APOM

Question 1

APOM purpose

Answer 1

Routine film but best to see the dens and arches of atlas

Question 2

If dens is not present

Answer 2

Agenesis of the dens

Question 3

Fx through dens tend to go

Answer 3

Oblique

Question 4

Smiling arch

Answer 4

Posterior arch

Question 5

Frowning arch

Answer 5

Ant arch

Question 6

Mach lines

Answer 6

Arches of atlas
Occiput - vertical radiolucency
Teeth - fx = horizontal radiolucency

Question 7

Check the base of dens for a radiolucent line

Answer 7

Fracture - thin and jagged radiolucency with displacement

Non-union - thick radiolucency, smooth cortices

Question 8

Trace out the dens making sure it is in place

Answer 8

Leaning or tilting dens suggests fx

Question 9

Para-odontoid spaces

Answer 9

If unequal think Jefferson bursting fracture

Lateral masses check to confirm

Question 10

Check lateral masses

Answer 10

Overhanging
Jefferson bursting fracture
Associated with RUst sign
Refer for surgical stabilization
Go to lat C2 body - draw staright vertical line up

Question 11

Check posterior arch of atlas and spinouses of C2 and C3 for spina bifidas

Answer 11

Refer to orthopedist all 3 dens fx

Question 12

3 types dens fx

Answer 12

1. Thin radiolucent line above dens base (tip
2. Thin radiolucent line through dens base - leaning/tilting dens
3. Thin radiolucent line below dens base

Question 13

Type 1/3 are

Answer 13

Most stable

Question 14

Type 2 is

Answer 14

Most common
Most unstable
Most severe