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Radiographic Procedures 2 > SI Joints Sacrum/Coccyx Scoliosis > Flashcards

SI Joints Sacrum/Coccyx Scoliosis Flashcards

1
Q

Label 1-3

A
  1. L4, L5, illiac crest
  2. S1 and ASIS
  3. Coccyx, pubic symph, and greater trochanter
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2
Q

How do you demonstrate AP L5-S1?

A

AP Axial

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3
Q

When demonstrating S.I. Joints, what is better, PA or AP?

A

PA

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4
Q

True or false?

Posteriorly SI joints are more medial, anteriorly they are more lateral.

A

True

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5
Q

Label the yellow, blue and red lines.

A

Yellow: SI joints
Blue: Illium
Red: Superior pubic ramus

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6
Q

What should be seen on a S.I. Joints – AP Axial

A
  1. No rotation
  2. Both S.I. joints demonstrated without superimposition from the superior pubic ramus
  3. Open lumbosacral joint L5/S1 SPOT
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7
Q

Why is PA Axial S.I. Joints better than AP?

A
  1. The CR divergence aligns nicely with the anatomy, and will help to open and visualize the joint better.
  2. Offers better gonadal protection
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8
Q

Why do we not do PA axial joints all the time instead of AP?

A
  1. Easier to have them on their back,
  2. to reduce magnification, sometimes
  3. your patient cannot be on their stomach
  4. Less overlap of illium and sacrum
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9
Q

Where should the laser be exiting for PA axial SI joints?

A

Laser should not be exiting at the ASIS; it should exit 2 inches below

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10
Q

Label 1-23

A
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11
Q

What is the issue with this image?

A

Too much of a caudad was used

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12
Q

What does an RPO SI joint demonstrate?

A

The left SI joint

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13
Q

What does an LPO SI joint demonstrate?

A

The right side

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14
Q

What should be seen on an SI joint AP oblique?

A
  1. Open S.I. joint
  2. AP- center on the raised side
  3. Minimal overlapping of the ilium and the sacrum
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15
Q

What are the issues with this image? What way was the patient rotated for this SI joints?

A
  1. The CP on the PA Axial is a bit low,
  2. Not enough caudad angle was used
    -Patient rotated RPO due to the overlapping in the SI joints
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16
Q

What are the issues with these two images?

A

Left image:
-CP is slightly too lateral and inferior. (still a good image)
Right image:
-SI joint is rotated just a bit too much (nearly 45 degrees) so nearly closing the SI joint space.

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17
Q

What projection and position is the Bisecting angle method?

A

AP axial sacrum

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18
Q

What should be seen on an AP Axial Sacrum?

A
  1. No rotation
  2. Entire sacrum with no foreshortening
  3. Pubic bones not overlapping sacrum
  4. Tight collimation
  5. Open sacral foramina
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19
Q

What would happen if we didnt use an angle in an AP coccyx projection?

A

The tip of the coccyx would be covered by the superior pubic ramus without any angle

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20
Q

What does the CR hit first in an AP coccyx projection? Why is this important?

A

The CR ‘hits’ the superior pubic bone first, moving it inferiorly – the coccyx is less distorted

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21
Q

What should be seen on an AP coccyx?

A
  1. Entire coccyx demonstrated with segments not superimposed
  2. No rotation
  3. Tight collimation
  4. No superimposition with the pubic bones
  5. Coccyx must be superior (and should be in line with the pubic symphysis)
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22
Q

What is the issue with this image?

A

Patient is rotated slightly LPO

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23
Q

What is the main issue with this image? What projection is this?

A

-The coccyx is superimposed on the Pubic Bone, so either not enough angle or the incorrect angle direction was used.
-AP coccyx projection

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24
Q

How much more posterior is the sacrum to the ASIS?

A

3-4 inches posterior

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25
Q

How much more posterior and inferior is the coccyx to the ASIS?

A

Approximately 4” inferior and 3-4” posterior to the ASIS.

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26
Q

What should be seen on a lateral sacrum/coccyx?

A
  1. Sacrum and coccyx should both be seen clearly
  2. Tight collimation
  3. Superimposed acetabula and greater sciatic notches
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27
Q

What are the red lines demonstrating?

A

The right acetabular and siatic notch

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28
Q

What is the main issue with this image?

A

A caudad angle was not used

29
Q

What is the main issue with this image?

A

Could have centered more posterior

30
Q

What are the 2 main issues with this image of an AP axial sacrum?

A
  1. More of a cephalad angle could have been used
  2. Minimal rotation (RPO) occuring
31
Q

Critique this image:

A
  1. Lateral view has perfect superimposition of the Greater Sciatic Notches and acetabula.
  2. Collimator could have been turned to match the anatomy.
  3. Marker should be inluded
32
Q

In what situation would we do a lateral coccyx projection?

