Diagnostic Imaging: The Spine

Question 1

Describe how you would evaluate a spine from a radiograph

Answer 1

Alignement and number of vertebrae
Vertebral shape
Vertebral outline - proliferation/destruction?
Trabecular structure and overall opacity
Intervertebral disc spaces - width and opacity

Question 2

What does myelography show?

Answer 2

Delineates subarachnoid space
Localises lesions of the spinal cord

Question 3

Which agent should you use for myelography?

Answer 3

Non-ionic water-soluble contrast medium

Question 4

What are the indications of myelography?

Answer 4

Neuroloigcal dysfunction
Spinal pain
To further define lesions suspected on plain radiographs

Question 5

List five complications of myelography

Answer 5

Spinal cord damage (intramedullary injection)
Haemorrhage into cord
Infection (meningitis)
Seizures - meningeal irritation
Worsening of neurological signs

Question 6

What most commonly causes an extra-dural lesions, seen on myelography?

Answer 6

Disc extrusion/protrusion

Question 7

What most commonly causes an intra-medullary lesions, seen on myelography?

Answer 7

Cord oedema, myelitis, neoplasia

Question 8

What most commonly causes intra-dural or extra-medullary lesions, seen on myelography?

Answer 8

Nerve root tumour, meningioma