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Diagnostic Imaging Tatum > DegenerativeSpineDz > Flashcards

DegenerativeSpineDz Flashcards

1
Q

most common segments in spine for degenerative disc disease

A

cervicals - C5 and C6

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2
Q

characteristics of degenerative disc disease

A
  • decreased disc height
  • osteophyte formation
  • endplate sclerosis
  • vacuum phenomenon
  • subluxation
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3
Q

degeneration of outer disc. marked by osteophytes

A

spondylosis deformans

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4
Q

degeneration of inner disc. marked by reduced IVD space

A

intervertebral chondrosis

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5
Q

posterior osteophytes in DDD could suggest what

A

vertebral canal stenosis

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6
Q

who described inner and outer DDD

A

resnick and niwayama

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7
Q

what are some of the findings of IVD osteochondrosis

A
  • primary degeneration of the nucleus pulposus
  • loss of disc height with minimal osteophytosis
  • knutson’s vacuum phenomenon
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8
Q

nitrogen gas within cracks and fissures of a desiccated disc that causes radiolucent line in the IVD space

A

knutson’s vacuum phenomenon

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9
Q

where is knutson’s vacuum phenomenon most likely seen and what does it signify

A

best seen at anterior margin of the IVD on extension films and it indicates DDD

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10
Q

degeneration of annulus fibrosis

A

spondylosis deformans… also may includes prominent ostephytosis

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11
Q

do osteophytes in spondylosis deformans normally extend horizontally then vertically or vice versa

A

horizontally then vertically. they may even bridge the IVD space

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12
Q

intercalary ossicles indicate

A

annulus degeneration (spondylosis deformans)

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13
Q

represents infraction, compression, and necrosis of stressed subchondral bone trabeculae

A

endplate sclerosis

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14
Q

modic type I

A
  • dark T1

- bright T2

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15
Q

modic type II

A
  • bright T1

- bright T2

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16
Q

modic type III

A
  • dark T1

- dark T2

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17
Q

what does modic type I indicate

A

inflammation (marrow edema)

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18
Q

what does modic type II indicate

A

fat

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19
Q

what does modic type III indicate

A

sclerosis

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20
Q

exaggerated endplate sclerosis caused by DDD

A

hemispherical spondylosclerosis

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21
Q

abrupt, focal, radiolucent IVD displacement into the cancellous bone of the adjacent vertebral body

A

schmorl’s nodes

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22
Q

what do schmorl’s nodes indicate

A

DDD

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23
Q

disc space narrowing and endplate irregularity

A

scheuermann’s disease

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24
Q

juvenile discongenic disease

A

scheuermann’s disease

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25
Q

up to 20-40% of those presenting to MRI with back pain have what diagnosis

A

scheuermann’s disease

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26
Q

posterior subluxation is caused by

A

DDD

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27
Q

anterior subluxation is caused by

A

posterior joint arthrosis (spondylolisthesis)

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28
Q

what is the clinical significance of uncinate hypertrophy

A

IVF encroachment

29
Q

lateral projection of degeneration of uncinate processes can give the appearance of

A

pseudofracture

30
Q

exuberant hypertrophic changes involving the anterior vertebral body margins

A

DISH

31
Q

DISH

A

diffuse idiopathic skeletal hyperostosis

32
Q

synonyms for DISH

A
  • ankylosing hyperostosis

- forestier’s disease

33
Q

symptoms and associations with DISH

A
  • males over 50
  • incidence higher in diabetics
  • hoarsness
  • dysphagia
34
Q

where is DISH most prevalent in the spine

A

ALL from lower cervicals to upper lumbars

35
Q

pathological osseous proliferation at tendon or ligament insertion

A

enthesopathy

36
Q

are enthesopathies degenerative or inflammatory

A

both

37
Q

what is a clinical possibility that people with DISH to be checked for

A

diabetes mellitus

38
Q

what is the most likely etiology for siatica

A

disc herniation

39
Q

japanese disease

A

OPLL

40
Q

OPLL is often seen with what other condition

A

DISH

41
Q

can result in loss of sagittal diameter of the spinal canal, with resultant myelopathy

A

OPLL

42
Q

what percentage of disc herniations are asymptomatic

A

20-35%

43
Q

one of the most serious complications of disc herniations

A

cauda equina syndrome

44
Q

what is the next step upon diagnosis of cauda equina syndrome

A

neurosurgical consultation

45
Q

symptoms of cauda equina syndrome

A
  • altered bowel and bladder function
  • impotence
  • saddle paresthesia
  • progressive muscle atrophy
46
Q

most common surgical procedure to treat IVD herniation

A

discectomy. (others include laminectomy, precutaneous discectomy, microdiscectomy)

47
Q

conservative management of IVD herniation

A
  • chiropractic
  • limited bed rest
  • drugs (NSAID)
  • injections (epidural steroids)
  • physical therapy (ice, braces, modalities)
  • acupuncture
48
Q

if there is a lateral herniation of the C5/C6 disc what is affected

A

C6 nerve root

49
Q

if there is a midline disc herniation of the C5/C6 what is affected

A

this results in myelopathies

50
Q

if there is a lateral herniation of the L3/L4 disc what is affected

A

L3 nerve root

51
Q

if there is a midline herniation of the L3/L4 disc what is affected

A

L4 nerve root

52
Q

what are the contents of the spinal canal

A
  • thecal sac
  • epidural fat
  • internal vertebral plexus
  • ligamentum flavum
  • PLL
53
Q

which film modality does not use radiation

A

MRI

54
Q

considered gold standard for disc imaging

A

MRI

55
Q

zones of herniation

A
  • central
  • paracentral
  • foraminal
  • extraforaminal
56
Q

what are some indirect findings on plain films of disc herniation

A
  • marginal osteophytes
  • reduced disc space
  • posterior subluxation
  • radiopaque ossicle in vertebral canal
57
Q

area of high signal intensity on T2-weighted MRI of the disc, usually referring to the outer annulus

A

high intensity zone

58
Q

circumferential symmetric extension of the disc beyond the interspace

A

bulge

59
Q

focal or asymmetric extension of the disc beyond the interspace

A

protrusion

60
Q

extreme extension of the disc beyond the interspace

A

extrusion

61
Q

no connection between the disc and the fragment that used to be the disc

A

sequestration

62
Q

imaging study that identifies disc lesions by injecting a water or oil based contrast into the subarachnoid space

A

myelogram

63
Q

imaging study that identifies disc lesions by injecting a radiopaque contrast into the nucleus pulposus to image morphology

A

discography

64
Q

narrowing of the spinal canal or IVF

A

spinal stenosis

65
Q

ocngenital form of spinal stenosis

A

achondroplasia

66
Q

three zones of the spinal canal

A

central - spinal canal

67
Q

what is considered “spinal stenosis” in the cervical spine

A

less than 12mm

68
Q

what is considered “spinal stenosis” in the lumbar spine

A

less than 15mm

69
Q

what are the parameters for the sagittal spinal canal when making measurements

A

anterior line - posterior portion of vertebral body

Diagnostic Imaging Tatum (4 decks)

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