Top Tweets for #PT546Week7
MRIs ~
Bone is black, fat is white, T1s tryna keep it light
T2s look like a negative version, don’t let imaging become an aversion
#PT546Week7 @juliehershberg @manjiridahdul
So apparently that imaging class in the first semester of PT school was really important!
Using MRI is great to look for old lesions or new lesions within the brain to help differentiate multiple sclerosis!
#PT546Week7 @juliehershberg
Keys to MS diagnosis 🔑
🧐 Clinical exam
⏱ DIT: symptoms at different times
🌌 DIS: damage in different spaces of the CNS
✂️ Lesions in MRI
➕ Positive oligoclonal bands in the CSF
🙅🏻♀️ And rule out other possible diagnoses
#PT546Week7 @juliehershberg
The graph of secondary progressive MS is kiiind of like my studying motivation every week. It gets bad, then back to normal, a little bit worse, back to normal, and then by Thursday night my concentration plummets and all bets are off. #PT546Week7 @juliehershberg
M.S. is a tough diagnosis to have. Sometimes you may feel fine, other times you may not be able to get out of bed but with all that said, your quality of life can still be good with a proper medical management, friends, and resources. @juliehershberg #PT546Week7
MS, as are many immune-mediated diseases, is a great imitator. Key signs:
-multifocal CNS plaques on MRI (spread in space)
-pt report includes more than one episode of symptoms (spread in time)
-CSF fluid + for oligoclonal bands
*no frank LMN/PNS symptoms!*
#PT546Week7
New relapse, who DIS/DIT?
Dissemination In Space: multifocal CNS signs (ie ⬆️reflexes/tone, dysarthria, dysmetria)👀MRI for round/oval lesions in white matter
➕
Dissemination in Time: new & old sxs/lesions present 👀MRI Flair
🤔MS? Check CSF
@juliehershberg #PT546Week7
#PT546Week7
Requirements for MS diagnosis:
If there are white matter lesions all over the place
Then they say the disease is disseminated in space!
If you’ve have an episode before, and again symptoms climb,
Then they say the disease is disseminated in time!
@juliehershberg
When should you choose to use an MRI vs. CT Scan? MRI is better for anatomical details and can be beneficial when identifying lesions. CT Scan is fast, inexpensive, and helpful when looking at bony structures. #PT546Week7 @juliehershberg
#PT546Week7 @juliehershberg Brain MRI with gadolinium-recommended for diagnosis of MS. Left: FLAIR sequence image of a transverse section from the brain of a patient with multiple sclerosis (MS). Right: Ric Flair (Nature Boy): Figure four finisher move on Hogan (Mr. America).
MS typically presents with a relapsing/remitting progression 📈. With this in mind, take note of the pattern 🧐. If the pt’s dysarthria or uncoordinated movement patterns occur only on the weekends, MS may not be the problem. #PT546Week7 @juliehershberg
MS.... Who DIS? 🤷🏻♀️ Identifying lesions disseminated in space and time (DIR) are key 🔐components in diagnosing MS. #PT546Week7 @juliehershberg
Brain imaging rhyme:
If the skull hugs the brain, 🧠
you are looking at CT Scan.
Ventricles are dark and fat is bright, 💡
it is T1 MRI.
CSF is lit and lesions too,
it is most likely T2! ✌️@manjiridahdul @NoraDarakDPT @juliehershberg #PT546Week7
Tips to differentiate between MRI T1 and T2!
🧠T1: looks like a wet brain, grey matter & CSF is dark, bone is black!
🧠T2: looks like a negative, CSF is bright, white matter is dark!
#PT546Week7 #neuropathology @juliehershberg
MS has an unknown etiology🤷🏻♀️but it may be linked to vitamin D deficiency. Spend some time outside today and soak up that southern CA sun! ☀️😎🧠 #PT546Week7 @juliehershberg
T1? T2? CT?? Look for the bright fluid or the bright bone. And always keep in mind that a flair could sneak up on ya @juliehershberg #PT546Week7
Multiple Sclerosis is a diagnosis that can lead even the greatest of sleuths on a wild goose hunt! Carefully check the patients signs and symptoms! @juliehershberg @LibbyKrauseDPT #PT546Week7
Did you know @Drake's head producer @OVO40 was dx'd with MS on his 22nd bday? When asked about his perspective on MS, he said "I wish people knew how unpredictable the disease is. 1 day I can walk 5 miles and the following day only 500 ft." #PT546Week7 #RapFacts @juliehershberg
Here’s a tip to help you distinguish a T1 vs. T2 MRI:
✏️ T2️⃣ MRI = bright H2️⃣0
#PT546Week7
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