Anomalies & Variants Imaging Flashcards
(33 cards)
Run the five cervical lines on the lateral view. Which one is abnormal?
McGregor line
dens is above the line, indicating its within foramen magnum
What are the two present diagnoses?
- SBO C2
- Occipitalization
What imaging modality is demonstrated?
What has happened to the cerebellum?
MRI T1 and MRI T2
Cerebellum has herniated (Chiari malformation)
What are two findings seen at C5/C6?
- Wasp-waist deformity
- Hypoplastic disc
congenital fusion
How do you confirm that the image on the right is a surgical fusion?
No wasp-waist deformity
same worries of hypermobility above and below the fusion
What is the diagnosis?
What additional diagnoses can be related to it, but can also be seen independently?
Klippel Feil
- Omovertebral bone
- Sprengel deformity
- Occipitalization
- Cervical rib
What is the diagnosis?
What is the clinical significance?
SBO at C1
No significance (DMS)
note hypertrophy of anterior tubercle and missing spinolaminar junction line
What is the diagnosis?
What follow up is needed?
Posterior arch agenesis
Flexion/extension radiographs for transverse ligament instability
What is the diagnosis?
What follow up is needed?
Posterior arch agenesis
Flexion/extension radiographs for transverse ligament instability
What is the diagnosis?
Os odontoideum
note round smooth corticated margins
unstable by definition; concern for guillotine effect
Which of the 5 cervical lines is abnormal?
Why is this so?
Spinolaminar and anterior body lines are abnormal
C1 has translated forward
Note the position of C1.
What is the DDx?
C1 has translated forward
29+ diagnoses
transverse ligament issues (26+) and dens issues (3) can translate C1 forward
Which of the 5 cervical lines is abnormal?
Why is this so?
Spinolaminar and anterior body lines are abnormal
C1 has translated forward
This radiograph demonstrates translation of C1 that presents concern for ___ effect.
guillotine effect: C1 translates forward, posterior elements hit the spinal cord
What is the diagnosis?
What follow up question would you ask this patient?
Ossified stylohyoid ligament (with pseudoarthrosis)
Trouble swallowing solids?
This patient reports struggling to swallow food.
What are your concerns for this patient?
- Diagnosis of Eagle syndrome
- Vertebral artery insufficiency
- Fracture
What are the diagnoses?
- Occipitalization
- Basilar impression
- Congenital fusion (C2/C3)
- Cervical ribs (bilaterally)
Patient complains of upper extremity numbness/weakness.
What orthopedic test should be performed?
Adson’s
What are the diagnoses?
- Congenital fusion (C2/C3)
- Lateral hemivertebra (T1)
Which of these patients has Schmorl nodes?
Right patient
note step-off appearance
left patient has nuclear impressions
What is the diagnosis?
Anterior superior limbus bone (L4)
variant of the Schmorl node
What is the diagnosis?
What is its clinical significance?
Anterior superior limbus bone (L4)
No significance
posterior limbus bones associated with central stenosis
Which lumbar line is abnormal?
What is the diagnosis?
What is its clinical significance?
Posterior body line is interrupted
Posterior inferior limbus bone (L4)
Central stenosis association
What is the diagnosis?
What is its clinical significance?
Facet tropism (L5)
No significance
