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Diagnostic Imaging I Exam One > Roentgenometrics > Flashcards

Roentgenometrics Flashcards

1
Q

Does distortion/magnification occur when the position is closer or further from the central ray?

A

Further from

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2
Q

What are the normal (max) dimensions of the sella turcica?

A

16mm in sagittal plane

12mm in depth

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3
Q

What is the significance of an enlarged sella turcica?

A

1 empty sella
2 tumor
3 normal
4 aneurysm

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4
Q

An enlarged sella turcica would be seen on which view?

A

Lateral cervical

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5
Q

What are the symptoms of an enlarged sella turcica?

A

Headaches, hormonal changes, growth issues, visual issues

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6
Q

What does the sella turcica house?

A

Pituitary gland

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7
Q

Why are visual disturbances associated with an enlarged sella turcica?

A

Optic chiasm located directly above

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8
Q

What measurement is used to determine platybasia?

A

Martin’s basilar angle

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9
Q

What is the range of normalcy of Martin’s basilar angle?

A

137-152 degrees

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10
Q

What are the anatomical points that make up Martin’s basilar angle?

A

Nation to center of sella to basion

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11
Q

What is the most common pathological cause of platybasia?

A

Bone softening diseases (Paget’s, osteomalacia, fibrous dysplasia = top 3)

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12
Q

What condition is seen with a martin’s basilar angle measurement of greater than 152 degrees?

A

Platybasia

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13
Q

What bones are mal-developed from congenital platybasia?

A

Sphenoid and/or occipital bones

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14
Q

What is the term for the anterior margin of the foramen magnum and inferior aspect of the clivus?

A

Basion

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15
Q

Upon what imaging system does cortical bone appear black? White?

A 
Black = MR
White = CT and X-ray
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16
Q

What is the term for the posterior margin of the foramen magnum?

A

Opisthion

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17
Q

Chamberlain’s line extends from which two anatomical points?

A

Hard palate to opisthion

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18
Q

The odontoid should not extend more than how many millimeters above Chamberlain’s line?

A

7mm

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19
Q

What condition is detected by Chamberlain’s line?

A

Basilar impression

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20
Q

Which is a congenital and which is pathological in nature: basilar invagination or basilar impression?

A

Basilar invagination = congenital

Basilar impression = pathological (bone softening diseases)

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21
Q

What is basilar invagination?

A

Upward displacement of the vertebral elements into the normal foramen magnum with normal bone

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22
Q

What is basilar impression?

A

Upward displacement of vertebral elements into the normal foramen magnum due to softening of bones at the base of the skull

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23
Q

McGregor’s line extends from which two anatomical points?

A

Hard palate to inferior occiput

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24
Q

The odontoid should not extend above McGregor’s line by how many millimeters?

A

8-10mm in males and females respectively

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25
Q

What condition is detected by McGregor’s line?

A

Basilar impression

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26
Q

What are the general symptoms of cord problems (example = basilar impression)?

A

Myelopathic

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27
Q

What are the 4 most common disorders that can cause basilar invagination?

A

1 Paget’s (Beethoven)
2 osteomalacia
3 fibrous dysplasia
4 rheumatoid arthritis

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28
Q

What are the four areas used to determine vertebra alignment?

A

1 anterior body
2 posterior body
3 spinolaminar line
4 tips of spinous (hardest to do)

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29
Q

What are the possible causes of antero- or retrolisthesis?

A 
1 fracture
2 dislocation
3 ligamentous laxity
4 DJD
5 anatomic/physiologic
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30
Q

Is DJD of the facet joints most likely to result in anterior or posterior vertebral body displacement?

A

Posterior

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31
Q

What is another term for anterolisthesis?

A

Spondylolisthesis

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32
Q

What is the space called between the posterior surface of the anterior tubercle and the anterior surface of the odontoid?

A

Atlantodental interval (ADI)

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33
Q

What structure maintains the ADI?

A

Transverse atlantal ligament

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34
Q

What are the normal ADI measurements for both adults and children?

A 
Adults = less than 3mm
Children = less than 5mm
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35
Q

What is the most common cause of a weak ADI?

A

Rheumatoid arthritis

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36
Q

What are the possible causes for a weak ADI?

A 
1 trauma 
2 inflammation
3 arthropathies
4 Down syndrome
5 upper cervical abnormalities
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37
Q

What are the top three most common cases for a weak ADI?

A

1 RA
2 upper cervical abnormalities
3 Down syndrome

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38
Q

If an increased ADI is seen on a lateral cervical X-ray, what other views should then be taken?

A

Flexion/extension

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39
Q

What is significant about a large ADI in the realm of chiropractic?

