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Diagnostic Imaging II > Part 2 > Flashcards

Part 2 Flashcards

1
Q

if there is posterior trauma, where do we see the affected vertebra?

A

relatively anterior

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2
Q

if there is anterior trauma, where do we see the affected vertebra?

A

relatively posterior

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3
Q

describe a hangman’s fracture

A

bilateral pedicle fracture of C2
hyperextension mechanism
possible increased RPI
relative lack of neurological findings

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4
Q

other names for hangman’s fracture

A

traumatic spondylolisthesis of C2
bilateral pedicle fracture of C2
anterior displacement of C2

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5
Q

compression fracture is also known as

A

wedging compression fracture

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6
Q

describe compression fracture

A 
flexion mechanism
predominantly superior endplate
may have a small anterior fragment
stable
zone of impaction possible
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7
Q

what are some helpful ways to determine a new fracture from an old fracture on am MRI?

A 
cortical disruption
blurry or hazy endplates
fracture line
line of impaction
step defect
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8
Q

what is the saying to help determine a new fracture from an old fracture?

A

white is right, black is whack

T1

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9
Q

what are some ways to determine and old fracture from a new fracture?

A

old fracture: old films help, intact cortex

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10
Q

burst fracture

A

vertebral body “explodes” into several fragments
fragments are driven centrifugally
axial compression forces predominate
possible cord compression/CT exam
unstable
may see vertical split of the body on AP film
lateral shows comminuted body flattneed centrally
neurological infovlement is variable

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11
Q

unilateral facet dislocation

A

flexion, rotation mechanism
inferior articular process dislocates into IVF
anterior body displacement
mechanically stable

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12
Q

what sign is associated with a unilateral facet dislocation?

A

bow tie sign

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13
Q

what are the radiographic features of a unilateral facet dislocation

A

abrupt dereased laminar length

spinous rotation to the side of dislocation

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14
Q

what xrays should be taken if you suspect a unilateral facet dislocation?

A

cervical obliques

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15
Q

bilateral facet dislocation

A

hyperflexion mechanism of C4-7 MC
severe soft tissue injury
unstable, high incidence of cord injuries
anterior dislacement typically

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16
Q

ppathological fracture

A 
decreased height of the entire body
implies pathology
MC osteoporosis
also lytic mets, multiple myeloma
proper workup needed
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17
Q

burst fractures in thoracics of lumbars

A 
widened intrapedicular distance
CT exam needed
vertebral body "explodes
axial compression mechanism
may have post. body convexity
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18
Q

widened intrapedicular disttance means there is?

A

neural arch fx or posterior wall fracture

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19
Q

chance fracture

A

horizontal splitting of neural arch and vertebral body
flexion distraction mechanism
seatbelt acts as a fulcrum
MC L1-3

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20
Q

what signs do we see with chance fractures?

A

empty vertebra sign

ghost vertebra sign

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21
Q

findings we can see with chance fracture

A

decreased anterior body height
step defect
zone of impaction
horizontal radiolucent line in neural arch

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22
Q

TVP fracture

A 
2nd most common lumbar fx
direct trauma or avulsion
MC L2 or 3
vertical to oblique in orientation
often unilateral and often milti level
may or may not be displaced
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23
Q

what can TVP fractures be obscured by?

A

gas and fecal material

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24
Q

what else do you need to do with TVP fractures?

A

uninalysis for potential hematuria b/c the kidney could be damaged

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25
Q

sponlylolysis

A

interruption of the parts

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26
Q

spondylolisthesis

A

anterior displacement

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27
Q

osteoporotic compression fractures general features

A 
more common after 50
females MC
mid thoracolumbar spine
dowager's hump
resorption of horizontal trabeulae
accentuated vertical striations
28
Q

osteoporotic compression fractures xray features

A

decreased anterior body height
multiple ones are often contiguous
discontiguous raises concerns
potential pathology, special imaging

29
Q

most thoracic and lumbar fractures are MC where?

A

T11-L2

30
Q

contiguous fractures are uncommon or common?

A

common

31
Q

what kind of thoracic and lumbar fractures are most common?

A

compression fracture

32
Q

thoracolumbar compression fractures

A

osteoporotic fx may have no trauma

upper thoracic compression may result from seizures or electrical shock

33
Q

what are some xray features of thoracolumbar compression fractures

A

anterior wedging
depression of superior endplate
posterior body height usually maintained
may see step defect and zone of impaction

34
Q

what is whiplash?

