Medical Lin Zhengzheng 丨 Comic diagram orthopedic image checks, you can understand at a glance

The column of the "Medical Forest Bone" was created by Professor Lin Dingkun and his team of famous Chinese medicine doctors in Guangdong Province.

In the diagnosis of orthopedic diseases, imaging examinations occupy an important part.

X -ray, CT, MRI, ultrasound ...

In the face of dazzling examinations, patients often have some confusion:

"Is this check?"

"Why am I doing this?"

"Is it more expensive to check?"

In this section, our special invitation "soul painter" will use the hand -painted method of comics to unveil the mysterious veil of these inspection projects.

1

X -ray examination

X -ray examination, also known as "X -ray inspection", "old friend" in our orthopedic examination.

Often a few photos can take our bone structure at a glance.

How is this achieved?

Imaging principle

Radio perspective

The density thickness of the body structure is different from the degree of blocking X -ray. In the process of filming, the X -ray can penetrate the muscles but cannot penetrate the bones. Therefore, the rays projected on the negatives can form an image that shows the overall skeletal shape after processing.

Scope

Establishment of orthopedic disease

When orthopedics, X -ray is often used as a means of first screening. Whether it is observation of the overall structure or the evaluation of bone condition, clinicians can quickly assist clinicians to make diagnosis. Especially the evaluation of external trauma, such as fractures, joint dislocation, etc., the imaging is intuitive and clear, and it is of strong significance to clinical guidance. Even if there is no major problem, the diagnosis of doctors is a reference support.

Overall evaluation

Advantages: cheap, fast inspection, good imaging integrity, small radiation, etc.

Disadvantages: Organizational images overlap each other, lack of evaluation of details, and can only provide very few soft tissue information.

2

CT examination

CT examination, like X -ray, is also used by X -rays.

The difference is that its imaging is three -dimensional, not plane.

Imaging principle

Slice perspective

The imaging of the CT examination is "slicing" imaging. It can be used according to the condition/side/horizontal section according to the condition, so as to obtain multiple "slices" and then combine into a three -dimensional bone three -dimensional structure diagram. The observation of details is more comprehensive.

Scope

Further clarify the osteo structure lesions

CT examination also focuses on the imaging of the bones. Compared with the overallness of X -ray, CT is better at the presentation of details. The formulation of diagnosis and treatment plans has an important guiding role. In addition, it can also reflect soft tissue lesions to a certain extent.

ask

CT and X -rays are also bone structures. Why do you sometimes make X -ray and CT?

answer

Compared with the X -ray single appearance after all structures overlap, the CT can scan the overall structure layer by layer. Each cut surface can form a corresponding image. The lesion position, and can carefully and comprehensively observe its morphological changes and the impact on peripheral tissue from the lesion position, etc., and enhance the CT to show the blood supply condition of the lesion position.

Therefore, in the case of preliminary judgment of bone structure in X -ray, but not clearing the details, CT can provide doctors with more diagnostic information.

Overall evaluation

Advantages: accurate osteo structured portrait, multi -plane imaging, which has good effect on details.

Disadvantages: The radiation of CT is slightly larger, and the soft tissue state display effect is not good.

3

MRI examination

MRI examination, also known as MRI.

In the diagnosis and treatment of many orthopedic diseases, MRI examinations are often indispensable.

Due to different imaging principles, CT and MRI have better imaging of CT and MRI compared to X -ray films.

Imaging principle

Slice watching atomic movement

The human body contains a lot of water, even if it is hard bones, it is inseparable from water. Magnetic resonance is used to imagine the hydrogen atom contained in water.

When performing MRI examinations, it is equivalent to exercising in the magnetic field under the influence of the magnetic field. It can collect the motion information of the hydrogen atom from the front/side/horizontal section according to the condition, and then perform a combined imaging.

Similar to the method presented by CT, the MRI examination is also a "slicing" type, and then combined into a three -dimensional structure.

