Lateral Thoracic

Question 1

Check down the front of the bodies

Answer 1

Lipping/spurring
Hyperostosis
Loss of anterior body height 25% or more
Loss of anterior body height by 10-15%

Question 2

Loss of anterior body height by 25% or more

Answer 2

Osteoporosis/osteopenia
Trauma
Infection
Malignancy

Question 3

Osteoporosis

Answer 3

Grey bone/grey soft tissue with pencil thin cortices of the vertebral bodies
NEVER causes decrease in posterior body height

Question 4

Case hx or signs of new trauma on film

Trauma

Answer 4

Step defect

Line of double density

Question 5

Step defect

Answer 5

Fractured vertebral endplate and it slides forward

Question 6

Line of double density aka

Answer 6

Line of condensation

Zone of impaction

Question 7

Loss of ant and post body height

Answer 7

Malignancy

Question 8

Slight loss of body height 15%

Answer 8

Mild compression
Infection
Scheurmann’s

Question 9

Scheurmann’s aka

Answer 9

Avascular necrosis
Ischemic necrosis
Aseptic necrosis
Osteonecrosis
Subchondral necrosis
Osteochondrosis of the spine

Question 10

Scheurmann’s description

Answer 10

Most commonly seen 10-16

AVN secondary growth centers

Question 11

Case history scheurmann’s

Answer 11

Rounding of the shoulders
Increased kyphosis
Back pain

Question 12

Radiographic signs scheurmann’s

Answer 12

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

Question 13

Case management scheurmann’s

Answer 13

Thoracolumbar brace
Strengthen erectors
Stretch the pecs
Self resolving
Adjust

Question 14

Scheurmann’s ask to speak to

Answer 14

Ortho surgeon

Takes 2 months to show up on x-ray

Question 15

Scheurmann’s can lead to

Answer 15

Permanent postural deformity

Early DJD

Question 16

Special test scheurmann’s

Answer 16

MRI - 1st

Bone scan - 2nd

Question 17

Check bodies for alterations in shape and color

Answer 17

Shape - PFC
Color - whiter = blastic, pagets
Darker = lytic or mm
Grey = osteopetrosis or HPT

Question 18

Posterior body destruction indicates

Answer 18

Malignancy if no signs of trauma or infection

Question 19

Multiple segments involved in a row posterior body destruction

Answer 19

Multiple myeloma

Question 20

Schmorls nodes

Answer 20

Tiny AVN
Small irregular
Ant 1/2 of body; can be seen on sup/inf aspect of body
Irregular rough borders

Question 21

3 or more schmorls nodes

Answer 21

Scheurmann’s disease

Question 22

Hyperparathyroidism - HPT

Answer 22

Metabolic condition
Rugger jersey spine
Brown’s tumor - area of bone resorption
Ca2+ from bone to blood
Refer to endocrinologist

Question 23

Nuclear impression

Answer 23

Larger and smoother
Persistent notochord
Post 1/2 of body usually inferior aspect
Smooth borders
On A-P gives Cupid’s Bow deformity

Question 24

Osteopetrosis

Answer 24

Marble bone disease
Alber schonbergs disease
Systemic condition
Bones become extremely white
Bone-in-bone appearance/sandwich vertebrae
Hepatosplenomegaly
Refer to orthopedist