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Bone Path I > 3 - Spinal Anomalies > Flashcards

3 - Spinal Anomalies Flashcards

1
Q

What are C1 lateral mass notches

A

Apparent defects in the medial aspects of lateral masses — lucencies of atlas represent attachment sites of transverse ligament

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2
Q

What are central maxillary incisors

A

May look like vertical fracture through dens but actually is space between teeth

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3
Q

What is Mach effect?

A

Overlapping structure of posterior arch C1. Could also be lips, tongue, occiput.

Don’t mistake this for a fracture or os odontoideum — may need to retake xray

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4
Q

What are paraodontoid notches?

A

Notches next to dens that represent part of the growth centers/synchondrosis that didn’t fill with bone.

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5
Q

What is eagles syndrome

A

When you have stylohyoid ossification AND dysphagia (trouble swallowing)

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6
Q

What is DISH?

A

Diffuse
Idiopathic
Skeletal
Hyperostosis

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7
Q

What is facet notching?

A

Can mimic erosion or fracture, no trauma. Yet trauma can cause it

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8
Q

Rotation of the spine may cause articulate pillars to overlap which may mimic

A

Vertebral pillar fracture

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9
Q

Why might a pseudofracture show up in the cervical spine in Lateral view?

A

Because of arthrosis. Arthrosis will cause hypertrophied and sclerotic uncinate processes and that presents as a pseudofracture in lateral view.

(Recall what the joints of leuska look like in AP cervical — and then recall what they look like when the joint gets curved)

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10
Q

What is the pyriform sinus?

A

Bilateral leucency medial to VB on AP film. May look like lesion but its just airspace

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11
Q

What are Hahn’s venous clefts?

A

Vascular channels seen as horizontal lucencies through mid-vertebral body. Most common in lower thoracic spine

Normal finding

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12
Q

What are block vertebra and is it more common in lumbar or cervical?

A

Non segmentation of 2 adjacent segments.

MORE common in cervical.
Most common lumbar is L4/5

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13
Q

When you see multiple block vertebra, what syndrome do you think about?

A

Klippel-Feil syndrome

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14
Q

Congenital block vertebra triad of findings

A

Remnant disc
Wasp waist
Posterior element fusion (50% of cases)

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15
Q

What are butterfly vertebra? How do you know if its congenital?

A

Central hourglass shaped lucency in body on AP radiograph. Continuous disc material from adjacent discs. The body is often wider and may look like a burst fracture

Congenital because the end plates of L4 and S1 conform to the butterfly shape

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16
Q

What causes hemivertebra?

A

Failure of ossification center

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17
Q

What does a hemivertebra look like?

A

Wedge shaped vertebra.

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18
Q

How do you know hemivertebra is congenital?

A

Absence of osteophytes.

DDX disc degeneration = osteophytes

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19
Q

What is the concern with hemivertebra?

A

May cause scoliosis

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20
Q

What are schmorl’s nodes?

A

Herniation of NP through vertebral endplate due to weak endplate, trauma or pathological process

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21
Q

Does disc size change with schmorl’s nodes?

A

Yes, may be smaller because they get imbedded into vertebral body

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22
Q

DDX schmorl’s node from nuclear impression

A

Schmorl’s nodes are larger, sclerotic, jagged

Nuclear impression (persistent notochord) is smooth, larger and often posterior

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23
Q

Sometimes large schmorl’s nodes can change the vertebral body size — how?

A

Longer AP but shorter

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24
Q

What is anterior limbus vertebra/bone?

A

Similar to schmorl’s node in that NP herniated through endplate. Specifically through ring apophysis: 2˚ growth area of vertebral body.

In other words, a piece of disc squeeze into the bone and prevent the 2˚ growth area from joining the body.

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25
Q

What does anterior limbus vertebra look like on lateral film?

A

Almost like a fracture or cut off piece of the anterior-superior vertebral body

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26
Q

DDX tear drop fracture from anterior limbus vertebra

A

Teardrop Fx is anterior-inferior w/o corticated edges

Anterior limbus vertebra is anterior-superior WITH corticated edges

27
Q

What is Cupid’s bow deformity?

A

Developmental phenomenon that is unrelated to osteopenia or mechanical stress on spine

28
Q

What is spina bifida occulta?

A

Failure of posterior elements (lamina) to fuse, usually leaving lucent cleft

NO protrusion

29
Q

In spina bifida Vera, what radiographic evidence might you see

A

Larger defect in posterior elements that allow meninges and/or spinal cord protrusion

30
Q

What is diastematomyelia

A

2 spinal cords

An intraspinal canal cartilage, osseous or fibrous sagittal bar dividing the spinal cord into 2 hemicords.

