Imaging (spine) Flashcards
What shows bone outlines in more detail, CT, MRI or X-ray?
CT
X-rays only show bone outlines
CT shows bone outlines in more detail and some soft tissue structures eg lumbar discs
MRI shows bone outlines in less detail but shows bone marrow, discs, ligaments and the spinal cord and nerves
(ie All the soft tissue structures)
What imaging technique shows bone marrow, discs, ligaments and the spianl cords and nerves?
MRI
What does X ray show of the spine?
Only shows bone outlines
What shows soft tissues? (2)
CT
MRI
(especially MRI)
Which parts of spine form lordosis and which form kyphosis?
cervical lordosis
thoracic kyphosis
lumbar lordosis
The third to seventh cervical, all 12 thoracic and 5 lumbar vertebrae have consistent anatomy, comprising:
A vertebral body
A posterior arch, comprising:
2 pedicles
2 laminae
1 spinous process
1 transverse processWhen on the vertibra does the neural foramen lie?
Inferior to the pedicle
What forms the facet joints?
Articular processes project superiorly and inferiorly between the pedicles and laminae, forming the facet joints
Which vertibra has no vertebral body?
C1
IN C1, anterior and posterior arches, united by two large lateral masses, articulate with the occipital bone and C2
Which vertibra has an odontoid process which projects superiorly?
C2
C2 has an odontoid process which projects superiorly into C1, forming a joint with its anterior arch
”#” =
Fracture
When do you CT a trauma?
If x-ray shows fracture but more detail required or need to see if any more fractured present
If x-ray normal but high clinical suspicion of fracture
What is a “burst” fracture?
A burst fracture is a descriptive term for an injury to the spine in which the vertebral body is severely compressed.
What are the CT signs of a “burst fracture”?
A squished vertibra
consecutive vertebrae are meant to be similar size
What is the role of the intervertebral ligaments?
tether vertebrae together and are responsible for spinal stability
What are ligaments seen on?
X-ray, CT, MRI
MRI
(not x-ray or CT)
(normal ligaments are black on MRI scans, damaged ligaments are light on MRI)
What does abnormal vertebral ALIGNMENT on x-ray or CT imply?
Ligament damage
Unstable spine
How does a damaged ligament look on MRI?
Light
Normal ligaments are black on MRI
When is MRI used to image spinal trauma?
To provide detail of the spinal ligaments
In patients with neurological deficit, which is not explained by x-ray or CT, to show soft tissue abnormality, such as:
Acute prolapsed intervertebral disc
Epidural haematoma
Spinal cord damage
What imaging features of bony tumours in the spine may by seen on X-ray and CT.
Bone destruction (reduced bone density) Vertebral collapse (‘pathological #’) Bone sclerosis increased bone density)
What unique findings may be found on MRI (of bony tumours in the spine)?
early - bone marrow infiltration
late - extradural mass and spinal cord compression
What is the purpose of intervertebral discs?
cushion the body from spinal stressed
What happens when intervertebral discs dehydrate?
Prelude to disease
Healthy discs are pliable and contain water – allows them to be spongy
What is the annulus fibrosis
Disc lining
(The annulus fibrosus is the strong wrapping that makes up the outside portion of the intervertebral disc. Its job is to contain and protect the soft material located in the center of the disc. This soft center is called the nucleus pulposus.)
What type of imaging shows intervertebral discs and disc prolapse?
(x rays, CT, MRI)
CT and MRI
(not X-ray as they’re made of soft tissue)
MRI is best (even shows early disc dehydration which precedes herniation)
What type of imaging shows the spinal cord?
x rays, CT, MRI
MRI
(poorly shown by CT)
(invisible on x-rays)
Name 4 causes of spinal cord disease:
Trauma
Demyelination
Tumour
Ischaemia
Can normal vertebral antomy be appreciated on x-ray?
Yes
Can x-rays help in patients with sciatica?
No
What imaging technique is best for seeing soft tissue disorders?
MRI
