Radiology Quiz 2

Question 1

Minima Diagnosis series for Thoracic Spine

Answer 1

AP
Lateral
Additional View: Swimmers and Oblique

Question 2

Minimal Diagostic Series for Lumbar Spine

Answer 2

AP or PA (need to write down both on test)
Lateral
Additional Views: Oblique, Lumbosacral Spot, Flexion/Extension

Question 3

Cobb Scoliosis Measurement

Answer 3

AP Spine
find end vertebrae at scoliosis extremes and draw line parallel to the superior endplate of the cephalic vertebra and inferior endplate of the caused vertebra
draw perpendicular lines to the endplate lines and measure the resultant angle
Errors up to 10 degrees are possible and may result in mismanagement
CURVES >20 require bracing
>40 may need surgery
Monitor in young (10-15 yrs)

Question 4

Risser-Ferguson Scoliosis Measurement

Answer 4

AP Spine
Find end vertebrae at scoliosis extremeness and draw intersecting lines from vertebral corners to find the body centres
find apical vertebra which is the one most laterally displaced and then find its centre
draw connecting lines b/w the end vertebrae and the centre vertebra and measure the resultant angle
Given a measurement 255 (10 degrees) below Cobb method. Cobb is more widely used

Question 5

Thoracic Kyphosis

Answer 5

Lateral Thoracic
Lines drawn parallel to superior endplate of T1 and inferior endplate of T12
Perpindicular lines from the above line and resultant angle is measured
Increased in old age, osteoporosis, Scheuermann’s disease, anomalies, muscular paralysis
Decreased may alter intracardia hemodynamic

Question 6

Thoracic Cage Dimension

Answer 6

Lateral Chest
Measure the distance from posterior of sternum to the anterior surface of the eighth thoracic vertebra body
Minimum distance in males is 11cm, with 9cm in females
Indicative of straight back syndrome, possible cardiac complications

Question 7

Lumbar Lordosis

Answer 7

Lateral Lumbar
Parallel lines are drawn along the superior endplate of L1 and the base of the sacrum
Perpindiculars are constructed to these lines and the resultant angle is measured
Normal is 50-60 degrees
Significance is debated

Question 8

Lumbosacral Angle

Answer 8

sacral base angle, Ferguson’s angle
Lateral Lumbar
A line is drawn along the sacral base and another in drawn horizontal, parallel to the bottom edge of the film
The resultant angle is measured
Normal is 26-57 degrees
No consensus on significance, increase angle may favour in LBP in shearing and compressive forces on L/S posterior joints

Question 9

Lumbosacral Disc Angle

Answer 9

Sacrovertebral Disc Angle
Lateral Lumbar
Line is drawn along the sacral base another is drawn along inferior endplate of L5
The resultant angle is measured
Normal is 10-15 degrees
Increase > 15 facet impaction and LBG
Decrese possible acute L5 IVDH

Question 10

Lumbar Gravity Line

Answer 10

Lateral Lumbar
find the centre of the body of L3
A vertical line is contracted from the centre body point of L3
The line should intersect the anterior one third of the sacral base, and should not be more than 10 mm anterior to the base
rough estimate of anterior and posterior weight bearing

Question 11

Degenerative Lumbar Spine Instability

Answer 11

lateral lumbar
Groos assessment using georges line should be no more than 4mm of translation from flexion to extension or compression to traction
Can also compare disc angles from flexion to extension
Denotes ligamentous laxity d/t trauma or DJD usually
May or may not correlate with symptomology

Question 12

Meyerding’s Spondylolisthesis Grading

Answer 12

Lateral Lumbar projection
The sacral base is divided into 4 equal sections
Grade 1 - The post-inf corner of L5 is aligned with the 1st division
Grade 2 - “ “ second division
Grade 3 - “” third division
Grade 4 - “” fourth division
Grade 5 - Spondyloptosis

Question 13

Ullman’s Line

Answer 13

Lateral Lumbar Projection
A line drawing along sacral base and another is drawn perpendicular to and through anterior aspect of the sacral base
evaluate relationship of L5 to the perpendicular line
L5 should be posterior to or just contact the perpendicular line
Anterolistesis

Question 14

Interpedicular Distance

Answer 14

AP lumbar spine
shorted distance between inner convex cortical margins of pedicles at one level
should get wider the further caudal in the lumbar spine. know the trends
May indicate spinal stenosis, congenital malformations, and spinal tumors

Question 15

Eisenstein’s Method for Sagittal Canal Measurement

Answer 15

Lateral Lumbar spine
Line is constructed joining the tips of the superior and inferior articular processes at a given level. The distance between this line and the back of the vertebral body is measure, should be greater than 14-15mm
Spinal Stenosis - definitive diagnosis with CT