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Di Imaging 2 > Test 1 Spinal Trauma > Flashcards

Test 1 Spinal Trauma Flashcards

1
Q

Order of Davis Series

A
  1. Lateral
  2. APOM
  3. AP Cervical
    4/5. Left/Right Obliques
    6/7. Flexion/Extension
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2
Q

What is deemed unstable?

A

Gross ligamentous damage with or without neurological insult

Or

Potential of neurological insult/compromise

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3
Q

Unstable vs. stable using column method

A

Unstable:

If more than one column disrupted

Or

Middle column disrupted

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4
Q

What are the 3 columns boundaries for determining stability

A

Anterior: ant. 2/3 VB
Middle: post 1/3 VB—> pedicle
Posterior: pedicle—> SP

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5
Q

Stability of pathological fracture?

A

Unstable

Because entire VB heigh decreased

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6
Q

Retropharyngeal space at ____ and should be less than ____mm?

Retrotracheal space at ___ and should be less than ____ mm?

A

C2 less than 7mm

C6 less than 22mm

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7
Q

How to tell if posterior arch fracture is traumatic or developmental?

A

Cortical bone around fracture

Anterior tubercle hypertrophy

=developmental

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8
Q

Bilateral fracture of anterior and posterior arches

A

Jefferson’s fracture

Bursting fracture of C1

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9
Q

How to tell if transverse Atlantan ligament is torn and what fracture is it usually torn with?

A

More than 7mm of horizontal offset

Jefferson’s Fx/Bursting Fx of C1

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10
Q

Increased ADI etiologies

A
  • Trauma
  • Down syndrome
  • Inflammatory arthropathies
  • RA **
  • agenesis of post. Arch
  • os odontoideum
  • occipitalization of atlas

**absent spinolaminar line + increased ADI = spina bifida occulta

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11
Q

Fracture of tip of dense. Stability?

A

Type one odontoid fracture

Stable

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12
Q

Fracture at base of dens. Stability?

A

Type two (high dense) odontoid fracture

Unstable

Nonunion common—> os odontodieum
(Hypertrophy and sclerosis of c1 anterior tubercle)

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13
Q

Fracture into body of C2. Stability

A

Type 3 (lower dens) fracture of c2

Unstable.

May see fat C2 body

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14
Q

Bilateral pedicle fracture of C2

A

Hangman’s fracture

Traumatic spondylolisthesis of C2

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15
Q

Decreased anterior body height

A

Compression fracture

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16
Q

Decreased anterior and posterior body height

A

Pathological fracture

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17
Q

DDx of pathological fractures

A

Osteoporosis
Multiple Myeloma
Metastasis of bone cancer

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18
Q

Indications the fracture may be new

A 
No cortex
Blurred/hazed endplates
Fracture line
Zone of impaction
Step defect

T1: black T2: white

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19
Q

Posterior body convexity

Widened interpeduncular space on AP

A

Bursting fracture

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20
Q

Inferior articulate process dislocates into the IVF

A

Unilateral facet dislocation

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21
Q

Bow tie sign

A

Unilateral facet dislocation

Spinous rotates toward side of dislocation

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22
Q

Abrupt decreased laminar length

A

Unilateral facet dislocation

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23
Q

Inverted hamburger sign on CT

A

Unilateral facet dislocation

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24
Q

If the anterior tubercle is round with a large ADI, is this new or old?

25
Ddx of type one odontoid fx? And what differentiates?
Normal & Os terminale Normal: normal growth center in children under 12 years OT: “V” shaped, well defined boarders.
26
Most severe injury of the cervical spine
Flexion teardrop fracture (bursting teardrop fracture)
27
Triangular fragment at the ant/inf body
Flexion teardrop fracture
28
Anterior cord syndrome associated with?
Flexion teardrop fracture
29
Flexion teardrop fracture xray
Decreased height Widening of facets Triangular fragment at the ant/inf body Retro pulse on of remainder of segment
30
Buckling of ligamentous flavum occurs with what fx?
Extension teardrop fx
31
Difference between flexion and extension teardrop
Both have triangular fragments at ant/inf body But extension teardrop does NOT have decreased VB heigh—just has avulsion fx
32
Clay shoveler’s fx
Fx of C6,7 T1 spinous base
33
Double spinous sign on AP
Clay shoveler’s fx
34
What is the MC fracture of the thoracic and lumbar vertebra?
Compression fractures
35
Step defect and zone of impaction tell you what?
That the compression fracture is new Step defect: anterior protrusion Zone of impaction: radiolucent density at superior end plate
36
The interpeduncular space on an AP should _____ as you go down the spine? If L2 space is wider than L3 what should you suspect?
It gets wider from L1-L5 | Bursting fracture
37
Ddx for pathological compression fracture
OP Lytic mets MM
38
Chance fracture
Horizontal splitting of the arch and body | See horizontal radiolucent line in the neural arch on AP
39
Empty vertebra/ghost sign
Chance fracture/lap belt fracture
40
Spondyloysis
Interruption of pars
41
Spondylolisthesis
Anterior displacement
42
Type 1 spondy
Dysplasic-congenital RARE
43
Type 2 spondy
Spondylolytic (isthmic) MC early onset Have a pars defect MC at L5
44
Type 3 spondy
Degenerative Older onset from facet arthrosis Pars normal MC at L4 females
45
Inverted Napoleon hat/bowsline of brailsford sign
Spondylolistesis
46
If one side of a facet has increased density. Why?
Unilateral pars defect on opposite side (potentially ongoing —> MRI) Tumor ipsilateral side
47
Duverney fracture
Iliac wing fracture
48
What is the most common fracture of the pelvis
Ischiopubic rami fractures
49
Avulsion fracture of ASIS
Sartorious
50
Avulsion fx of AIIS
Rectus femoris
51
Avulsion fracture of ischial tuberosity
Hamstring
52
Avulsion fracture of lesser trochanter
Iliopsoas | Mc in adults due to METs
53
Mc avulsion fracture of the pelvis
Ischial tuberosity due to hamstrings
54
Most common unstable pelvis practice
Malgaigne fracture
55
Malgaigne fracture
Fracture of superior and inferior pubic rami with fx/dislocation of ipsilateral SI
56
Bucket handle fracture
Fracture of superior and inferior ramus with fx/dislocation of contralateral SI joint
57
Straddle fracture
Bilateral fracture of superior and inferior rami
58
Sprung pelvis
Open book fx Diastasis/widening of pubic symphysis and one or both SI joints

Di Imaging 2 (5 decks)

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