Unit 1 Week 1-2 Imaging Flashcards
what are the radiologic features of RA?
oft tissue changes, articular erosions, osteoporosis/periarticular demineralization, joint deformities
when do articular erosions become apparent in RA?
first 2 years of the disease
what changes in the cervical spine may be seen in patient with RA?
erosion and subluxation of facet joints
C1-C2 subluxation
what types of imaging are more sensitive in detecting early changes of RA?
US and MRI
what are the radiologic features of OA?
joint space narrowing, asymmetrical
subchondral sclerosis
osteophyte formation
pseudocysts
temporary joint effusions
joint deformities
what are the radiologic characteristics of osteoporosis?
cortical thinning
loss of trabeculae
fractures
what are the most common fractures in patients with generalized osteoporosis?
vertebral bodies
ribs
proximal humerus
distal radius
proximal femur
what are the major differences on radiograph in RA and OA?
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
what is the routine series of imaging for the cervical spine?
- AP open mouth
- AP lower C-spine
- lateral
- right oblique
- left oblique
what does the AP open mouth view demonstrate?
the articulation of C1 and C2
what is assessed in an AP open mouth view?
ABCs
C1-C2 joint symmetry
dens midline between the lateral masses of C1
C2 spinous process midline
what does the AP lower cervical spine view demonstrate?
the lower five cervical vertebrae, an upper thoracic vertebra and any associated ribs, the middle third of the clavicles and the trachea
what is assessed in an AP lower cervical spine view?
spinous processes midline, pedicles equidistant, interpedicular distance = transverse diameter of spinal canal
what does the lateral view demonstrate?
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
what is the 1st radiograph assessed after trauma?
lateral view
what is the most significant things assessed in any region of the spine?
3 vertebral parallel lines
what are the indications for CT for any region of the spine?
acute trauma in adults
degenerative conditions
abnormal conditions at the spinal cord when MRI is contraindicated
the sagittal diameter of the spinal canal should be ___ the diameter of the vertebral body
equal to
how is the cranial cervical relationship assessed?
CT
distances seen between C1-C2 and occiput
what is the coronal CT best for?
demonstrating fractures of the dens
what is the value of the MRI of the spine?
the direct visualization of the spinal cord nerve roots and disks
what is the difference between stable and unstable injuries?
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)
what is the 1st stop after MVA?
CT TAP scan
patients should have radiography if:
dangerous MOI
>65 years old
paresthesia
midline tenderness
unable to rotate 45 degrees
the lateral view is diagnostic for:
abnormal soft tissues
abnormal vertebral alignment
abnormal joint relationships
what is a cross table lateral view?
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
what are the 2 types of cervical spine sprains (whiplash)?
hyperextension (injures anterior tissues)
hyperflexion (injures posterior tissues)
what are lateral flexion and extension stress views used for?
done to assess injuries from sprains
what are you looking for in the lateral flexion and extension stress views?
preservation of spatial relationship of 3 parallel lines
constant width of atlantodental interface
where are the 3 sites that degenerative changes can occur in the spine?
DDD (discs), DJD (facet joints), and foraminal encroachment (intervertebral foramina)
