Lec 04: Neuroimaging of the Spine and Spinal Cord

Question 1

Which of the following imaging modalities is/are NOT contraindicated for pregnant women.

A. X-ray
B. CT scan
C. MRI
D. PET scan
E. C & D only

Answer 1

C. MRI

X-ray and CT scan machines emit radiation while PET scan uses radioactive tracers.

Question 2

The classical Jefferson burst fracture of C1 is characterized by

A. break due to high energy frontal load
B. four-part break in the anterior and posterior arches
C. lateral displacement of structures from the dens
D. B & C only
E. AOTA

Answer 2

D. B & C only

It is due to high energy AXIAL load.

Question 3

ID: What view is optimal for visualization of an isolated fracture of the posterior arch of C1?

Answer 3

lateral view

Question 4

ID: This common fracture of the C2 is characterized by hyperextension with bilateral fracture of the pedicles or pars interarticularis.

Answer 4

hangman’s fracture

Question 5

Characteristics of hyperextension dislocation of lower cervical spine EXCEPT

A. disruption of ligaments
B. thickening of soft tissues
C. hematoma formation
D. spinous process fracture
E. NOTA

Answer 5

D.

The findings of X-ray are usually NORMAL.

Question 6

The following are hyperflexion fractures EXCEPT

A. wedge fracture
B. bilateral interfacet joint fracture
C. clay shoveler's fracture
D. burst fracture
E. NOTA

Answer 6

D.

Burst fractures are due to high energy axial loading or vertical compression.

Question 7

ID: This condition is likely if the angle of the spine in a wedge fracture is less than 20 degrees.

Answer 7

osteoporosis

If the angle is greater than 30, consider trauma.

Question 8

True of chance fracture EXCEPT

A. vertically-oriented fracture
B. also called as 'seat belt injury'
C. majority have associated intraperitoneal injuries
D. may fracture the body and lamina
E. NOTA

Answer 8

A.

It is a HORIZONTALLY-oriented fracture.

Question 9

ID: This sign is characteristic of insufficiency fractures when subjected to scintigraphy.

Answer 9

Honda sign

Question 10

The following is/are associated with vertebral disc degeneration

A. accumulation of water
B. disappearance of gas
C. loss of height of disc
D. loss of turgor of annulus fibrosus
E. AOTA

Answer 10

C.

Characteristics of Disc Degeneration

• loss of water
• appearance of nitrogen gas (vacuum phenomenon)
• loss of turgor of nucleus pulposus
• loss of height

Question 11

A disc is said to be bulging when the disc margin beyond the end plates is

A. > 30% of disc circumference
B. > 40% of disc circumference
C. > 50% of disc circumference
D. > 60% of disc circumference
E. protruding regardless of extent

Answer 11

C. > 50% of disc circumference

Question 12

Extrusion is defined as disc herniation that

A. is wider than tall
B. is taller than wide
C. is of equal dimension
D. compresses the spinal cord
E. NOTA

Answer 12

B.

Protrusion is wider than tall.

Question 13

ID: This is herniation of disc and subsequent detachment of the herniated fragment.

Answer 13

sequestration

Question 14

T/F: Spinal stenosis is common among the Japanese people.

Answer 14

T

Question 15

In the Meyerding scale of spondylolisthesis, a subluxation of 80% is graded as

A. 2
B. 3
C. 4
D. 5
E. The Meyerding scale is not used for spondylolisthesis.

Answer 15

C. 4

1 = 0-25%
2 = 25-50%
3 = 50-75%
4 = 75-100%
5 = >100%

Question 16

Enumerate the three most common etiology of IV disc infections.

Answer 16

Staphylococcus
Enterobacteria
Pseudomonas

Question 17

The most common spinal area of affectation in rheumatoid arthritis is

A. cervical
B. thoracic
C. lumbar
D. sacral
E. anywhere in the spine

Answer 17

A.

cervical and craniocervical junctions

Question 18

ID: This is the most common radiologic finding in ankylosing spondyloarthritis.

Answer 18

bamboo spine

Question 19

Tumor/s with propensity to grow on the neural arch of the lumbar spine.

A. aneurysmal bone cyst
B. osteoblastoma
C. osteoid osteoma
D. giant cell tumor
E. C & D only

Answer 19

C. osteoid osteoma

Question 20

ID: Where are spinal chondromas thought to arise from?

Answer 20

cellular remnants of the notochord

Question 21

ID: Typical finding in Langerhans cell histiocytosis.

Answer 21

pancake vertebra

Question 22

ID: This is the term for the hyperdensity found in vertebral body hemangiomas.

Answer 22

corduroy sign

Question 23

Where are the two most common locations of multiple myeloma and plasmacytoma?

A. cervical / thoracic
B. thoracic / lumbar
C. lumbar / sacral
D. sacral / coccyx
E. anywhere in the spine

Answer 23

B. thoracic / lumbar

Question 24

True of radiculomeningeal vascular malformations EXCEPT

A. fistula between radicular arteries and veins
B. more common in the lower thoracic spine
C. more common in younger children
D. requires insertion of a coil
E. NOTA

Answer 24

C.

It is a rare affliction and there are no predominance in a particular age group.

Question 25

ID: A common complication of epidural hematoma.

Answer 25

quadriplegia