A

Contraindication to adjust atlas (requires neurologic referral)

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40
Q

Is a large or small ADI a more clinically significant finding?

A

Large

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41
Q

What is the atlantoaxial “overhand” sign?

A

Lateral margin of the lateral masses of atlas extend more lateral bilaterally than the superior articular processes of the axis

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42
Q

What does lateral displacement of the lateral margin of the lateral masses of atlas over the superior articular processes of the axis indicate?

A

Fracture of atlas

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43
Q

Mild atlantoaxial “overhang” is a normal variant among wha population?

A

Children (seen in a 1 year old, for example)

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44
Q

What type of fracture results in the atlantoaxial “overhang” sign?

A

Burst fracture of atlas (injured transverse atlantal ligament)

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45
Q

What are the degree measurements that indicate hypo- or hyperlordosis of the cervical spine?

A 
Hypolordosis = less than 35 degrees
Hyperlordosis = greater than 45 degrees
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46
Q

Where is the line drawn and what is measured for the cervical lordosis depth method?

A

Line from tip of odontoid to posterior surface of C7; measure the depth at C4

47
Q

What is the average range seen with the cervical lordosis depth method?

A

8-12mm

48
Q

Where are the two lines drawn to establish the Harrison posterior tangent method for cervical lordosis?

A

Along posterior body of C2 and another along the posterior body of C7

49
Q

What is the average value of the cervical curvature from C2-C7 via the Harrison posterior tangent method for evaluating cervical lordosis?

A

34 degrees (SD = 9)

50
Q

Which angles are assessed for the Harrison posterior tangent method for cervical lordosis?

A

Superior and inferior angles

51
Q

Where are the lines drawn for Ruth Jackson stress lines?

A

Along posterior aspects of C2 and C7 bodies

52
Q

Where should the Ruth Jackson stress lines intersect on flexion? Extension?

A 
Flexion = C5/C6 disc or facets
Extension = C4/C5 or facets
53
Q

What does it mean when the cervical gravitational line does not touch the anterior body of C7?

A

Anterior weight placement

54
Q

Where is the cervical gravitational line drawn?

A

From the middle of the odontoid tip to the anterior superior aspect of C7 (perpendicular to bottom of film)

55
Q

Where is George’s line drawn?

A

Along posterior aspect of all vertebral bodies

56
Q

Where are the lines drawn to measure the width of the sagittal canal?

A

Anterior line = posterior vertebral body

Posterior line = spinolaminar line

57
Q

What is the normal range for a sagittal canal measurement?

A

12-16mm

58
Q

At what sagittal canal measurement can stenosis be determined?

A

Less than 12mm

59
Q

What kinds of conditions can cause a sagittal canal measurement to be less than 12mm?

A

1 disc facet degeneration
2 disc herniation
3 congenital

60
Q

At what segmental level is the cord the largest?

A

C5/C6

61
Q

What things could cause an enlarged retropharyngeal or retrotracheal space?

A

1 edema
2 hemorrhage
3 pus
4 tumor

62
Q

The retropharyngeal space is measured in front of which vertebral level?

A

C2

63
Q

The retrotracheal space is measured in front of which vertebral level?

A

C6

64
Q

What should be the normal measurements for the retropharyngeal and retrotracheal spaces?

A 
Retropharyngeal = less than 7mm
Retrotracheal = less than 22mm
65
Q

Where are the lines drawn to measure thoracic spine kyphosis?

A

Along superior endplate of T1 and inferior endplate of T12 (then lines perpendicular to them to form angle)

66
Q

What is the average angle of thoracic spine kyphosis?

A

30 degrees

67
Q

What is the upper limit of normal of thoracic spine kyphosis for both genders?

A 
Females = 56 degrees
Males = 66 degrees
68
Q

Where are the lines drawn to measure lumbar spine lordosis?

A

Along superior endplate of L1 and base of sacrum (then lines perpendicular to them to form angle)

69
Q

What is the range of average measurement for lumbar spine lordosis?

A

50-60 degrees

70
Q

On what films are thoracic spine kyphosis and lumbar spine lordosis measured?

A

Lateral thoracic and lateral lumbar

71
Q

Where is the lumbar gravity line drawn?

A

Vertically from mid portion L3 body to interact anterior 1/3 of sacrum

72
Q

What does the lumbar gravity line assess?

A

Weight bearing direction

73
Q

What two lines make up the lumbosacral/Ferguson’s angle?

A

Line 1 = across sacral base

Line 2 = horizontal to ground

74
Q

What is the range of normalcy for the lumbosacral/Ferguson’s angle?

A

26-57 degrees

75
Q

What is the grading system used for spondylolisthesis involving dividing the sacrum into 4 parts?

