Unit 1 Week 1-2 Imaging

Question 1

what are the radiologic features of RA?

Answer 1

oft tissue changes, articular erosions, osteoporosis/periarticular demineralization, joint deformities

Question 2

when do articular erosions become apparent in RA?

Answer 2

first 2 years of the disease

Question 3

what changes in the cervical spine may be seen in patient with RA?

Answer 3

erosion and subluxation of facet joints
C1-C2 subluxation

Question 4

what types of imaging are more sensitive in detecting early changes of RA?

Answer 4

US and MRI

Question 5

what are the radiologic features of OA?

Answer 5

joint space narrowing, asymmetrical
subchondral sclerosis
osteophyte formation
pseudocysts
temporary joint effusions
joint deformities

Question 6

what are the radiologic characteristics of osteoporosis?

Answer 6

cortical thinning
loss of trabeculae
fractures

Question 7

what are the most common fractures in patients with generalized osteoporosis?

Answer 7

vertebral bodies
ribs
proximal humerus
distal radius
proximal femur

Question 8

what are the major differences on radiograph in RA and OA?

Answer 8

RA: is an erosive arthritis and will show radiolucent erosions on the subchondral bone. loss of joint space is concentric

OA: will show attempts at repair and have sclerosis and osteophytes at the subchondral bone and joint margins. loss of joint space is asymmetrical

Question 9

what is the routine series of imaging for the cervical spine?

Answer 9

1. AP open mouth
2. AP lower C-spine
3. lateral
4. right oblique
5. left oblique

Question 10

what does the AP open mouth view demonstrate?

Answer 10

the articulation of C1 and C2

Question 11

what is assessed in an AP open mouth view?

Answer 11

ABCs
C1-C2 joint symmetry
dens midline between the lateral masses of C1
C2 spinous process midline

Question 12

what does the AP lower cervical spine view demonstrate?

Answer 12

the lower five cervical vertebrae, an upper thoracic vertebra and any associated ribs, the middle third of the clavicles and the trachea

Question 13

what is assessed in an AP lower cervical spine view?

Answer 13

spinous processes midline, pedicles equidistant, interpedicular distance = transverse diameter of spinal canal

Question 14

what does the lateral view demonstrate?

Answer 14

all 7 cervical vertebrae, the intervertebral disc spaces, the articular pillars, the facet joints, the spinous processes, and the prevertebral soft tissues, as well as air in the trachea

Question 15

what is the 1st radiograph assessed after trauma?

Answer 15

lateral view

Question 16

what is the most significant things assessed in any region of the spine?

Answer 16

3 vertebral parallel lines

Question 17

what are the indications for CT for any region of the spine?

Answer 17

acute trauma in adults
degenerative conditions
abnormal conditions at the spinal cord when MRI is contraindicated

Question 18

the sagittal diameter of the spinal canal should be ___ the diameter of the vertebral body

Answer 18

equal to

Question 19

how is the cranial cervical relationship assessed?

Answer 19

CT
distances seen between C1-C2 and occiput

Question 20

what is the coronal CT best for?

Answer 20

demonstrating fractures of the dens

Question 21

what is the value of the MRI of the spine?

Answer 21

the direct visualization of the spinal cord nerve roots and disks

Question 22

what is the difference between stable and unstable injuries?

Answer 22

stable: compression fractures, disc herniations, unilateral facet dislocations

unstable: refers to the immediate or potential risk to the spinal cord or nerve root (fractures dislocations and bilateral facet dislocation)

Question 23

what is the 1st stop after MVA?

Answer 23

CT TAP scan

Question 24

patients should have radiography if:

Answer 24

dangerous MOI
>65 years old
paresthesia
midline tenderness
unable to rotate 45 degrees

Question 25

the lateral view is diagnostic for:

Answer 25

abnormal soft tissues
abnormal vertebral alignment
abnormal joint relationships

Question 26

what is a cross table lateral view?

Answer 26

x-ray beam is on a portable unit. the patient is supine on the gurney and the x-ray beam travels horizontally across the table

Question 27

what are the 2 types of cervical spine sprains (whiplash)?

Answer 27

hyperextension (injures anterior tissues)
hyperflexion (injures posterior tissues)

Question 28

what are lateral flexion and extension stress views used for?

Answer 28

done to assess injuries from sprains

Question 29

what are you looking for in the lateral flexion and extension stress views?

Answer 29

preservation of spatial relationship of 3 parallel lines
constant width of atlantodental interface

Question 30

where are the 3 sites that degenerative changes can occur in the spine?

Answer 30

DDD (discs), DJD (facet joints), and foraminal encroachment (intervertebral foramina)