Imaging (spine)

Question 1

What shows bone outlines in more detail, CT, MRI or X-ray?

Answer 1

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)

Question 2

What imaging technique shows bone marrow, discs, ligaments and the spianl cords and nerves?

Answer 2

MRI

Question 3

What does X ray show of the spine?

Answer 3

Only shows bone outlines

Question 4

What shows soft tissues? (2)

Answer 4

CT
MRI

(especially MRI)

Question 5

Which parts of spine form lordosis and which form kyphosis?

Answer 5

cervical lordosis
thoracic kyphosis
lumbar lordosis

Question 6

The third to seventh cervical, all 12 thoracic and 5 lumbar vertebrae have consistent anatomy, comprising:

Answer 6

A vertebral body
A posterior arch, comprising:
    2 pedicles
    2 laminae
    1 spinous process
    1 transverse process

Question 7

When on the vertibra does the neural foramen lie?

Answer 7

Inferior to the pedicle

Question 8

What forms the facet joints?

Answer 8

Articular processes project superiorly and inferiorly between the pedicles and laminae, forming the facet joints

Question 9

Which vertibra has no vertebral body?

Answer 9

C1

IN C1, anterior and posterior arches, united by two large lateral masses, articulate with the occipital bone and C2

Question 10

Which vertibra has an odontoid process which projects superiorly?

Answer 10

C2

C2 has an odontoid process which projects superiorly into C1, forming a joint with its anterior arch

Question 11

”#” =

Answer 11

Fracture

Question 12

When do you CT a trauma?

Answer 12

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

Question 13

What is a “burst” fracture?

Answer 13

A burst fracture is a descriptive term for an injury to the spine in which the vertebral body is severely compressed.

Question 14

What are the CT signs of a “burst fracture”?

Answer 14

A squished vertibra

consecutive vertebrae are meant to be similar size

Question 15

What is the role of the intervertebral ligaments?

Answer 15

tether vertebrae together and are responsible for spinal stability

Question 16

What are ligaments seen on?

X-ray, CT, MRI

Answer 16

MRI
(not x-ray or CT)

(normal ligaments are black on MRI scans, damaged ligaments are light on MRI)

Question 17

What does abnormal vertebral ALIGNMENT on x-ray or CT imply?

Answer 17

Ligament damage

Unstable spine

Question 18

How does a damaged ligament look on MRI?

Answer 18

Light

Normal ligaments are black on MRI

Question 19

When is MRI used to image spinal trauma?

Answer 19

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

Question 20

What imaging features of bony tumours in the spine may by seen on X-ray and CT.

Answer 20

Bone destruction (reduced bone density)
Vertebral collapse (‘pathological #’)
Bone sclerosis increased bone density)

Question 21

What unique findings may be found on MRI (of bony tumours in the spine)?

Answer 21

early - bone marrow infiltration

late - extradural mass and spinal cord compression

Question 22

What is the purpose of intervertebral discs?

Answer 22

cushion the body from spinal stressed

Question 23

What happens when intervertebral discs dehydrate?

Answer 23

Prelude to disease

Healthy discs are pliable and contain water – allows them to be spongy

Question 24

What is the annulus fibrosis

Answer 24

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.)

Question 25

What type of imaging shows intervertebral discs and disc prolapse?
(x rays, CT, MRI)

Answer 25

CT and MRI
(not X-ray as they’re made of soft tissue)

MRI is best (even shows early disc dehydration which precedes herniation)

Question 26

What type of imaging shows the spinal cord?

x rays, CT, MRI

Answer 26

MRI
(poorly shown by CT)
(invisible on x-rays)

Question 27

Name 4 causes of spinal cord disease:

Answer 27

Trauma
Demyelination
Tumour
Ischaemia

Question 28

Can normal vertebral antomy be appreciated on x-ray?

Answer 28

Yes

Question 29

Can x-rays help in patients with sciatica?

Answer 29

No

Question 30

What imaging technique is best for seeing soft tissue disorders?

Answer 30

MRI