w6 - radiology Flashcards
clinical presentation
key ss
neck pain - stiffer in the morning, better once up and moving
Osteoarthritis
clinical presentation
greatly decreased cervical rotation =
osteoarthritis
clinical presentation
gradula increase in pain stiffness in the morning middle age > 50 yrs initially - pain relived with rest later - pain constant
osteoarthritis
examination findings
insidious onset mild-moderate aching stiffness resting stiffness with disappears with activity joint pain deformity swelling inflammation crepitus decr. ROM
osteoarthritis
osteoarthritis AKA
DJD
degenerative joint disease
OA/DJD causes changes in the cervical region of…*2
lateral canal stenosis - IVFs - nerve roots - lower motor neuron ss LMN OA in facet jts > IVFs less room OA in vert bodies > less height> IVFs less room
central canal stenosis - spinal canal - spinal cord - upper motor neuron ss UMN OA causes narrowing of spinal canal > osteophytes press on spinal cord
LMN ss
osteoarthritis
hyporeflexia
nerve impulses not reaching properly to lower neurons in muscles
UMN ss
osteoarthritis
hyperreflexia
excessive stimulus to nerve pathway by osteophytes pressing on spinal cord
hyperactive or repeating (clonic) reflexes.
ususally interruption of corticospinal and other descending pathways that influence the reflex arc
imaging
for Dx of OA
xray (radiography)
lower radiation than CT
cheaper
standard “cervical series”
for OA Dx
x3
- AP open mouth
- AP lower cervical
- Lateral cervical
also request extra
- Oblique cervical
(to check IVFs for stenosis)
radiological changes
often _ _ with
clinical signs and symptoms
poorly correlates
which imaging has been shown superior in
management and Dx of OA
MRI
radiological features
OA
*6
- asymmetrical changes
- non-uniform jt space
- effusion/edema
- articular deformity
- subchodral sclerosis
- cyst formation
AP cervical
look for
- uncinate process blunting
- subchondral sclerosis
- osteophytes
Lateral cervical
radiographical findings
look for
- osteophytes
- georges line (post. vert bodies)
- loss disc height / jt space
- facet jt loss jt space
- osteophytes on post. inf. vert bodies = central canal stenosis (into spinal canal)
Oblique cervical
(eg. left posterior oblique LPO)
(eg. right posterior oblique RPO)
look for…
- osteophytes in IVFs
(DJD into IVFs) = Lateral canal stenosis
lateral cervical
look for
- george‘s line
= ind eg. C3 anterolisthesis
(vert body slipping forward) - wear and tear of facet jts/loss space
- osteophytes
- loss of disc height
case 2 Dx?
acute neck pain
- post fall
- pain on extention
- NAD dermatome, myotomes, reflexes
- spurling’s (maximal cervical compression)
Clay shovelor’s fracture
(avulsion fracture - muscle pulls off piece of bone)
Eg. Of impact fracture
Indentation cheek bone
Eg. Stress fracture
Shins runner
Teardrop fracture
Type of avulsion fracture
Bone piece off body of vert
radiological features - fracture healing
first 5 days
resorption of fracture line (gets wider)
radiological features - fracture healing
10-30days
callus formation
new bone adj to fracture, fills cortical disruption
radiological features - fracture healing
after 30 days
remaining healing time
callus remodelling
healing time
entire process (young)
4-6 weeks
4 = kid 6 = 20yr old
healing time
entire process (old/eldery)
6-12 weeks
10 = 50s 12 = elderly
