Syndrome
• Fractures
• Dislocations
• Cervical Spine Sprains
• Intervertebral Disk Herniations
• Degenerative Diseases of the Cervical Spine
• Degenerative Disk Disease
• Degenerative Joint Disease
• Foraminal Encroachment
• Cervical Spine Spondylosis
• Spondylosis Deformans
• Diffuse Idiopathic Skeletal Hyperostosis
• Clinical Considerations of the Degenerative Spine
• Cervical Spine Anomalies
• Summary of Key Points
• Case Studies
• Self-Test
• Chapter 8 Radiologic Evaluation of the Temporomandibular Joint
• Historical Perspective
• Causes of Temporomandibular Joint Disorders
• Review of Anatomy
• Osseous Anatomy
• Articular Disk
• Ligamentous Anatomy
• Biomechanics of the Temporomandibular Joint
• Growth and Development
• Imaging in the Evaluation of the Temporomandibular Joint
• Conventional Radiographs
• Computed Tomography
• Magnetic Resonance Imaging
• Ultrasound
• Pathological Conditions of the Temporomandibular Joint
• Osteoarthritis
• Rheumatoid Arthritis
• Disk Displacement
• Etiology
• Clinical Presentation
• Classification
• Grading Displacements
• Radiologic Findings
• MRI of Disk Displacements
• Treatment of Disk Displacement
• Other Disorders and Findings
• Temporomandibular Joint Hypermobility
• Disk Adhesion
• Fractures
• Craniomandibular Anomalies
• The Temporomandibular Joint and the Cervical Spine
• Positional Faults of the Cervical Spine
• Positional Faults in the Coronal Plane
• Acknowledgment
• Summary of Key Points
• Case Study
• Self-Test
• Chapter 9 Radiologic Evaluation of the Thoracic Spine, Sternum, and Ribs
• Review of Anatomy
• Osseous Anatomy
• Ligamentous Anatomy
• Joint Mobility
• Growth and Development
• Spinal Cord Anatomy
• Routine Radiologic Evaluation
• Practice Parameters for Spine Radiography in Children and Adults
• Standard Projections and Radiologic Observations
• Advanced Imaging Evaluation
• Introduction to Interpreting Sectional Anatomy of CT/MRI
• Practice Parameters for Computed Tomography of the Spine
• Basic CT Protocol
• Practice Parameters for Magnetic Resonance Imaging of the Spine
• Basic MRI Protocol
• Trauma at the Thoracic Spine
• Diagnostic Imaging for Trauma of the Thoracic Spine
• The Three-Column Concept of Spinal Stability
• One- or Two-Column Injuries
• Two- or Three-Column Injuries
• Fractures of the Bony Thorax
• Abnormal Conditions (Non-traumatic)
• Osteoporosis
• Scoliosis
• Tuberculous Osteomyelitis (Pott’s Disease)
• Scheuermann’s Disease
• Vertebral, Rib, and Sternal Anomalies
• Summary of Key Points
• Case Studies
• Self-Test
• Chapter 10  The Chest Radiograph and Cardiopulmonary Imaging
• Where Does Cardiopulmonary Imaging Begin?
• Radiographic Anatomy
• Bony Thorax
• Respiratory Organs
• The Heart
• The Mediastinum
• The Hilum
• The Diaphragm
• Routine Radiologic Evaluation
• Practice Parameters for the Performance of Pediatric and Adult Chest Radiography
• Basic Projections and Radiologic Observations
• Pathology
• Imaging Choices in Cardiopulmonary Assessment
• Diagnostic Categories
• The Lung Field Is Abnormally White
• The Lung Field Is Abnormally Black
• The Mediastinum Is Abnormally Wide
• The Heart Is Abnormally Shaped
• Advanced Imaging
• Ultrasound of the Heart: Echocardiography
• Ultrasound of the Thorax
• Nuclear Medicine
• Conventional Angiography
• Computed Tomography Pulmonary Angiography
• Magnetic Resonance Angiography
• Summary of Key Points
• Case Study
• Self-Test
• Chapter 11  Radiologic Evaluation of the Lumbosacral Spine and Sacroiliac Joints
• Review of Anatomy
• Osseous Anatomy
• Ligamentous Anatomy
• Joint Mobility
• Growth and Development
• Routine Radiologic Evaluation
• Practice Parameters for Lumbar Spine Radiography in Children and Adults
• Standard Projections and Radiologic Observations
• Advanced Imaging Evaluation
• Introduction to Interpreting Sectional Anatomy
• Practice Parameters for Computed Tomography of the Spine
