Radiologic C/S eval Flashcards
List the ABCDs for viewing imaging
- Alignment
- Bone Signal
- Canal Space (also CNS for MRI)
- narrowing/indent (encroachment) in canal from potential structures
- Discs Integrity
- Soft tissues
List general indications for CT of the C-Spine (9)
- Acute trauma (adults)
- Degenerative conditions
- Post-op assessment
- Infection
- Image-guided intervention procedures
- Neoplasm
- Inflammatory lesions
- Congenital/developmental conditions
- Cord syrinxes/masses (with MRI contraindicated)
what may be best observed with an axial CT of the C-spine?
- spatial relations → dens and lateral masses, dens and anterior arch
- atlantodental interface
- spinal canal
what may be best observed with a coronal CT of the C-spine?
- integrity of the dens
- spatial relations of C1 and C2
- a burst fracture or Jefferson’s fracture is best seen in this plane
list general indications for MRI of the C-spine
- Acute trauma with suspected cord encroachment
- DDD
- Neoplasm
- Dx and intervention f/u
- Intrinsic spinal cord pathology
- Congenital/developmental conditions
- Cord masses
- Post-op assessment (soft tissues, vertebroplasty)
- Meningeal abnormalities
- Infection
- disc space infections
- epidural abscess
what is myelomalacia? What is the best imaging to see it?
encroachment on the cord from a bulging disc resulting in softening of the spinal cord
best seen with a T2 MRI
what does PECARN stand for?
Pediatric Emergency Care Applied Research Network
what is PECARN?
a guideline that states → high risk for cervical spine injury (do imaging) if one or more of the following are present:
- AMS
- focal neurologic findings
- Torticollis (new onset)
- Substantial torso injury
- Conditions predisposing to cervical spine injury
- diving
- high-risk motor vehicle crash
list the 4 ACR Appropriateness criteria for the neck
- Cervical neck pain or cervical radiculopathy
- Myelopathy
- Suspected spine trauma
- Suspected spine trauma - child
in general if a child (ages 3-16) has suspected spine trauma and meets criteria (PECARN, NEXUS, Pieretti-Vanmarcke) what is the most appropriate intial study?
radiography of spine area
T/F: if imaging is not indicated by NEXUS or CCR for pts ages 16-65 then they don’t need imaging?
TRUE
if clinical or imaging findings suggest a ligamentous injury in the neck/cervical region what imaging study is best?
initially - CT
next study - MRI
What view can you best see the Z-joints in in the C-Spine vs the T-spine?
C-Spine: lateral
T-spine: Oblique 70
What view can you best see the intervertebral foramin in in the C-spine versus the T-spine?
C-spine: oblique 45
T-spine: lateral
