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Image Interp II > Cervical Spine > Flashcards

Cervical Spine Flashcards

1
Q

Osteoarthritis is more common to develop at what levels

A

C5/C6

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2
Q

What findings are seen here

A

Degenerative disc C5/C6

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3
Q

Loss of disc height with no vacuum cleft is key for this radiographic diagnosis =

A

Degenerative disc

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4
Q

Maintained disc height with osteophytes is the key for this radiographic diagnosis =

A

Spondylosis

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5
Q

Loss of disc height with a vacuum cleft is key for this radiographic diagnosis =

A

Intervertebral Osteochondrosis (IVOC)

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6
Q

What arthritic condition is the result of these findings

A

With intercalary bone circled

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7
Q

What arthritic condition is the result of these findings?

A
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8
Q

Blunting/hypertrophy of uncinates that gives pseudofracture appearence to vertebral body on lateral view =

A

Uncinate arthrosis

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9
Q

What condition is demonstrated in these findings?

Left = normal

A

Facet arthrosis

(middle = moderate, right = severe)

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10
Q

What condition is demonstrated by these findings?

A

Spondylotic myelopathy

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11
Q

General features of ____ include:

  • Ossification/calcification of spinal/extraspinal ligaments & tendinous attachments (most prominent = ALL)
  • Flowing hyperostosis at four continuous vertebral levels
  • Relative preservation of disc height
  • Absence of SI and facet joint sclerosis, osseous fusion
  • May see associated ossification of the posterior longitudinal ligament (OPLL) (can cause myelopathy)
  • Dysphagia is common sx
A

DISH (Diffuse Idiopathic Skeletal Hyperostosis)

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12
Q

What condition is likely the cause of these findings?

A
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13
Q

Radiographic features of ____ include:

  • ADI instability (due to inflammatory changes at articulation of transverse ligament w/ the dens)
  • Odontoid eroisions (resulting in a whittled dens) & sclerosis
  • Facet erosions & sclerosis
  • Whittling of SPs
  • Anterolisthesis C2-C4 giving a step ladder appearence
A

Rheumatoid Arthritis

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14
Q

What condition is likely the cause of these findings?

A

RA w/ atlantoaxial instability

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15
Q

What condition is likely the cause of these findings?

A

RA with atlantoaxial instability

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16
Q

What condition is likely the cause of these findings?

A

RA

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17
Q

The primary, preferred imaging for suspected CS trauma is ___

A

CT (though not readily available so x-rays often first modality performed)

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18
Q

High risk criteria for cervical spine injury that requires imaging

A

65 or older

Dangerous mechanism of injury

Presence of paresthesia in extremities

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19
Q

____ is suggested on a neutral lateral cervical view when:

  • 3.5 mm horizontal translation or 20% of the endplate distance of one vertebral segment over another

OR

11 degrees or more of angular deformity between two adjacent vertebral segments (compared to the surrounding segments)

A

Instability

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20
Q

_____ is suggested on flexion/extension radiographs when:
- Relative translation is greater than 3.5mm or 20% of the endplate distance

OR
- Over 20 degrees of sagittal plane rotation

A

Instability

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21
Q

What pathology is demonstrated here?

A

Cervical instability

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22
Q

What four lines should be checked on the lateral cervical view in the case of trauma?

A

Anterior vertebral body line

Posterior vertebral body line

Spinolaminar line

Spinous process line

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23
Q

____ general features include:

  • Burst fracture from axial compression
  • Usually from auto or diving accident
  • 4 fx (2 ant, 2 post) is classic pattern
  • Lateral displacement of C1 lateral masses
A

Jefferson Fracture

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24
Q

General & radiographic features of ____ include:

  • MC from C4-C7
  • Body above displaces anterior usually less than 25% of the width of the vertebral body below
  • Look for bow-tie sign
  • Due to hyperflexion w/ rotation
  • Usually stable
A

Unilateral facet dislocation

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25
Q

What pathology is demonstrated in these 2 different cases?

A
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26
Q

General features of ____ include:

  • Most common from C4-C7
  • Body above displaced anterior 50% or more of the width of the vertebral body below
  • Due to hyperflexion
  • Unstable injury
A

Bilateral Facet Dislocation (C4/C5)

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27
Q

General & radiographic features of ____ include:

  • Often referred to as Clay-shoveler fracture
  • C7 MC level affected
  • Due to avulsion injury or direct blow
  • Stable injury
  • SP moves inferior typically → results in double spinous sign on AP radiograph
A

Spinous process fracture

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28
Q

What traumatic pathology is demonstrated here?

A

C7 SP fracture

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29
Q

General & radiographic features of ____ include:

  • MOI is hyperflexion with compression
  • Often a result of motor vehicle accidents or diving injuries
  • Unstable injury
  • Anterior inferior vertebral body fracture
A

Flexion teardrop fracture

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30
Q

What traumatic pathology is demonstrated here?

A

C6 flexion teardrop fx

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31
Q

What traumatic pathology is demonstrated here?

