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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
Clinical presentation of occipitalization
``` Usually asymptomatic Limited ROM Vertigo Headaches Unsteady gait Paresthesias ```
26
Management of occipitalization
Flexion and extension views to confirm MRI for extent of neurological involvement Adjust if stable
27
Presentation of blocked vertebrae
Failure of somite segmentation in embryological development
28
M/c levels for blocked vertebrae
C2/3 and C5/6
29
Clinical presentation for blocked vertebrae
Diminished ROM
30
DDX for blocked vertebrae
Surgically fused vertebrae | Post-discitis appearance
31
Klippel-feil presentation
low posterior hairline decreased ROM short, webbed neck (pterygium colli)
32
About 25% of klippel feil cases demonstrate elevation where?
one or both scapula | - 30-40% demonstrate osseous, fibrous, or cartilaginous structure from the scapula to the spine - omovertebra
33
Os terminale AKA's
Os terminale of Bergmann | Bergmann's Ossicle
34
Presentation of os terminale
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
Management of os terminale
recognize that this is a normal finding under 12 yo; differentiate it from an os odontoideum or odontoid fracture
36
Presentation of os odontoideum
Separation of the ossification center of the dens and the ossification center of the body of C2
37
DDX for os odontoideum
odontoid fracture (type II), os terminale
38
Xray presentations for os odontoideum
Lateral View: separation of dens from body | APOM View: shortening of dens with horizontal cleft at base of dens
39
Management of Os odontoideum
- 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
Spina Bifida Occulta AKA's
``` Spina Bifida Cleft Defect Dysraphism Spondyloschisis Neural Tub Defect ```
41
M/c place for spina bifida occulta
C1, S1
42
Clinical presentation for spina bifida occulta
asymptomatic
43
Presentation of SBO
lack of spinolaminar line on lateral views, central lucency, non-complete lamina or arch and vertical midline cleft on AP views
44
SBO is sometimes found at which spinal segment
C6 associated with spondylolisthesis
45
Knife Clasp Defect AKA's
Clasp Knife deformity
46
Presentation of Knife Clasp Defect
Special case of spina bifida occulta at S1 with elongation of the L5 spinous process
47
Clinical Presentation of Knife Clasp Defect
Asymptomatic Increased pain on extension Bowel or bladder symptoms
48
What is nuchal bone
Nuchal ligament calcification
49
M/c age for nuchal bone
patients over 40
50
DDX for nuchal bone
clay shoveler's fracture | persistant spinous process apophysis
51
M/c segment for persistent spinous process apophysis
C7
52
DDX for cervical ribs
transverse process hyperplasia
53
Limbus bone presentation
Separated segment of the ring apophysis, usually in lumbar spine
54
Limbus bone is the result of what kind of disc herniation?
Peripheral intravertebral disc herniation that separates a corner of the vertebral body from the remainder
55
Clinical presentation for limbus bones
asymptomatic
56
Radiographic presentation of limbus bones
well rounded margins with a corresponding defect in the parent bone
57
DDX for limbus bone
intercalary ossicle, teardrop fracture
58
An inward defect of the vertebral endplate, similar to schmorl's node
nuclear impression
59
Radiographic presentation of nuclear impression
Smooth elongated curvilinear defect of the endplate on the lateral view Cupid's bow appearance on AP view
60
Clinical Presentation of nuclear impression
asymptomatic
61
DDX for nuclear impression
schmorl's nodes, scheuermann's
62
An intravertebral disc herniation that leaves a sharp, well-defined dfect in the vertebral body above or below; evidence of trauma
schmorl's node
63
M/c area for schmorl's node
thoraco-lumbar spine Thoracics- anterior 1/3 of endplates Lumbars - posterior 1/3 of endplates
64
Etiology for schmorl's nodes
Axial compression Trauma DDD Scheuermann's

Part 4 (19 decks)

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