A

Done as a follow up after we have determined that just the coccyx is fractured

33
Q

What should be seen on a lateral coccyx?

A

Lateral Coccyx visualized completely, including distal end of sacrum

34
Q

What causes Scoliosis?

A

Idiopathic, functional, neuromuscular, degenerative

35
Q

What does ideopathic mean?

A

Idiopathic: Has no known cause

36
Q

When does ideopathic scoliosis occur?

A

Idiopathic typically appears during adolescence

37
Q

What changes must be made to techniques for scolliosis imaging?

A

High kVp (and low mAs)

38
Q

Should a scoliosis patient be AP or PA?

A

PA

39
Q

True or false?

Initial Imaging should always be performed erect for scoliosis patients.

A

True

40
Q

True or false?

The curveture of a scoliosis’ patient spine is always larger than anticipated.

A

True-collimate widely

41
Q

What is the purpose of this structure?

A

To provide lead shieling to scoliosis patients for the breasts

42
Q

How many cassettes are used in scoliosis imaging with Computed Radiography?

A

2-3 CR cassettes can be attached together to achieve the desired length

43
Q

What is the name of the process that combines all of the images taken for scolliosis in computed radiography cassettes?

A

Software uses image stitching

44
Q

True or false?

With CR systems, the length of the SID is determined by the length of the anatomy you are imaging for scolliosis image stitching.

A

True

45
Q

What does it mean to have malignant scoliosis?

A

Malignant scoliosis: Changing so dramatically and needs surgery

46
Q

What are the 2 types of scoliosis?

A
  1. Non-Structural (Secondary or Compensatory)
  2. Structural
47
Q

What type of scoliosis has a temporary curvature?

A

Non-Structural (Secondary or Compensatory) scoliosis

48
Q

What type of scoliosis can also be called a primary curve?

A

Structural scoliosis

49
Q

When does Non-Structural (Secondary or Compensatory) scoliosis disappear?

A

Curve disappears when supine, with side-bending, or when the cause is removed

50
Q

True or false?

Curve does not disappear when supine or with side-bending with structural scoliosis?

A

True

51
Q

What are some symptoms of Non-Structural (Secondary or Compensatory)
scoliosis?

A

Muscle spasm, leg length discrepancy, hip dysplasia, poor posture, or just compensates for structural curve

52
Q

Is structual scoliosis permentent?

A

Curvature is permanent (unless treatment is offered)

53
Q

If a primary curve is large enough, what does the spine do to compensate?

A
  1. Body produces a “Compensatory” curve (Secondary, Non-Structural) to keep the body aligned
  2. Compensatory curve will be in the opposite direction from the primary or structural curve
54
Q

When a compensatory curve is created from a primary curvature, at what situation is it naturally eliminated?

A

When supine, eliminating gravity eliminates the compensatory curve

55
Q

Which way do the vertebral bodies rotate in relation to the primary curvature?

A

Vertebral body rotates towards convex side of curve

56
Q

Absorb information on this slide in case you need it for the exam :)

A

:-)

57
Q

What is the purpose of doing a AP/PA Upright examination for scoliosis?

A

To assess the degree of curvature left to right with the force of gravity

58
Q

What is the purpose of doing a AP/PA Supine/Prone examination for a scoliosis series?

A

to assess Structural from Non-structural curves

59
Q

What is the purpose of doing a AP/PA With Lateral Bending examination for a scoliosis series?

A

To assess Primary from Secondary curves And Mobility

60
Q

What is the purpose of doing a Lateral Upright examination for a scoliosis sereis?

A

To assess the degree of Kyphosis or Lordosis – degree of anterior or posterior curvature

61
Q

What is the cobbs angle?

A

Determines the vertebra whose endplates are most tilted towards each other

62
Q

How do you find the degree of curvature in a scoliosis patient?

A
  1. Lines are drawn along the top of the superior tilted vertebra and the bottom of the inferior tilted vertebra
  2. Two more lines are drawn at an angle of 90° to these lines, so that they intersect
  3. The resulting angle = Cobb Angle
63
Q

With the cobbs angle, what does an angle that is less than 20 degrees indicate?

A

Normal spine

64
Q

With the cobbs angle what does a 20-40 degrees angle indicate?

A

Need for brace (can stop progression if caught early on)

65
Q

With the cobbs angle, what does an angle that is >40-50 degrees indicate?

A

Need for rods, spinal fusion

66
Q

True or false?

There is no minimum degree of curvature that will necessitate surgery.

A

True

67
Q

What are the rods called in scoliosis patients that have had surgery?

A

Harrington rods

68
Q

What is the purpose of doing side bending images in scoliosis series?

A

To assess structural from non-structural curves

69
Q

What is the primary and secondary curvature in the spine?

A

Lumbar curve is secondary
Thoracic is primary

Radiographic Procedures 2 (18 decks)

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