Scope

Check the nervous system and soft tissue lesion

MRI can be better divided into various tissue components of the human body, such as the nervous system (brain and spinal cord and peripheral nerves) and soft tissue imaging (muscle, ligament, cartilage, etc.). Therefore The diagnosis of highlights such as protruding, rotating cuff injury, knee ligament and half -moon plate injury is indispensable.

ask

Can you see the structure clearly after doing X -ray and CT? Why do I do MRI?

answer

X -ray and CT imaging is faster than MRI, mainly providing bone information;

MRI's soft tissue resolution is higher than X -ray and CT, which can provide richer and more detailed soft tissue information, such as cartilage, ligaments, etc., and diagnose the diagnosis of X -ray and CT for bone marrow dysfunction, hidden fracture, judgment of fresh fractures and other aspects. Certain.

For example, in the diagnosis of spinal cervical spondylosis, on the basis of the X -ray tape to understand the entire cervical spine structure, the degree of spinal cord compression and spinal cord injury need to be judged by MRI examination.

Overall evaluation advantages: no radiation, soft tissue imaging effect is the best, which can distinguish the differences in the components in the tissue;

Disadvantages: The cost is relatively high, the examination time is long, and those with metal implants in the body are limited.

4

Ultrasonography

Ultrasound examination is relatively rare in orthopedic examination, but it is also important for orthopedic diseases.

Imaging principle

See the echo in the cut surface

When the ultrasonic is penetrated through the human body, it generates a reflex wave, collects the reflected wave information for imaging, reflects the structure in the cut surface, and the probe can be checked with any cut surface.

Scope

"Navigation instrument" in diagnosis and treatment

Ultrasonic is also an "slicing" imaging, but ultrasound uses probes to perform local imaging, with high resolution, which is good for local cortex, subcutaneous fascia, peripheral nerves and micro -lesions in the muscles.

Especially ultrasonic operations and instant imaging are manually real -time operation. During the examination, patients can perform dynamic observations in the state of exercise. The use of maturity in the diagnosis of crickets and other diseases is a common "navigation expert" in the diagnosis and treatment process.

ask

MR and ultrasound are also used for soft tissue imaging. How should the two choose?

answer

MRI shows that the overallness of the tissue is better, which can evaluate the overall nerve and soft tissue of the tissue, and ultrasound can only be localified.

However, the resolution of ultrasound on superficial tissue can reach 3 times or higher of the MRI. Seeing a slightly fine lesions, and can be achieved in different postures in different postures, in the treatment, it can also perform real -time ultrasound assisted puncture intervention intervention in treatment. Essence

overall evaluation

Advantages: good radiation, good soft tissue appearance, dynamic real -time imaging, can guide treatment;

Disadvantages: It can only reach the surface of the bone, the overallness of the appearance is low, and the more vague, and the inspector's experience is affected.

5

Are these inspections safe?

Focus on

The radiation volume is within the scope of safety, no need to panic

The X -ray examination and CT examination are completed with the help of radiation. The radiation amount of a chest X -ray is 0.1MSV. A typical CT scanned effective dose is about 10msv. Studies have shown that only in a short period of time, the amount of radiation of more than 100msv in a short time will increase the probability of human cancer.

Therefore, there is no scientific basis for fear or escape from the low doses of medical imaging inspection.

Kind tips

Can pregnant women check in imaging?

At present, domestic women should be recommended to avoid X -ray and CT examinations in the first three months of pregnancy.

If the pregnant woman needs to perform X -ray or CT inspections without the case, there is no need to worry too much. The Guide of the American Academy of Obstetrics and Gynecology has shown that in general, the X -ray irradiation below 50MSV will not cause fetal injury. Or terators.

Summarize

Suggestions

What kind of movie should I take for orthopedic diseases?

Initial diagnosis of osteopia, choose X -ray examination in most cases;

When the skeletal problem is complex and the lesion is difficult to be clear, CT examination is needed;

Suspected of muscle, ligament, nerve injury, etc., MRI examinations need to be added;

If you need dynamic imaging and guide therapy, you can choose to increase the B -ultrasound.

The above suggestions are for reference only. Specific inspection items still need to be selected according to the advice of the main doctor.

For patients with cervical spondylosis, if you want to learn more about the choice of the inspection items in detail, click the picture below to view:

(Click the picture to jump to read)

For more orthopedic medical examination methods, please pay attention to our subsequent push ~

Supply: Lin Dingkun Studio Team

Executive editor: Wu Yuan Tuan

Audit school pair: Zhuang Yingge

Editor in charge: Song Liping

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