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Tri 6 - Ortho Image > Classification of Lumbar Disc > Flashcards

Classification of Lumbar Disc Flashcards

1
Q

purpose of lumbar disc classification

A

develop a clear system to avoid

confusion between the radiologist and clinician

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2
Q

T/F: These classifications are based on anatomy and pathology, and DO
NOT define or imply cause, symptomatology, or treatment

A

TRUE

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3
Q

̜ Scoliosis
̜ Spondylolisthesis
̜ Hypoplastic intervertebral disc

A

Congenital / Developmental Variation

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4
Q

what type of scoliosis is most common

A

right sided

left has to get MRI ASAP

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5
Q

spondylolisthesis creates a ____buldge

A

pseudo buldge

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6
Q

what are the 3 types of disc degenerations

A

̜ Degeneration
̜ Herniation
̜ Annular fissure

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7
Q

Separations between the annular fibers or separations of the annular fibers from their attachments to the vertebral bone • aka high intensity zone (HIZ)
̜ Fluid and/or granulation tissue
̜ T2-weighted MRI
Separations between the annular fibers or separations of the annular

A

Subtype I: annular fissure

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8
Q

“Tear” or fissure

• REMEMBER – it is a ________ term; does NOT imply a traumatic origin

A

descriptive

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9
Q

• Dessication • Fibrosis • Narrowing of the disc space • Diffuse bulging of the annulus beyond the disc space • Fissuring (i.e., annular fissures)

A

Subtypes II and III: degeneration

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10
Q

• Mucinous degeneration of the annulus • Intradiscal gas • Osteophytes of the vertebral apophyses • Defects • Inflammatory changes • Sclerosis of the endplates

A

Subtypes II and III: degeneration

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11
Q

is it normal to see gas in the intervertebral disc?

A

NO, means degenerative

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12
Q

̜ Affects mainly the annulus fibrosus and adjacent apophyses
̜ Mild to moderate disc height loss
̜ Exuberant spondylophyte formation (i.e., apophyseal osteophytes)

A

Spondylosis deformans

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13
Q

̜ Dramatic disc height loss
̜ Minimal spondylosis
̜ Possible vacuum (intradiscal gas)
̜ Endplate cartilage erosion

A

Intervertebral osteochondrosis

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14
Q

• Localized or focal displacement of disc material beyond the limits
of the intervertebral disc space
• Extension of disc material less than 25% (90o) of the periphery of
the disc as viewed in the axial plane

A

Subtypes II and III: herniation

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15
Q

how are disc herniations classified

A

• Protrusion • Extrusion

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16
Q

̜ Disruption of the disc associated with physical and/or imaging
evidence of violent fracture and/or dislocation

A

trauma

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17
Q

does trauma include: Repetitive injury

A

NO

18
Q

does trauma include: Contribution of less than violent trauma to the degenerative process

A

NO

19
Q

does trauma include: herniation Fragmentation of the ring apophysis in conjunction with disc

A

NO

20
Q

does trauma include: Disc abnormalities associated with degenerative subluxations

A

NO

21
Q

Infection

Modic disease

Inflammatory response to a spondyloarthropathy

A

inflammatory change to the

intervertebral disc

22
Q

Inflammatory spondylitis of the subchondral endplate and bone marrow associated with degenerative pathologic changes to the disc

A

Modic disease

23
Q

Vertebral:
• Loss of vertebral endplate cortex • Vertebral marrow signal abnormality abutting the disc • Hypointense on T1, hyperintense on fat-sat T2 or STIR • Avid enhancement with gad

A

Infectious spondylitis and discitis

24
Q

Disc:
• Disc space narrowing
• Hypointense on T1, hyperintense T2
• Diffuse post-gad enhancement

A

Infectious spondylitis and discitis

25
Q

when you see an infection of the spine w/ an xray… how long has the pt had to be infected

A

2 weeks

26
Q

Acute, with disruption and fissuring of the endplates with adjacent fibrous
tissue • Marrow edema and inflammation • Low on T1, high on T2

A

type I changes of Modic endplate

27
Q
  • More chronic process
  • Fatty degeneration of adjacent marrow
  • High on T1, iso- to slightly high on T2
A

type II changes of Modic endplate

28
Q
  • Consistent with endplate sclerosis on x-ray

* Low on both T1 and T2

A

type III changes of Modic endplate

29
Q 
̜ First involves the SI joints
̜ Second involves T/L junction
̜ MRI: 
• Low signal intensity bone marrow at corner on T1
• High signal intensity bone
marrow at early corner on T2 and STIR
A

Seronegative

spondyloarthropathy

30
Q

Anytime a neoplasm, benign or malignant, primary
or metastatic, is present within the osseous spine, it
may have a morphological effect on the

A

adjacent disc

31
Q

beyond the edges of the ring apophyses, throughout the circumference of the disc
Presence of disc tissue extending

A

Disc Bulge

32
Q

asymmetric bulging disc tissue is greater than _____ of the disc circumference

A

25%

33
Q

generalized disc bulge:

A

greater than 50%

34
Q

circumferential disc bulge:

A

100%

35
Q

what is a contained disc bulge

A

If the displaced portion of the disc is covered by outer annulus fibers and/or the PLL

36
Q

When the base of the herniated disc material is larger than the most distal portion

A

Protrusion

37
Q

̜ When the distal portion of disc material is larger than the base
of the herniation ̜
The material, while attached to the parent disc, may migrate in the cephalad or caudal direction

A

Extrusion

38
Q

no continuity exists between the disc material

that is beyond the disc space and that which is within the disc space

A

Sequestration

39
Q

When a portion of disc material separates from the parent disc and migrates away, either cephalad, caudal, lateral, or
posterior

A

Sequestration

40
Q

Intravertebral Herniation

A

“Schmorl’s node”

41
Q

Disc material herniates in the
vertical direction through a defect in
the vertebral endplate

A

Intravertebral Herniation

42
Q

̜ _____ means to rub or wipe out

̜ To obliterate or make indistinct; the obliteration of features

A

Effacement

Tri 6 - Ortho Image (4 decks)

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