A

C2 teardrop fx

32
Q

General & radiographic features of ____ include:

  • MC due to hyperextension
  • MC in elderly
  • Commonly have associated C1 fx
  • 3 Types
A

Odontoid fracture

33
Q

Type ___ Odontoid Fx =

  • An oblique fx limited to superior one half of the dense, avulsion type fx
  • Stable
A

Type I

34
Q

Type ___ Odontoid Fx =

  • Transverse fx at the base of the dense
  • Unstable
  • MC type
A

Type II

35
Q

Type ___ Odontoid Fx =

  • An oblique fx at the base of the dens and extending into the body
  • Stable
A

Type III

36
Q

What traumatic pathology is demonstrated here?

A

Type I dens fx

37
Q

What traumatic pathology is demonstrated on this coronal MRI?

A

Type III dens fx

38
Q

General features of ____ include:

  • Etiology includes ununited type II dens fx or ununited growth center
  • Can be associated w/ significant upper cervical instability
A

Os Odontoideum

39
Q

Radiographic features of ____ include:

  • Avascular disc protects joint initially in adults
  • Latent period for osseous changes is 21 days
  • Occurs at anterior aspect of body, spreads along endplate → endplate irregularity/destruction, body destruction, disc height loss
A

Infectious spondylitis

40
Q

What pathology is demonstrated here?

A

Infectious spondylitis C5/C6

41
Q

What pathology is demonstrated here?

A

Infectious spondylitis

42
Q

Radiographic features of ____ include:

  • Located in posterior elements
  • Lucent, soap bubbly appearence, highly expansile
  • DDx w/ aneurysmal bone cyst
A

Osteoblastoma

43
Q

What pathology is demonstrated here?

A

Osteoblastoma at C1 posterior arch

44
Q

Best evaluated w/ US, magnetic resonance angiography, or CT

= what pathology

A

Atherosclerosis of carotid arteries

45
Q

General features of ____ include:

  • MC at C5/C6 and C2/C3

4 radiographic findings:

  • Rudimentary disc (with calcification occasionally)
  • “Wasp-waist” deformity: anterior concavity at the mid-point due to failure of formation of rim apophyses
  • Posterior element involvement
  • Height is less than 2 normal discs
A

Congenital blocked vertebra

46
Q

What pathology is demonstrated here?

A

Congenital block C5/C6

47
Q

What pathology is demonstrated here?

A

Congenital block C5/C6

48
Q

General & radiographic features of ____ include:

  • Multiple block vertebra
  • Other segmentation anomalies
  • Associated skeletal findings (Sprengel’s deformity, rib anomalies, spina bifida, scoliosis)
  • Clinical triad: short webbed neck, low posterior hairline, decreased CS ROM
A

Klippel Feil Syndrome

49
Q

What normal anatomic variant is seen here?

A

Ossification of stylohyoid ligaments

50
Q

What condition is associated with these findings?

A

Acromegaly

51
Q

What condition is associated with findings seen here?

A

Post-menopausal/senile osteoporosis

52
Q

What condition is shown here?

A

Klippel-Feil Syndrome

53
Q

What normal anatomic variant is seen here?

A
54
Q

Findings & Impressions =

A
55
Q

Findings & Impressions =

A
56
Q

Findings & Impressions =

A
57
Q

38 YOM ambulates into your office with a chief complaint of neck pain following a motor vehicle accident in which he rear ended another car at 10mph. What is the next step with this patient?

A

No high risk factors. Patient may be full evaluated with a physical exam including active ROM

58
Q

67 YOM ambulates into your office with a chief complaint of neck pain following a motor vehicle accident in which he rear ended another car at 10mph. What is the next step with this patient?

A

Because of age, is at high risk. Patient should be evaluated with a 3 view cervical radiographic study before any active range of motion is performed

59
Q

20 YOM ambulates into your office with a chief complaint of neck pain following an injury in which a box of books fell on the top of his head. What is the next step with this patient?

A

Because of axial load to spine, is at high risk. Patient should be evaluated with a 3 view cervical radiographic study before any active range of motion is performed.

60
Q

20 YOF ambulates into your office with a chief complaint of neck pain for past 2 years. 2 years ago she recalls straining her neck while swimming (not related to a diving injury). Remaining history including review of systems is unremarkable. What is the next step with this patient?

A

No high risk factors. Patient may be full evaluated with a physical exam including active ROM

61
Q

Findings & Impressions =

A
62
Q

Findings & Impressions =

A
63
Q

Findings & Impressions =

A
64
Q

Findings & Impressions =

A
65
Q

Findings & Impressions =

A
66
Q

Findings & Impressions =

A
67
Q

Findings & Impressions =

A
68
Q

Findings & Impressions =

A
69
Q

Findings & Impressions =

A
70
Q

What normal anatomical variant is demonstrated here?

A
71
Q

What normal anatomical variant will result in abnormal Chmberlain’s or McGregor’s line due to dens moving into foramen magnum

A

Basilar impression (aka basilar invagination)

72
Q

This case demonstrates an normal ____ line

A

Chamberlain’s line

73
Q

This abnormal finding is indicative of ____

A

Basilar impression

74
Q

This abnormal finding is indicative of ____

A

Basilar impression

75
Q

What normal anatomical variant is seen here?

A

Image Interp II (10 decks)

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