A

soft tissue injury (flexion component)
disruption of posterior ligament complex
abrupt kyphotic spine
pain, tenderness, muscle spasm

35
Q

what are the xray features of whiplash?

A

widened interspinous spaces (fanning)
subluxated widened facets (loss of parallelism)
flexion and extension views to stress ligaments
flexion malposition
high riding facets (NOT perched)

36
Q

uncinate fractures

A

rare
stable
lateral flexion

37
Q

lateral flexion

A

unilateral fx of the lateral mass of C1
TVP fx
uncinate fx

38
Q

pillar fractures

A 
not common fx
commonly missed
seen on AP and lateral
MC C4-7
extension-compression mechanism
39
Q

laminar fractures

A 
uncomon
hyperextension
lower cervicals
may been CT
mechanically stable
40
Q

spinous fractures

A

mid cervical, thoracic (NOT T1) or lumbar

41
Q

clay shoveler’s fx is what kind of mechanism?

A

flexion

42
Q

clay shoveler’s fx

A

fracture at the base of the spinous of C6-T1 only
avulsion fracture
stable

43
Q

what are the xray signs of clay shoveler’s fx?

A

fracture at base of spinous
double spinous sign on AP
may or may not be displaced inferior
jagged, irregular radiolucency (new)

44
Q

extension teardrop fx

A

extension mechanism
triangular fragment of anterior-inferior body
usualy C2
unstable
buckling of ligamentum flavum (cord trauma)

45
Q

flexion teardrop fx

A 
most severe injury of cervical spine
triangular fragment at the anterior inferior body
unstable, acute "anterior cord syndrome"
flexion mechanism
facets "subluxated or dislocated"
typically spine considerably flexed
46
Q

bilateral facet dislocation

A

hyperflexion mechanism (C4-7)
severe soft tissue injury
unstable, high incidence of cord injuries
anterior displacement

47
Q

perched facets

A

incomplete bilateral facet dislocation

48
Q

interlocking facets

A

complete bilateral facet dislocation

49
Q

unilateral facet dislocation

A 
pillars not superimposed (bowtie sign)
abrupt decreased laminar length
spinous rotation to the side of dislocation
cervical obliques should be done
flexion rotation mechanism
inferior articular process dislocates into IVF
anterior body displacement
stable
50
Q

burst fracture

A 
vertebral body "explodes" into several fragments
fragments are driven centrifugally
axial compression forces predominate
pssible cord compression
unstable
may see vertical split of the body on AP
lateral shows comminuted body flattened centrally
neurological involvement is variable
51
Q

describe ischiopubic rami fractures

A

stable
most common fracture of the pelvis
stress fx may occur

52
Q

what part is most commonly fractured in ischiopubic rami fractures?

A

inferior rami, but superior rami can take part as well

53
Q

who are more likley to get avulsion fractures of the pelvis?

A

athletic adolescents

sprinters, long jumpers, hurdlers, gymnasts

54
Q

what leads to an avulsion fracture?

A

muscular traction

55
Q

what kind of avulsions are avulsion fractures of the pelvis?

A

apophyseal avulsion

56
Q

what muscle cause an avulsion fracture of the ASIS?

A

sartorius

57
Q

what muscle causes an avulsion fracture of the AIIS?

A

rectus femoris

58
Q

what muscle causes an avulsion fracture of the ischial tuberosity?

A

hamstring

59
Q

where do you most commonly get avulsion fx of the pelvis?

A

ischial tuberosity

60
Q

what are some radiographic signs and treatments for avulsion fractures of the pelvis?

A

curvilinear calcific densities
from conservative to surgical fixation
could unite, or not
may have enlgargement with healing

61
Q

malgaingne fracture

A

ipsilateral double vertical shearing fx of superior and inferior pubic rami with fx or dislocation about ipsilateral SI joint

62
Q

what is the most common unstable pelvic fx?

A

malgaingne fx

63
Q

bucket-handle fracture

A

contralateral double vertical fx
superior and inferior pubic rami fx
fx or dislocation about contralateral SI
unstable

64
Q

straddle fracture

A

bilateral superior and inferior rami fx
substantial soft tissue injury
unstable

65
Q

sprung pelvis

A

“open book” fx
diastasis of pubic symphysis
diastasis of one or both SI joints
unstable

66
Q

complex pelvic fractures

A 
unstable
severe injury
comminution of the pelvis
difficult to classify
complex multiple fx
67
Q

if an adult has an avulsion fracture of the lesser trochanter, what does this mean?

A

it’s probably lytic mets

Diagnostic Imaging II (19 decks)

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