c-spine radiology Flashcards
indics
trauma
suspect instability
UE sxs
occipital HA
ROM limits
pre/post op
malignancies
arthropathy
suspect congenital abnorm
health conditions associated w/ spinal abnorm
monitoring known abnorm
AP lower c-spine
align: SPs, lateral bodies, lateral columns
ovular pedicles
lateral
smooth lines: A/P bodies, spinolaminar line, articular pillars
spatial: disk heights, TP over body
bodies box like
norm atlantodental interval
Open mouth/odontoid
spatial: atlas and axis, lateral borders of C1 and and superior z-joint surfaces axis
SP of C2 midline
symmetry: lateral masses C1, joint space C1/2 z-joints
continuity: anterior arch and dens
R and L Oblique
IV foramina
Pedicles
Flexion-ext stress view
smooth lines: A/P bodies, spinolaminar line, articular pillars
spatial: bodies
excess widening of atlantodental interface in flexion
C-spine CT and MRI ABCDs
Alignment
Bone signal
Canal space (CNS for MRI)
Disc integ
Soft tissues
CT of c-spine indics
-acute trauma
-degen conditions
-post op assess
-infection
-image guided intervention procedure
-neoplasm
-inflam lesions
-congenital conditions
-cord syrinxes/masses (when MRI contra)
CT c-spine what can you see
spatial: dens and lateral masses, dens and anterior arch
atlantodental interface
spinal canal
sagittal: similar to lateral w/ radiograph
coronal: integ of dens, spatial relationship of C1/2
MRI c-spine indics
-acute trauma w/ suspect cord encroachment
-DDD
-neoplasm (dx and intervention f/u)
-intrinsic sc patho
-congenital/develop conditions
-cord masses
-post op assess (ST, vertebroplasty)
-meningeal abnorms
-infection (disc space, epidural abscess)
Adult. Prior sx. Acute/incresing cervical pain or radic. no trauma. Initial image
radiography, MRI, CT usually approp
adult. chronic cervical pain with radic. no trauma. initial
MRI
acute onset myelopathy. initial or chronic/progressive myelopathy
MRI
16+, acute blunt trauma. image indic by CCR or Nexus
CT
16+, acute blunt trauma, no unstable injury but kept in collar for pain. no new neuro sxs. follow up
CT
16+ acute c/t/l spine blunt trauma. suspected lig, sc, nerve injury w/ or w/o trauma on CT
MRI
PECARD
high risk of injury if 1+ are present:
-altered mental
-focal neuro findings
-neck pain
-torticollis
-substantial torso injury
-conditions predisposing to c-spine injury
-diving
-MVA
3-16, acute trauma, at least one rf on PECARN or Nexus, initial
radiography
