True or False

Functional dominance must be considered when choosing which forearm to scan.

True

Functional dominance will affect BMD of the forearm. For this reason, the non-dominant forearm should be scanned.

This images illustrates proper positioning for a hip scan. What are the positioning elements the tech should look for?

[image]

a) Proper internal rotation which rolls the lesser trochanter behind the femoral shaft

b) Elongated femoral neck

c) Femoral shaft is straight, parallel to table edge

d) All of the above

What is the third site commonly used in bone density scanning?

a) Ankle

b) Heel

c) Ribs

d) Forearm

d) Forearm

The third site commonly scanned is the forearm.

True or False

Improper rotation of the baseline hip scan will affect precision and reproducibility.

True

This statement is true. Improperly rotating the femur on the baseline hip scan will affect precision and reproducibility. This is especially true if the baseline scan is going to be used to track a patient undergoing drug therapy.

What region of the hip is the T-score calculated from?

a) Ward's area

b) Shaft

c) Trochanter

d) Total

d) Total

The T-score is calculated at the total region of interest because all the individual regions are included. The total regions is a combination of trabecular and cortical bone.

For a bone density study, how should the femur be oriented?

a) In natural position where femur curves in

b) Knees up on the positioning block

c) Femur shaft should be straight and parallel to the table edge

d) In a lateral position

c) Femur shaft should be straight and parallel to the table edge

The femur should be straight and parallel to the table edge. This can be achieved by gently pulling the thigh outward and away from centered position.

Serial scanning is part of clinical management of patients with osteoporosis. How does the technologist insure adequate results?

a) Follow up scans must be done on the same scanner

b) Follow up scans must be performed with same scan speed and positioning devices

c) The technologist must understand the relationship between LSC and precision on scanner

d) All the above

d) All the above

Each point presented in this question is relevant to serial scanning. Serial scans are the best way to determine how effective drug therapy is for the patient. However, in order for serial scans to be clinically useful, the precision assessment must be preformed and the LSC must be determined.

True or False

This is an example of a properly positioned spine.

[image]

True

This is an example of a well positioned PA spine. All the landmarks are well visualized, the spine is straight and the crests are visible.

Why is the manufacturer's positioning device used to position for the hip scan?

a) Insures the femur is straight

b) To keep toes pointing upright c) To create optimal femur rotation of 15-25 degrees from the hip and helps patient maintain the rotation during scan d) Prevent patient from straightening leg.

c) To create optimal femur rotation of 15-25 degrees from the hip and helps patient maintain the rotation during scan

The positioning device is used to insure optimal internal rotation of the femur. It also helps the patient maintain the position.

Why is the whole body composition analysis software useful?

a) It offers a comprehensive look at body composition, with accurate BMD, lean tissue and fat

b) It can give T-scores of most bone simultaneously

c) It is only useful for premenopausal women

d) It is not useful in clinical practice

a) It offers a comprehensive look at body composition, with accurate BMD, lean tissue and fat

Whole body composition is useful in research and managing patients with metabolic disorder syndromes. An accurate account of lean muscle and fat distributions can aid in treatment for patients.

What would optimal positioning display for a PA spine scan?

a) L1-L4 are regions of interest and must clearly visible

b) The iliac crests should be level and ribs visible at T12

c) Spine should be straight with clear separations between the vertebrae

d) All the above

d) All the above

Each of these are points are necessary for a well positioned PA spine scan. L1-L4 must be visualized, the spine should e straight with clear separations between vertebrae and iliac crests should be level.

Why is it important to place a positioning block under the patient's knees for the spine scan?

a) It is for the patient's comfort

b) The positioning block is used to flatten out the small of the back and open disk spaces

c) Upright knees help patient remain still during scan

d) When the knees are drawn up, the spine naturally falls into a straight line.

b) The positioning block is used to flatten out the small of the back and open disk spaces

The positioning block is used to flatten out the small of the back and open disk spaces.

What are the most common sites for BMD measurement using DXA technology?

a) Heel and forearm

b) Spine and proximal femur

c) Forearm and proximal femur

d) Spine and heel

b) Spine and proximal femur

The most common sites for BMD measurement is the spine and proximal femur.

What are the regions of interest the proximal femur is divided into?

a) Shaft, tibia, neck

b) Femoral joint, lesser trochanter, shaft, femoral head

c) Neck and shaft

d) Femoral neck, trochanter, Ward's area, shaft

True or False

The technologist should palpate the top of both crests to see if they are level and observe patient from the head of the table.

True

This statement is true. This will allow the tech to position patient before starting the scan.

When should a forearm scan be included in the study?

a) Patients suffering from hyperparathyroidism

b) Patients with surgical hardware, pathology or other contraindication in the spine or hip

c) Ordering doctor's discretion

d) All the above

d) All the above

The correct answer is all the above. Each of the reasons listed are valid grounds to do a forearm scan as part of a comprehensive study.

In addition to proper positioning, what else should the technologist look for when reviewing image?

a) No motion

b) No artifacts

c) Proper image contrast

d) All the above

d) All the above

In addition to proper positioning, there should be no motion, artifacts and the image should have proper contrast.

In the images shown, which is correct for forearm positioning?

[image]

a) The image with the positioning device

b) The image without the positioning device

c) Both are correct.

d) Neither image shows correct positioning for the forearm.

c) Both are correct.

Both are correct. GE requires a positioning device for the forearm scan while Hologic does not require a device to be used.

What are the advantages of including a VFA in a DXA study?

a) Lower radiation dose than regular X-rays

b) Fractures and deformities are best seen in the lateral view

c) In fan array DXA spine image, the C-arm travels along the spine allowing the beam to remain perpendicular to produce an image with clear visualization of the vertebral end plates without distortion

d) All the above

d) All the above

Each answer choice is a valid advantage of including VFA in a study when indicated. Patients who suffer from height loss or have a history of fracture over the age 50 are candidates for VFA.

The human skeleton is comprised of 206 bones. What other function does the skeleton have?

a) Protection for internal organs

b) Anchorage for skeletal muscles

c) Metabolic

d) All the above

d) All the above

The function of the skeleton is protection, anchorage, metabolic and provides a mineral reservoir.