Imaging of the Spine Flashcards
What are the lecture outcomes for the imaging of the spine?
- Revise spine anatomy
- Identify normal anatomy of the spine on x-ray
- Appropriate imaging of the spine
- Introduction to common pathologies of the spine on imaging
- Introduction to image guided spinal procedures
List the modalities used for spinal imaging.
- X-ray
- Fluoro – procedures, myelography
- CT – bone assessment, guided biopsy, steroid injection
- MRI – cord, nerves, cauda equina, vertebral column, muscles
- DSA – spinal angiography, venography, myelography
- NM – Bone scan
- Ultrasound – fetal, neonatal spine
What is the sensitivity of cervical spine x-ray compared to CT?
Cervical spine x-ray sensitivity is 50-60% while CT sensitivity is 98%.
What are the indications for spine x-ray?
- Significant trauma
- Low back pain (only image if red flags)
True or False: CT has a higher radiation dose compared to x-ray.
True
What is a flexion teardrop fracture?
A type of fracture associated with significant trauma, often indicating instability.
What constitutes an unstable spine fracture?
Fracture involving two or more columns.
What is spondylolisthesis?
A condition where a vertebra slips out of place.
What is the next investigation for a patient with lower back pain and reduced sensation?
MRI
Fill in the blank: The common treatment options for spine issues include _______.
[oral analgesia, physiotherapy, radiologically guided targeted analgesia, surgery]
What is the significance of correlating imaging findings with symptoms?
It is crucial due to the high prevalence of low back pain (up to 2/3 of people).
What is the diagnosis for a patient with vertebral bone fragments showing metastatic poorly differentiated adenocarcinoma?
The diagnosis is in keeping with breast primary.
What findings are expected in a case of L1-2 discitis and osteomyelitis?
Elevated white blood cell count, high CRP, and possible MRI findings.
What procedures are included in image guided spinal procedures?
- Steroid injection
- Myelography
What is the typical investigation for a patient with a suspected psoas abscess?
CT guided percutaneous drainage.
What are the common pathologies of the spine mentioned?
- Fractures
- Disc protrusions
- Metastatic disease
- Infection
What does an MRI assess in relation to the spine?
- Cord
- Nerves
- Cauda equina
- Vertebral column
- Muscles
What are the potential next investigations for a patient with atraumatic back pain?
- NM Bone Scan
- FDG PET-CT
- CT chest, abdomen and pelvis