A

Meyerding’s method

76
Q

What measurement is used to assess for spondylolisthesis using one line across the sacral base and another perpendicular to it on the anterior margin of sacrum?

A

Ulmann’s line

77
Q

Which is more sensitive to spondy: Ulmann’s or Meyerding’s method?

A

Meyerding’s

78
Q

What method is used to assess for scoliosis?

A

Cobb’s method

79
Q

Where are the lines drawn for Cobb’s method?

A

Line 1 = across superior plate of upper most vertebra tipped maximally into curve
Line 2 = across inferior plate of the lower most vertebra tipped maximally into curve
(then perpendiculars drawn to form angle)

80
Q

What is the specific Cobb’s angle needed for the official diagnosis of scoliosis?

A

Greater than 10 degrees (zero is normal, less than 10 = a curve)

81
Q

What is the distance called that is measured of the medial hip joint space?

A

Tear drop distance

82
Q

What is the normal range for the tear drop distance?

A

9-11mm

83
Q

What could cause an enlarged tear drop distance (greater than 11mm)?

A

1 trauma
2 infection
3 inflammation (Legg-Calve-Perthes disease or joint disease )
4 aka space occupy lesions

84
Q

Is the tear drop distance usually increased or decreased in pathologies involving children? Adults?

A 
Children = larger tear drop
Adults = smaller tear drop
85
Q

The distance between two tear drop distances should never be more than how many millimeters?

A

2

86
Q

What is the eponym associated with tear drop distance?

A

Kohler’s tear drop

87
Q

Kline’s line is used to assess for what condition?

A

Slipped capital femoral epiphysis (SCFE)

88
Q

Where is Kline’s line drawn?

A

Across lateral border of femoral neck

89
Q

What should Kline’s line intersect?

A

Outer aspect of femoral head

90
Q

What is the next procedure needed if suspecting an infection due to an increased tear drop distance?

A

Aspiration

91
Q

The “beak sign” upon a pelvic X-ray is suggestive of what condition?

A

Slipped capital femoral epiphysis (SCFE)

92
Q

What is the “beak sign” upon a pelvic X-ray?

A

Sharp point at the margin of the femoral head due to SCFE

93
Q

If SCFE is seen upon X-ray, what would be the next film to take?

A

Frog leg

94
Q

Slipped capital femoral epiphysis is most commonly in which hip?

A

Left

95
Q

What is the typical patient profile for slipped capital femoral epiphysis?

A

Obese boys

96
Q

What does it mean when Kline’s line does not intersect the outer aspect of the femoral head?

A

SCFE

97
Q

Shenton’s line is drawn between what pieces of anatomy?

A

Medial femoral neck to superior margin of the obturator foramen (arc)

98
Q

Shenton’s line is abnormal in what conditions?

A

1 hip dislocation
2 femur fracture
3 SCFE

99
Q

What conditions can cause acetabular protrusion?

A

1 arthritic joint disease
2 Paget’s disease
3 bone softening diseases
4 idiopathic

100
Q

What condition is Kohler’s line assessing for?

A

Acetabular protrusion

101
Q

Where is Kohler’s line drawn?

A

From medial pelvic rim to external margin of obturator foramen

102
Q

What finding involving Kohler’s line means acetabular protrusion has occurred?

A

Acetabulum exceeds past Kohler’s line

103
Q

What is the condition called involving bilateral acetabular protrusion?

A

Otto’s pelvis

104
Q

What is the purpose of Boehler’s angle?

A

Determining calcaneus fracture or dysplasia

105
Q

How is Boehler’s angle made?

A

2 lines connecting the 3 highest points of the calcaneus

106
Q

What is the range of normalcy for Boehler’s angle?

A

28-40 degrees (average = 30-35 degrees)

107
Q

What measurement of Boehler’s angle is indicative of a calcaneal fracture or dysplasia?

A

Less than 28 degrees

108
Q

The acromiohumeral space is measured between what to structures?

A

Under surface of acromion and superior surface of humeral head

109
Q

What is the average measurement for the acromiohumeral space?

A

10mm

110
Q

Narrowing of the acromiohumeral space is associated with what condition?

A

Supraspinatus tendinopathy

111
Q

What is the normal size of the AC joint space on X-ray?

A

Less than 5mm

112
Q

The right and left AC joint spaces should not differ by no more than how many millimeters?

A

2-3mm

113
Q

What is the normal coracoclavicular distance?

A

Less than 11-13mm

114
Q

The right and left coracoclavicular distances should not differ by no more than how many millimeters?

A

Less than 5mm

Diagnostic Imaging I Exam One (5 decks)

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