• Basic CT Protocol
• Practice Parameters for Magnetic Resonance Imaging of the Spine
• Basic MRI Protocol
• Trauma at the Lumbar Spine
• Diagnostic Imaging for Trauma of the Lumbar Spine
• Fractures of the Lumbar Spine
• Spondylolysis
• Spondylolisthesis
• Degenerative Conditions at the Lumbar Spine
• Clinical Considerations of the Degenerative Spine
• Lumbar Stenosis
• Intervertebral Disk Herniations
• Sacroiliac Joint Pathology
• Ligamentous Injury
• Degenerative Joint Disease
• Sacroiliitis
• Ankylosing Spondylitis
• Lumbosacral Anomalies
• Facet Tropism
• Aberrant Transitional Vertebrae
• Spina Bifida
• Summary of Key Points
• Case Studies
• Self-Test
• Chapter 12  Radiologic Evaluation of the Pelvis and Hip
• Review of Anatomy
• Osseous Anatomy
• Ligamentous Anatomy
• Joint Mobility
• Growth and Development
• Routine Radiologic Evaluation
• Practice Parameter for Extremity Radiography in Children and Adults
• Standard Projections and Radiologic Observations
• Additional Views Related to the Hip
• Advanced Imaging Evaluation
• Introduction to Interpreting Hip Sectional Anatomy
• Practice Parameter for CT of the Hip
• Basic CT Protocol
• Practice Parameter for Magnetic Resonance Imaging of the Hip
• Basic MRI Protocol
• Trauma at the Pelvis and Hip
• Diagnostic Imaging for Trauma of the Pelvis and Hip
• Fractures of the Pelvis
• Fractures of the Acetabulum
• Fractures of the Proximal Femur
• Hip Dislocation
• Pathological Conditions at the Hip
• Degenerative Joint Disease of the Hip
• Rheumatoid Arthritis of the Hip
• Avascular Necrosis of the Proximal Femur
• Slipped Capital Femoral Epiphysis
• Developmental Dysplasia of the Hip
• Femoroacetabular Impingement With Labral Pathology
• Summary of Key Points
• Case Studies
• Self-Test
• Chapter 13  Radiologic Evaluation of the Knee
• Review of Anatomy
• Osseous Anatomy
• Ligamentous Anatomy
• Joint Mobility
• Growth and Development
• Routine Radiologic Evaluation
• Practice Parameter for Knee Radiography in Children and Adults
• Standard Projections and Radiologic Observations
• Additional Views Related to the Knee
• Advanced Imaging Evaluation
• Introduction to Interpreting Knee Sectional Anatomy
• Practice Parameter for CT of the Knee
• Basic CT Protocol
• Practice Parameter for Magnetic Resonance Imaging of the Knee
• Basic MRI Protocol
• Trauma at the Knee
• Diagnostic Imaging for Trauma of the Knee
• Fractures
• Patellofemoral Subluxations
• Injury to the Articular Cartilage
• Meniscal Tears
• Injury to the Ligaments
• Degenerative Joint Disease
• Radiologic Evaluation
• Location of Degenerative Joint Disease
• Treatment
• Knee Anomalies
• Genu Valgum
• Genu Varum
• Genu Recurvatum
• Summary of Key Points
• Case Studies
• Self-Test
• Chapter 14  Radiologic Evaluation of the Ankle and Foot
• Review of Anatomy
• Osseous Anatomy
• Ligamentous Anatomy
• Routine Radiologic Evaluation
• Practice Parameter for Ankle and Foot Radiography in Children and Adults
• Standard Projections and Radiologic Observations
• Advanced Imaging Evaluation
• Introduction to Interpreting Ankle and Foot Sectional Anatomy
• Practice Parameter for CT of the Ankle and Foot
• Basic CT Protocol
• Practice Parameter for Magnetic Resonance Imaging of the Ankle and Hindfoot
• Basic MRI Protocol
• Trauma at the Ankle and Foot
• Diagnostic Imaging for Trauma of the Ankle and Foot
• Sprains at the Ankle
• Tendon Pathology
• Fractures at the Ankle
• Fractures of the Foot
• Deformities of the Foot
• Radiologic Evaluation
• Hallux Valgus
• Pes Cavus
• Pes Planus
• Talipes Equinovarus
• Foot Anomalies
• Accessory Bones
• Summary of Key Points
• Case Studies
• Self-Test
• Chapter 15  Radiologic Evaluation of the Shoulder
• Review of Anatomy
• Osseous Anatomy
• Ligamentous Anatomy
• Joint Mobility
• Growth and Development
• Routine Radiologic Evaluation
• Practice Parameters for Radiography of the Shoulder in Children and Adults
