Imaging of the spine Flashcards

1
Q

What are the curvatures of the spine?

A
  • Cervical and lumbar lordoses
  • Thoracic and sacral kyphoses
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2
Q

What orientation are the facets in the lumbar spine?

A

Oblique

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3
Q

What does oblique imaging of the spine allow for?

A

Visualisation of facet joints

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4
Q

What are the spaces present in the vertebral column?

A
  • Intervertebral foramina
  • Spinal canal
  • Intelaminar
  • Interspinous
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5
Q

Which MRI modality is useful for imaging IV discs?

A

T2 - signal comes from water in nucleus pulposis

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6
Q

What happens to the spinal cord below L1?

A

It becomes cauda equina

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7
Q

What exits the IV foramen from superior to inferior?

A
  • Spinal nerves
  • Small artery
  • Small nerve
  • Veins.
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8
Q

What is the IV forament between?

A

Pedicles (superior and inferior), vertebral body and IV disc anteriorly, spinous process posteriorly.

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9
Q

What do nerves exit below?

A

Their pedicle, e.g. L2 nerve root exits below L2 pedicle, between L2 and L3 vertebrae.

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10
Q

Will IV disc protrusion compress its spinal nerve?

A

No, because the spinal nerve exits above the level of the disc - it can affect the actual spinal cord, though.

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11
Q

What will lateral disc protrusion at the L4/L5 IV vertebrae affect?

A

L5 nerve, not L4.

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12
Q

How do the anterior and posterior longitudinal ligaments appear in MRI?

A

As black lines running down the front and back of the vertebral body.

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13
Q

Why do we use MRI in the spine?

A

Because it’s useful for looking at the contents of the spinal canal, the discs and the nerve roots.

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14
Q

What are the advantages and disadvantages of MRI in imaging the spine?

A
  • Advantages: can see the spinal canal, cord, IV discs and nerve roots. Doesn’t use radiation.
  • Disadvantages: bone visualisation is poor.
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15
Q

What is present in the thoracic vertebrae that isn’t in other vertebrae?

A
  • Shape and direction of spinous process is different
  • Longer and directed more inferiorly
  • Superior and inferior articular facets not coronal, allowing rotation
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16
Q

What is the main use of plan film x-rays in the spine today?

A

For alignment

17
Q

What can disc protrusions be diagnosed using?

A

CT but not on plain films.

18
Q

What are the disadvantages of CT?

A

Radiation

19
Q

What are the advantages of CT?

A
  • Bone detail
  • Can visualise complex and multi-planar images
20
Q

What is bone scintigraphy?

A
  • Injected technetium emits gamma rays – counted by scanner.
  • Technetium taken up by osteoblasts.
21
Q

What is bone scintigraphy used to assess?

A

Vascularity and osteoblastic activity

22
Q

What is bone densitometry?

A
  • Dual energy X-Ray Absorptiometry
  • Uses low dose radiation (X-rays) to measure bone mineral density (BMD)
  • Compares measured BMD of the femoral neck or lumbar spine with age-matched reference ranges (Z score) or young normals (T score)
23
Q

What can bone densitometry combined with other clinical information give information on?

A

Risk of fracture