LAteral Lumbar Flashcards
Check soft tissue in front of the vertebral bodies
Abdominal aorta
Renal artery
Most common location for an aortic aneurysm
Distal to the renal arteries (L2-4)
AAA
More than 1/2 width of vertebral body
Normal abdominal aorta can measure up to 3.8 cm if
Calcified atherosclerosis
If larger than the VB
AAA
Radiographic signs abdominal aorta
Aortic dilation
Curvilinear calcification
Fusiform appearance
Special test Abdominal aorta
Doppler
Diagnostic ultrasound
Ultrasonography
CT
Case management abdominal aorta
Refer to cardiovascular specialist
Small aneurysm
May produce no signs
Refer to cardiologist
Tearing pain, deep rebounding pain, sudden onset LBP, deep/boring pain in abdomen
Shock
Refer immediate surgery
ER
Renal artery
Most commonly found at L2
Calcification renal artery
Cheerio sign smaller than L2
Renal artery aneurysm
Cheerio sign larger than L2
Check front of VB
Avulsion/compression fx
AS marg syndesmophytes
Lipping/spurring - DJD, inflammation
DISH disc presence
Check alterations of color and shape
Shape PFC
Draw a line along ant body
Does fragment cross line
Yes = avulsion fx No = limbus bone
Check disc spaces and endplates
Disc still presents DISH etc
Check posterior bodies, pedicles, facets and pars
Spondylolisthesis
Slippage of the VB with or without fracture
Spondylolisthesis
Type 1 dysplastic spondylolisthesis
Congenital anomaly causes anterior slippage
Type 2 isthmic spondylolisthesis aka spondylolytic spondylolisthesis
Break through the pars
Type 3 degenerative spondylolisthesis aka non-spondylolytic spondylolisthesis
DJD of facets
Advanced OA
Type 4 traumatic spondylolisthesis
Break through the pedicles - hangman’s fx
Type 5 pathological spondylolisthesis
Obvious pathology on that segment
Meyerding’s grading system
Take VB and divide it into quarters Grade 1 = 1-25% slippage Grade 2 = 26-50% slippage Grade 3 = 51-75% slippage Grade 4 = 76-100% slippage
Inverted napolean hat sign aka
Bowline of brailsford
Gendarme hat
X-rays spondylolisthesis napolean hat
Flexion/extension/oblique x-rays
Special tests spondylolisthesis
SPECT test
Case management spondylolisthesis
If stable, conservative chiro care and postural rehab
If L5 slips >100% dropped in front of sacrum
Spondyloptosis