• Standard Projections and Radiologic Observations
• Advanced Imaging Evaluation
• Introduction to Interpreting Shoulder Sectional Anatomy
• Practice Parameters for CT of the Shoulder
• Basic CT Protocol
• Practice Parameters for Magnetic Resonance Imaging of the Shoulder
• Basic MRI Protocol
• Trauma at the Shoulder
• Diagnostic Imaging for Trauma of the Shoulder
• Fractures of the Proximal Humerus
• Fractures of the Clavicle
• Fractures of the Scapula
• Dislocations of the Glenohumeral Joint
• Acromioclavicular Joint Separation
• Rotator Cuff Tears
• Glenoid Labrum Tears
• Abnormal Conditions
• Impingement Syndrome
• Adhesive Capsulitis
• Summary of Key Points
• Case Studies
• Self-Test
• Chapter 16  Radiologic Evaluation of the Elbow
• Review of Anatomy
• Osseous Anatomy
• Ligamentous Anatomy
• Joint Mobility
• Growth and Development
• Routine Radiologic Evaluation
• Practice Parameters for Elbow Radiography in Children and Adults
• Standard Projections and Radiologic Observations
• Advanced Imaging Evaluation
• Introduction to Interpreting Elbow Sectional Anatomy
• Practice Parameters for CT of the Elbow
• Basic CT Protocol
• Practice Parameters for Magnetic Resonance Imaging of the Elbow
• Basic MRI Protocol
• Trauma at the Elbow
• Diagnostic Imaging for Trauma of the Elbow
• Fractures and Dislocations
• Distal Biceps Tendon Tear
• Triceps Tendon Tear
• Abnormal Conditions at the Elbow
• Epicondylitis
• Osteochondritis Dissecans
• Summary of Key Points
• Case Studies
• Self-Test
• Chapter 17  Radiologic Evaluation of the Hand and Wrist
• Review of Anatomy
• Osseous Anatomy
• Joints and Ligaments of the Hand and Wrist
• Joint Mobility
• Growth and Development
• Routine Radiologic Evaluation
• Practice Parameters for Extremity Radiography in Children and Adults
• Standard Projections and Radiologic Observations
• Advanced Imaging Evaluation
• Introduction to Interpreting Wrist Sectional Anatomy
• Practice Parameters for CT of the Wrist
• Basic CT Protocol
• Practice Parameters for Magnetic Resonance Imaging of the Wrist
• Basic MRI Protocol
• Trauma at the Hand and Wrist
• Diagnostic Imaging for Trauma of the Hand and Wrist
• Fractures of the Hand
• Fractures of the Wrist
• Fractures of the Distal Radius
• Wrist Instability
• Imaging Techniques to Diagnose Instability
• Instability of the Distal Radioulnar Joint
• Classification of Carpal Instabilities
• Soft Tissue Disorders
• Pathology of the Triangular Fibrocartilage Complex
• Carpal Tunnel Syndrome
• Arthritides
• Degenerative Joint Disease
• Rheumatoid Arthritis
• Summary of Key Points
• Case Study
• Self-Test
• Chapter 18  Integration of Diagnostic Imaging into Physical Therapy Practice
• Changing Perspectives on Diagnostic Imaging in Physical Therapy Education
• Historical Perspective on Traditional Roles
• An Evolving Model
• The Physical Therapist as a Primary Care Provider in the United States
• The Physical Therapist as an Educated User of Diagnostic Imaging
• The Use of Diagnostic Imaging by Physical Therapists Inside the United States
• Other Practice Environments in the United States
• Access to Imaging and Relationships with Physicians
• Primary Care “Teams”
• Traditional Physical Therapy Practice
• Direct Referral to Radiology
• Physiotherapy Practice Concerning Diagnostic Imaging outside the United States
• Barriers to Access and Ordering Imaging
• State Practice Acts
• Third-Party Reimbursement
• Undefined Issues
• The Role of Imaging in the Diagnostic Process
• When to Refer for Imaging
• Understanding the Capability of Each Imaging Modality
• Clinical Decision-Making and Clinical Practice Guidelines
• The Role of Imaging in Physical Therapy Intervention
• What Do Physical Therapists Look For?
• Incorporating Imaging into Treatment Planning
• What Does the Future Hold?
• Summary of Key Points
• Case Studies
• Self-Test
• Answers to Self-Test Questions
• Index