W3- T-Spine/Ribs, Shoulder, and Elbow/Wrist/Hand Viewing Radiographic Images Flashcards
PART 1: T-SPINE AND RIBS
PART 1: T-SPINE AND RIBS
T-Spine and Ribs Viewing Indications. (12)
- Trauma
- Pain radiating around the chest wall
- ROM limitations
- Pre-op/ post-op
- Malignancies
- Osteoporosis/ compression frx
- Arthropathy
- Health conditions associated with spinal abnormality
- Evaluate scoliosis & kyphosis
- Suspected congenital abnormality
- Monitoring known abnormality
- Suspected instability
T-Spine:
- What are the (2) most common views when looking at the T-spine?
- What are some other views utilized and what are their purposes?
-AP and lateral
- Swimmers = great for looking at CT junction
- Oblique
- Coned views = highly zoomed looking at vertebrae segments
Sternum:
- Which view is utilized to view the sternum as a whole?
- What are (2) views utilized to view the SC joints?
- Why is a lateral view of the sternum useful?
- RAO for sternum (patient position), called posterior oblique (projection)
- RAO and LAO to view SC joints
- Lateral view utilized to distinguish malalignment of the sternum.
Ribs:
- What (3) views are utilized to view the ribs?
- Can also utilize what other x-rays to see the ribs?
- AP, PA, Oblique
- Chest x-ray
-Where does the central ray pass through in AP and lateral views of the T-spine?
-Where does the central ray pass through in posterior oblique and lateral view of the sternum?
-
- T7
- midway between jugular notch and xiphoid process
Things to look for in an AP view of the T-spine? (8)
- pedicle alignment
- distance between pedicle and SP
- symmetry and interpedicular distance, abnormalities indicative of Fx
- vertebral bodies/lateral border
- disc space
- TP
- midline of SP
- articulation between ribs and vertebrae
Things to look at in a lateral view of the T-spine? (10)
- anterior and posterior bodies, with spinolaminar line
- disc heights
- pedicles superimposed (cant discern)
- open lateral foramen
- partial viewing of some z-joints
- bodies box-like
Things to look at in a posterior oblique (RAO position) of the ribs? (7)
- sternum vs ipsilateral SC joint
- anterior and posterior ribs
- lungs
- manubrium and sternal body
- sternal angle
- sternal body/xiphoid process junction
- sternocostal joints
- 1st rib under clavicle
- Are we able to see the posterior ribs more clearly with an AP or PA view?
- Are we able to see the anterior ribs more clearly with an AP or PA view?
- AP = Posterior
- PA = Anterior Ribs
CT Spine Indications. (9)
- Acute trauma (adults)
- Degenerative conditions
- Post-op assessment
- Infection
- Image-guided intervention procedures
- Neoplasm
- Inflammatory lesions
- Congenital/ developmental conditions
- Cord Syrinxes/ masses (with MRI contraindicated)
MRI Spine Indications. (9)
- Acute Trauma with suspected cord encroachment
- DDD
- Neoplasm
- Intrinsic spinal cord pathology
- Congenital/developmental conditions
- Cord masses
- Pre/post-op assessment
- Meningeal abnormalities
- Infection
ABCDs of MRI.
- Alignment
- Bone signal
- Canal space
- Disc integrity
- Soft Tissue
When utilizing MRI, T1 weighted images are used for _________ while T2 weighted images are used for ______.
- anatomy
- fluid
PART 2: SHOULDER
PART 2: SHOULDER
Shoulder Viewing Indications. (11)
- Trauma
- Bone involvement with metabolic diseases/systemic disease/nutritional deficiencies
- Neoplasm
- Infection
- Arthropathy
- Pre-op/post-op
- Suspected congenital/developmental abnormality
- Vascular lesions
- Foreign body/soft tissue lesion
- Pain
- Correlation with other studies
What views are looked at with the shoulders? (2)
- AP External Rotation
- AP Internal Rotation
What views are looked at with the AC joint?
-Upright AP (with and without weights on wrist)
What views are looked at with the Scapula? (2)
- AP
- Lateral
What are some other views utilized at the shoulder?
- Axillary view of the GH
- Scapular “Y”
Why would we use the IR or ER view of the shoulder?
- IR = View lesser tuberosity
- ER = View greater tuberosity
What is abnormal when performing Upright AP with weights at the AC joint?
- Abnormal = Separation of AC joint when holding weights.
- Normal = Ligaments able to hold weight without separation of AC joint.
- Coroclavicular normal distance?
- AC joint space normal distance?
Coroclavicular = 1-1.3cm
AC Joint = .3-.8cm
Which view is best for looking at orientation of humeral head in relation to glenoid fossa?
Axillary View
