X-Ray Hits! Flashcards
DISH and OPLL
Diffuse Idiopathic Skeletal Hyperostosis-flowing anterior ossifications over many levels
fusion predisposes to carrot stick fractures
Ossification of Posterior Longitudinal Ligament- causes canal stenosis and predisposes to cord injury from minor trauma
What is “cervical split”
Seen with uncinate arthrosis -pseudo-fracture appearance mid vertebral body level on lateral projection due to enface osteophytes
Common C2 fractures
dens fracture:
type I = tip, type II = base and type III = involves vertebral body
*on alert for dens normal variants (os odontoideum vs os terminale)
hangman’s fracture:
fracture through bilateral pars interarticularis of C2
Lines and measurements at cervical spine
atlantodental interval
adult: <3 mm
child: <5 mm
prevertebral soft-tissue
< 7mm at C2
<22 mm at C7
PEG view
if well-aligned then upper teeth should align with occiput
lateral margins of the lateral masses of C1 and C2 should line up
*except in children > slight overhang is allowable = pseudo-Jefferson fracture
accepted maximal value of normal overhang is 6 mm
Cervical Swimmers View
lateral projection of the cervical spine to visualise the C7/T1 junction
help to visualise subluxation and fractures involving the inferior cervical spine, superior thoracic spine and adjacent soft tissue.
Spine: TB vs Osteomyelitis
TB: ‘subligamentous’: beneath the anterior longitudinal ligament, usually sparing the posterior elements and often involving multiple levels.
Tuberculous spondylitis can be difficult to detect in early stages because of relative preservation of the disc space.
Osteomyelitis/ Spondylodiscitis: ‘disc’ space narrowing and irregularity or ill definition of the vertebral endplates can be seen. In untreated cases, bony sclerosis may begin to appear in 10-12 wks
three commonest sites of pelvis apophyseal avulsion,
- ischial tuberosity at the insertion of the adductor magnus muscle of the hamstring;
- anterior inferior iliac iliac spine at the insertion of the rectus femoris muscle;
- anterior superior iliac spine at the sartorius muscle insertion.
X-ray investigations for suspected Acute Abdomen
- abdomen (supine/erect)
- chest sitting ( *obtain after 3-5mins of sitting)
Significance of INTRAvertebral vacuum cleft and what is it?
85% sensitivity and 99% specificity for OSTEONECROSIS
Radiolucent transverse band in the centrum of the collapsed vertebra OR adjacent to one of its endplates.
**effectively excludes metastatic disease or infectious involvement
Most common cause of vertebral body osteonecrosis?
Post traumatic»_space; typically following an osteoporotic vertebral body compression fracture
Predisposing factors to Gout
- chronic renal failure
- thiazide diuretics
- increased alcohol intake
- hyper- or hypoparathyroidism
- myeloproliferative disorder
- hemolytic anemias
- chemotherapy
Complications of gout
- tendon rupture
- nerve compression
- paralysis
X-ray of the Hand:
Degenerative changes of radio-carpal joint, a subchondral cyst in radius, calcification of triangular fibrocartilage, widened scapholunate interval and proximal migration of the capitate
What is the likely diagnosis?
Calcium Pyrophosphate Dihydrate Crystal Deposition Arthropathy
X-ray Shoulder:
Normal bones and glenohumeral joint. A curvilinear milky calcification seen just above greater tuberosity on AP view
Likely Diagnosis?
Hydroxyapatite Crystal Deposition with calcific tendinopathy
How many vertebrae does the spinal column consist of??
33 >> 7 cervical 12 thoracic 5 lumbar 5 sacral 4 coccygeal
