3 - Spinal Anomalies Flashcards
(63 cards)
What are C1 lateral mass notches
Apparent defects in the medial aspects of lateral masses — lucencies of atlas represent attachment sites of transverse ligament
What are central maxillary incisors
May look like vertical fracture through dens but actually is space between teeth
What is Mach effect?
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
What are paraodontoid notches?
Notches next to dens that represent part of the growth centers/synchondrosis that didn’t fill with bone.
What is eagles syndrome
When you have stylohyoid ossification AND dysphagia (trouble swallowing)
What is DISH?
Diffuse
Idiopathic
Skeletal
Hyperostosis
What is facet notching?
Can mimic erosion or fracture, no trauma. Yet trauma can cause it
Rotation of the spine may cause articulate pillars to overlap which may mimic
Vertebral pillar fracture
Why might a pseudofracture show up in the cervical spine in Lateral view?
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)
What is the pyriform sinus?
Bilateral leucency medial to VB on AP film. May look like lesion but its just airspace
What are Hahn’s venous clefts?
Vascular channels seen as horizontal lucencies through mid-vertebral body. Most common in lower thoracic spine
Normal finding
What are block vertebra and is it more common in lumbar or cervical?
Non segmentation of 2 adjacent segments.
MORE common in cervical.
Most common lumbar is L4/5
When you see multiple block vertebra, what syndrome do you think about?
Klippel-Feil syndrome
Congenital block vertebra triad of findings
Remnant disc
Wasp waist
Posterior element fusion (50% of cases)
What are butterfly vertebra? How do you know if its congenital?
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
What causes hemivertebra?
Failure of ossification center
What does a hemivertebra look like?
Wedge shaped vertebra.
How do you know hemivertebra is congenital?
Absence of osteophytes.
DDX disc degeneration = osteophytes
What is the concern with hemivertebra?
May cause scoliosis
What are schmorl’s nodes?
Herniation of NP through vertebral endplate due to weak endplate, trauma or pathological process
Does disc size change with schmorl’s nodes?
Yes, may be smaller because they get imbedded into vertebral body
DDX schmorl’s node from nuclear impression
Schmorl’s nodes are larger, sclerotic, jagged
Nuclear impression (persistent notochord) is smooth, larger and often posterior
Sometimes large schmorl’s nodes can change the vertebral body size — how?
Longer AP but shorter
What is anterior limbus vertebra/bone?
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.
