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Part 4 > Diagnostic Imaging > Flashcards

Diagnostic Imaging Flashcards

1
Q

Retropharyngeal space (mm) normal

A

7mm

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2
Q

Normal retrolaryngeal space

A

14 mm

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3
Q

Normal retrotracheal space

A

21/22 mm

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4
Q

If soft tissue is larger than vertebral body, this indicates

A

soft tissue swelling

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5
Q

Soft tissue swelling is due to

A

trauma, infection, malignancy

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6
Q

Normal ADI in adult

A

3 mm

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7
Q

Increased ADI indicates

A

Congenital (down’s syndrome)

Transverse ligament laxity = brace neck, refer out

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8
Q

If atlas has moved anterior: 4 possibilities

A
  1. increased ADI
  2. fractured dens
  3. non-union of the dens
  4. agenesis of the dens
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9
Q

If atlas has moved posterior: 3 possbilities

A
  1. fractured dens
  2. non-union of the dens
  3. agenesis of dens
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10
Q

Marginal syndesmophytes is in what pathology?

A

A.S.

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11
Q

Non-marginal syndesmophytes is in what pathology?

A

reactive arthritis or P.A.

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12
Q

A.S. m/c gender and age

A

males 15-35

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13
Q

Low back pain with morning stiffness

A

ankylosing spondylitis

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14
Q

Lines for basilar impression

A

Chamberlain’s
McGregor’s
McRae’s

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15
Q

Pituitary size

A

12mm x 16mm

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16
Q

AC joint space normal mm

A

3 mm

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17
Q

Acromiohumeral space

A

8-10mm

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18
Q

Xray lines for hips

A

Waldenstrom’s
Klein’s
Iliofemoral
Shenton’s

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19
Q

Boehler’s angle in foot normal

A

28-40 degrees

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20
Q

Posterior ponticle AKA’s

A

Ponticulus posticus
Kimmerle’s anomaly
Ponticle
Foramen arcuate

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21
Q

Presentation of posterior ponticle

A

Calcification of atlanto-occipital ligament or a separate ossficiation center

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22
Q

Clinical presentation of posterior ponticle

A

usually asymptomatic

headaches

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23
Q

Management of posterior ponticle

A

minor concern for ischemia of the posterior cerebral branch

minimize rotation

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24
Q

Occipitalization AKA’s

A

Assimilation of atlas
Blocked vertebrae
Occipito-cervical synostosis
Non-segmentation

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25
Q

Clinical presentation of occipitalization

A 
Usually asymptomatic
Limited ROM
Vertigo
Headaches
Unsteady gait
Paresthesias
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26
Q

Management of occipitalization

A

Flexion and extension views to confirm
MRI for extent of neurological involvement
Adjust if stable

27
Q

Presentation of blocked vertebrae

A

Failure of somite segmentation in embryological development

28
Q

M/c levels for blocked vertebrae

A

C2/3 and C5/6

29
Q

Clinical presentation for blocked vertebrae

A

Diminished ROM

30
Q

DDX for blocked vertebrae

A

Surgically fused vertebrae

Post-discitis appearance

31
Q

Klippel-feil presentation

A

low posterior hairline
decreased ROM
short, webbed neck (pterygium colli)

32
Q

About 25% of klippel feil cases demonstrate elevation where?

A

one or both scapula

- 30-40% demonstrate osseous, fibrous, or cartilaginous structure from the scapula to the spine - omovertebra

33
Q

Os terminale AKA’s

A

Os terminale of Bergmann

Bergmann’s Ossicle

34
Q

Presentation of os terminale

A

failure of fusion of the separate ossification center of the tip of the dens that presents around age 3 and should fuse around age 12

35
Q

Management of os terminale

A

recognize that this is a normal finding under 12 yo; differentiate it from an os odontoideum or odontoid fracture

36
Q

Presentation of os odontoideum

A

Separation of the ossification center of the dens and the ossification center of the body of C2

37
Q

DDX for os odontoideum

A

odontoid fracture (type II), os terminale

38
Q

Xray presentations for os odontoideum

A

Lateral View: separation of dens from body

APOM View: shortening of dens with horizontal cleft at base of dens

39
Q

Management of Os odontoideum

A
  • establish that it is an os odontoideum
  • consider the possibility of neurological compromise
  • perform flexion and extension radiographs
  • order an MRI to evaluate the spinal cord and thecal sac
  • offer a neurological consultation
  • neurosurgical wires to prevent slippage
  • adjust if stable
40
Q

Spina Bifida Occulta AKA’s

A 
Spina Bifida 
Cleft Defect
Dysraphism
Spondyloschisis
Neural Tub Defect
41
Q

M/c place for spina bifida occulta

A

C1, S1

42
Q

Clinical presentation for spina bifida occulta

A

asymptomatic

43
Q

Presentation of SBO

A

lack of spinolaminar line on lateral views, central lucency, non-complete lamina or arch and vertical midline cleft on AP views

44
Q

SBO is sometimes found at which spinal segment

A

C6 associated with spondylolisthesis

45
Q

Knife Clasp Defect AKA’s

A

Clasp Knife deformity

46
Q

Presentation of Knife Clasp Defect

A

Special case of spina bifida occulta at S1 with elongation of the L5 spinous process

47
Q

Clinical Presentation of Knife Clasp Defect

A

Asymptomatic
Increased pain on extension
Bowel or bladder symptoms

48
Q

What is nuchal bone

A

Nuchal ligament calcification

49
Q

M/c age for nuchal bone

A

patients over 40

50
Q

DDX for nuchal bone

A

clay shoveler’s fracture

persistant spinous process apophysis

51
Q

M/c segment for persistent spinous process apophysis

A

C7

52
Q

DDX for cervical ribs

A

transverse process hyperplasia

53
Q

Limbus bone presentation

A

Separated segment of the ring apophysis, usually in lumbar spine

54
Q

Limbus bone is the result of what kind of disc herniation?

A

Peripheral intravertebral disc herniation that separates a corner of the vertebral body from the remainder

55
Q

Clinical presentation for limbus bones

A

asymptomatic

56
Q

Radiographic presentation of limbus bones

A

well rounded margins with a corresponding defect in the parent bone

57
Q

DDX for limbus bone

A

intercalary ossicle, teardrop fracture

58
Q

An inward defect of the vertebral endplate, similar to schmorl’s node

A

nuclear impression

59
Q

Radiographic presentation of nuclear impression

A

Smooth elongated curvilinear defect of the endplate on the lateral view
Cupid’s bow appearance on AP view

60
Q

Clinical Presentation of nuclear impression

A

asymptomatic

61
Q

DDX for nuclear impression

A

schmorl’s nodes, scheuermann’s

62
Q

An intravertebral disc herniation that leaves a sharp, well-defined dfect in the vertebral body above or below; evidence of trauma

A

schmorl’s node

63
Q

M/c area for schmorl’s node

A

thoraco-lumbar spine
Thoracics- anterior 1/3 of endplates
Lumbars - posterior 1/3 of endplates

64
Q

Etiology for schmorl’s nodes

A

Axial compression
Trauma
DDD
Scheuermann’s

Part 4 (19 decks)

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