31
Q

What might be visualized on radiograph with diastematomyelia?

A

Increased interpediculate distance

Osseous intracranial density

32
Q

What sx might suggest diastematomyelia?

A

Tethered cord syndrome, CES

33
Q

What radiographic findings suggest pedicle agenesis

A

Absent pedicle on one side with hypertrophy and sclerosis of contralateral pedicle due to altered stresses

34
Q

What is the most common cause of pedicle agenesis?

A

Osteolytic metastasis

But there wouldn’t be hypertrophy of opposite pedicle because that’s a process that happens over time and breast/colon cancer doesn’t have time to do that

35
Q

What is characteristic of transitional L/S vertebra?

A

Undifferentiated L5 or S1

36
Q

What does transitional L/S vertebra look like?

A

when SP is spatulated/tall (>19 mm) unilaterally or bilaterally and this may form accessory joints with sacral ala or be fused to sacrum

37
Q

Spatulated transverse process is associated with what?

A

Transitional L/S vertebra (lumbarization/sacralization)

Spatulated TP may be associated with a small remnant disc and form an extra assymetrical joint with the sacrum

38
Q

What is facet tropism asymmetry?

A

Asymmetry of articulation facets at any level

39
Q

Facet tropism is most common at what level

A

L5-S1

40
Q

Facet tropism is when facets are _______ and not purely sagittal or coronal

A

Curved

41
Q

What is clasp-knife syndrome?

A

Spina bifida PLUS L5 SP enlargement (long, slender)

42
Q

Is articulate process agenesis common?

A

Nope.

43
Q

Where are lumbar ribs often seen? What do the TPs look like?

A

First lumbar vertebra
Sometimes with lumbosacral transitional segment

TPs are usually hypoplastic

44
Q

Sometimes secondary growth centers (apophysis) don’t fuse-how do you DDX from fracture?

A

Scerosis

45
Q

What is an unfused inferior articulate process in skeletal mature individual called?

A

Oppenheimer’s ossicle

46
Q

And where does Oppenheimer’s Ossicle tend to happen?

A

IAP (Inferior Articular Process) of L3

47
Q

What is illiolumbar ligament ossification?

A

👀 Ossification of illiolumbar ligament

48
Q

A trapezoidal shaped L5 body if seen with L5 spondylitic spondylolisthesis may indicated

A

Higher probability of slippage. Otherwise its a normal variant.

49
Q

What is sacral dysplasia/agenesis?

A

Congenital absence of distal portion of spinal column. “Caudal regression syndrome”

**Strong association with maternal diabetes

50
Q

What condition has a strong association with maternal diabetes?

A

Sacral dysplasia/agenesis

51
Q

Iliac apophysis is also called

A

Risser’s sign

52
Q

What is triradiate cartilage?

A

Area of synchondrosis between ilium, ischium, pubis

53
Q

What does triradiate cartilage look like in peds?

A

Radiolucency at the acetabulum

NORMAL FINDING

54
Q

What is ischial apophysis?

A

Secondary growth center at ischium

Common site of avulsion fracture in peds by hamstring muscles

55
Q

What is ischiopubic synchondrosis?

A

Area of synchondrosis between ischium and pubic in peds. Radiolucent area may look like callous formation of healing fracture… but its not.

Totally normal.

56
Q

What is paraglenoid soul I?

A

Notched out area at inferior aspect ilium adjacent to SI joints.

More common in females.

57
Q

Iliac nutrient grooves

A

Normal iliac vasculature seen as Y or V shaped lucent grooves with sclerotic margins

In thoracic its called: “Hans venous channel”

58
Q

What is phleboliths?

A

Radiopacities superior to superior pubic rami. Located within pelvic veins.

NO clinical significance.

59
Q

What is os acetabuli

A

Accessory ossicle located adjacent to superior-lateral aspect of acetabulum

60
Q

What is sacrococcygeal synostosis

A

Anomaly in which sacrum and coccus do not go through segmentation.

No clinical significance.

61
Q

What is ring epiphyses?

A

Anteroinferior margin - the growth center does not fuse.

Normal in peds.

62
Q

Precuts excavatum?

A

Midline depression of sternum

63
Q

What is rhomboid fossa?

A

Represents attachment of rhomboid lig to first rib. May or may not be bilateral, symmetrical.

Bone Path I (5 decks)

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