Lateral Thoracic Flashcards
Check down the front of the bodies
Lipping/spurring
Hyperostosis
Loss of anterior body height 25% or more
Loss of anterior body height by 10-15%
Loss of anterior body height by 25% or more
Osteoporosis/osteopenia
Trauma
Infection
Malignancy
Osteoporosis
Grey bone/grey soft tissue with pencil thin cortices of the vertebral bodies
NEVER causes decrease in posterior body height
Case hx or signs of new trauma on film
Trauma
Step defect
Line of double density
Step defect
Fractured vertebral endplate and it slides forward
Line of double density aka
Line of condensation
Zone of impaction
Loss of ant and post body height
Malignancy
Slight loss of body height 15%
Mild compression
Infection
Scheurmann’s
Scheurmann’s aka
Avascular necrosis Ischemic necrosis Aseptic necrosis Osteonecrosis Subchondral necrosis Osteochondrosis of the spine
Scheurmann’s description
Most commonly seen 10-16
AVN secondary growth centers
Case history scheurmann’s
Rounding of the shoulders
Increased kyphosis
Back pain
Radiographic signs scheurmann’s
Slight loss of anterior body height of one or more vertebrae (10-15%)
Multiple endplate irregularities of 3 or more continuous vertebrae
Destruction is similar from endplate to endplate
Case management scheurmann’s
Thoracolumbar brace Strengthen erectors Stretch the pecs Self resolving Adjust
Scheurmann’s ask to speak to
Ortho surgeon
Takes 2 months to show up on x-ray
Scheurmann’s can lead to
Permanent postural deformity
Early DJD
Special test scheurmann’s
MRI - 1st
Bone scan - 2nd
Check bodies for alterations in shape and color
Shape - PFC
Color - whiter = blastic, pagets
Darker = lytic or mm
Grey = osteopetrosis or HPT
Posterior body destruction indicates
Malignancy if no signs of trauma or infection
Multiple segments involved in a row posterior body destruction
Multiple myeloma
Schmorls nodes
Tiny AVN
Small irregular
Ant 1/2 of body; can be seen on sup/inf aspect of body
Irregular rough borders
3 or more schmorls nodes
Scheurmann’s disease
Hyperparathyroidism - HPT
Metabolic condition Rugger jersey spine Brown’s tumor - area of bone resorption Ca2+ from bone to blood Refer to endocrinologist
Nuclear impression
Larger and smoother Persistent notochord Post 1/2 of body usually inferior aspect Smooth borders On A-P gives Cupid’s Bow deformity
Osteopetrosis
Marble bone disease Alber schonbergs disease Systemic condition Bones become extremely white Bone-in-bone appearance/sandwich vertebrae Hepatosplenomegaly Refer to orthopedist
