Imaging Upper Quarter Flashcards

1
Q

What routine radiographs can we do for cervical spine?

A
  • AP open mouth
  • AP lower cervical spine
  • Lateral

Less commonly: oblique

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2
Q

What does the AP open mouth positioning best demonstrate?

A

The AA joint

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3
Q

What will we find with the AP open mouth image?

A
  • Dens is superimposed on anterior and posterior arches of C1
  • arch borders image as lines so distinguish from fractures
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4
Q

What does AP lower cervical spine demonstrate best?

A
  • demonstrates lower cervical vertebrae, upper thoracic, associated ribs and clavicles
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5
Q

What will we see on an AP Lower cervical spine image?

A
  • vertically aligned vertebral bodies
  • midline spinous processes
  • lateral column: overlapping articular pillars and Z jts., one smooth bony column lateral to the bodies
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6
Q

What other structures can we see on a AP lower cervical spine image aside from the lower cervical spine?

A
  • TPs difficult to discern
  • U joints
  • Air filled trachea
  • Clavicles
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7
Q

What does a lateral image best demonstrate?

A
  • alignment of all cervical vertebra
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8
Q

What is the normal alignment of the vertebral in a lateral image?

A

3 ~ parallel lines

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9
Q

What are the 3 parallel lines in the vertebra in a lateral image?

A
  • anterior vertebral borders
  • posterior vertebral borders
  • spinolaminar line
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10
Q

What is the spinolaminar line?

A
  • spinous process and laminae junction
  • represents posterior extent of central spinal canal
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11
Q

What should the 3 parallel lines do?

A

Remain constant whether neck is in neutral, flexed, or extended aka stress views when investigating mechanical instability

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12
Q

What is lateral the BEST view for?

A
  • view of disc spaces
  • view for z joint spaces
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13
Q

What are the vertebral bodies looking like in a lateral image?

A

boxed with smooth edges

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14
Q

Why can you not really see the TPs in a lateral image?

A

Superimposed over bodies

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15
Q

What is the space between anterior dens and atlas indicating?

A

The distance kept by the transverse ligament

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16
Q

How much of the distance should be kept by the transverse ligament in adults? How much is a concern?

A

2.5mm for adults; ≥ 3.5 is a concern for instability

17
Q

How much of the distance should be kept by the transverse ligament in children?

18
Q

What can too much distance indicate?

A

Transverse ligament may be damaged

19
Q

What is oblique the best view for?

A

single side intervertebral foramen

20
Q

What is the standard imaging in the ER following head and neck trauma?

A

CT - picks up more fractures

21
Q

What are routine radiographs for the shoulder?

A
  • AP in external rotation
  • AP in internal roatation
22
Q

What is AP in External rotation a profile of?

A

Greater tubercle and glenohumeral joint space

23
Q

What is AP in internal rotation a profile of?

A

lesser tubercle

24
Q

What is the scapular Y lateral view most frequently used for?

A
  • assessment of fractures or dislocations. of the proximal humerus
25
What is the axillary view most frequently used for?
Assessing dislocations
26
What should we look at in the shoulder when assessing for age related joint changes?
- humeral head alignment and shape possibly affected by supraspinatus - greater tuberosity ? - bone density? Sclerosis? - Cartilage space?
27
What is the most commonly missed fracture?
scaphoid fracture
28
After trauma, if clinical S&S indicate a fracture, what should we do?
- immobilize and refer for imaging
29
Following a gradual onset, if clinical S&S indicate a fracture, what should we realize?
early radiographs may be negative for a stress fx bc density changes take time to occur
30
Stress fractures may not show on imaging for up to how long?
1-2 weeks