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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?

A

Old.

25
Q

Ddx of type one odontoid fx? And what differentiates?

A

Normal & Os terminale
Normal: normal growth center in children under 12 years
OT: “V” shaped, well defined boarders.

26
Q

Most severe injury of the cervical spine

A

Flexion teardrop fracture (bursting teardrop fracture)

27
Q

Triangular fragment at the ant/inf body

A

Flexion teardrop fracture

28
Q

Anterior cord syndrome associated with?

A

Flexion teardrop fracture

29
Q

Flexion teardrop fracture xray

A

Decreased height
Widening of facets
Triangular fragment at the ant/inf body
Retro pulse on of remainder of segment

30
Q

Buckling of ligamentous flavum occurs with what fx?

A

Extension teardrop fx

31
Q

Difference between flexion and extension teardrop

A

Both have triangular fragments at ant/inf body

But extension teardrop does NOT have decreased VB heigh—just has avulsion fx

32
Q

Clay shoveler’s fx

A

Fx of C6,7 T1 spinous base

33
Q

Double spinous sign on AP

A

Clay shoveler’s fx

34
Q

What is the MC fracture of the thoracic and lumbar vertebra?

A

Compression fractures

35
Q

Step defect and zone of impaction tell you what?

A

That the compression fracture is new

Step defect: anterior protrusion
Zone of impaction: radiolucent density at superior end plate

36
Q

The interpeduncular space on an AP should _____ as you go down the spine? If L2 space is wider than L3 what should you suspect?

A

It gets wider from L1-L5

Bursting fracture

37
Q

Ddx for pathological compression fracture

A

OP
Lytic mets
MM

38
Q

Chance fracture

A

Horizontal splitting of the arch and body

See horizontal radiolucent line in the neural arch on AP

39
Q

Empty vertebra/ghost sign

A

Chance fracture/lap belt fracture

40
Q

Spondyloysis

A

Interruption of pars

41
Q

Spondylolisthesis

A

Anterior displacement

42
Q

Type 1 spondy

A

Dysplasic-congenital RARE

43
Q

Type 2 spondy

A

Spondylolytic (isthmic)
MC early onset
Have a pars defect
MC at L5

44
Q

Type 3 spondy

A

Degenerative
Older onset from facet arthrosis
Pars normal
MC at L4 females

45
Q

Inverted Napoleon hat/bowsline of brailsford sign

A

Spondylolistesis

46
Q

If one side of a facet has increased density. Why?

A

Unilateral pars defect on opposite side (potentially ongoing —> MRI)
Tumor ipsilateral side

47
Q

Duverney fracture

A

Iliac wing fracture

48
Q

What is the most common fracture of the pelvis

A

Ischiopubic rami fractures

49
Q

Avulsion fracture of ASIS

A

Sartorious

50
Q

Avulsion fx of AIIS

A

Rectus femoris

51
Q

Avulsion fracture of ischial tuberosity

A

Hamstring

52
Q

Avulsion fracture of lesser trochanter

A

Iliopsoas

Mc in adults due to METs

53
Q

Mc avulsion fracture of the pelvis

A

Ischial tuberosity due to hamstrings

54
Q

Most common unstable pelvis practice

A

Malgaigne fracture

55
Q

Malgaigne fracture

A

Fracture of superior and inferior pubic rami with fx/dislocation of ipsilateral SI

56
Q

Bucket handle fracture

A

Fracture of superior and inferior ramus with fx/dislocation of contralateral SI joint

57
Q

Straddle fracture

A

Bilateral fracture of superior and inferior rami

58
Q

Sprung pelvis

A

Open book fx

Diastasis/widening of pubic symphysis and one or both SI joints

Di Imaging 2 (5 decks)

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