Imaging of spine Flashcards
When should imaging be employed when patients present with back pain?
Most back pain patients don’t require imaging
Need to select patients that have potential for serious instability or neurological damage
When is plain film useful for spinal imaging?
Alignment
Fractures
When is MRI useful for spinal imaging?
Looking at soft tissue structures
When is CT useful for spinal imaging?
Fractures
Discs
Describe the curvatures of the spine?
Cervical and lumbar: lordosis
Thoracic and sacral: kyphosis
Describe the orientation of the facets in the lumbar spine?
Oblique
Describe the shape of vertebral bodies in the lumbar spine?
Concavity in lateral, anterior and posterior margins
Describe what is seen when viewing an X-ray of the anterior lumbar spine?
Thicker cortical bone
Concavity of body
Ring of shadows of cortex of pedicle
Spinal canal between pedicles
Describe why two lines of cortical bine are sometimes seen in imaging of the spine?
When cortical margin in oblique to X-ray beam
Describe what can be seen in an X-ray image of the lateral spine?
Thick and broad spinous process
Thicker cortical bone
Describe what can be seen in an oblique X-ray of the spine?
Scotty dog appearance
Where is a common fracture site of the spine in young people?
How does it appear on imaging?
Lamina - stress fractures
Neck of Scotty dog
Label the features of these X-rays?
How can intervertebral discs be visualised?
CT (T2 weighted)
MRI
Describe the appearance of the intervertebral discs in a T2 weighted C2 image?
Centre of discs appeasr bright
Strong signal due to water content of nucleus