L-Spine

Question 1

Trauma

age>/= 16 with blunt trauma criteria met

first image

Answer 1

thoracic and lumbar CT

Question 2

Trauma

age >/= 16 with positive results for acute Lspine or Tspine injury via x-ray or CT

second image

Answer 2

thoracic and lumbar MRI

Question 3

Trauma

age <16 with suspected trauma

Answer 3

thoracic and lumbar x-ray

Question 4

low back pain

acute or chronic w/ or w/o radiculopathy

Answer 4

NO imaging indicated

try conservative approach first

Question 5

low back pain

subacute/chronic LBP pt thats a surgical or therapeutic candidate who has undergone 6wks of therapy w/o improvement (or inc severity)

Answer 5

lumbar MRI

Question 6

low back pain

LBP + suspected cauda equina syndrome

Answer 6

MRI

Question 7

low back pain

LBP w/ Hx of surgery and new s/s

first image

Answer 7

x-ray OR MRI

Question 8

low back pain

LBP with or without radiculopathy + elderly, osteoporosis risk , steriods, low vel trauma

think Roman/ Henschke’s rules

catch all…

Answer 8

MRI or CT or X-ray

Question 9

low back pain

LBP +/- radiculopathy and suspected CA/ infection/ immunosuppression

Answer 9

MRI

Question 10

children

BP in children w/o red flags

Answer 10

not highly recommended (2/9)

Question 11

children

BP in children w/ red flags

Answer 11

x-ray (8/9)

Question 12

these are the (2) common routine radiologic exam views of the L- spine

Answer 12

AP
Lateral

Question 13

these are the (2) common routine radiologic exam views of the SIJ

Answer 13

AP axial
R/L oblique

Question 14

this x-ray view is preferrred for observing landmarks such as pedicles, spinious processes, lateral borders, disc space, and even psoas muscle abnormalities

Answer 14

AP projection

Question 15

this x-ray view is preferred for showing landmarks such as the AP border alignment, lat neuroforamen, disc space, postural abnormalities, etc.

Answer 15

lateral projection

Question 16

this x-ray view is preferred for viewing articulating processes, z-joints and the pars articularis (scotty dog)

which side is demonstrated in the picture?

Answer 16

posterior oblique (right PO pictured in pt pic)

Question 17

this x-ray view is preferred for viewing the 3 parallel lines (a/p vetebral body and spinous process alignment) , disc spaces, and lumbosacral angles

*typically focused on particular segment

Answer 17

coned lateral view

Question 18

thix x-ray view is preferred for landmarks such as osseous margins, SIJ symmetry, L5/S1 and the coccyx. It’s typically performed with the body angled at ~30-35deg

Answer 18

AP axial of SIJs

Question 19

this x-ray view is preferred for SIJ and degenerative change and ankylosing/fibrosis

Answer 19

L/R oblique views of SIJ

Question 20

basic protocol for lumbar/SIJ CT involves ___viewed via____ and reformatted to sagittal and coronal claims

Answer 20

lower thoracic to SIJ (or less) via axial slices

Question 21

basic protocol of lumbar/SIJ MRI involves these 2 planes

Answer 21

axial and sagittal