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Diagnostic imaging exam 3 extra stuff > Extra stuff- DD of the spine > Flashcards

Extra stuff- DD of the spine Flashcards

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1
Q

What condition involves degeneration of the annulus with prominent osteophytes that remain at the corners of vertebral bodies?

A

Spondylosis deformans- associated with intercalary ossicles

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2
Q

What condition involves the degeneration of the nucleus pulposus or inner disc and has a reduced IVD space/ loss of disc height and minimal osteophytes?

A

Intervertebral chondrosis

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3
Q

What is Knutson’s phenomenon?

A

Aka Vacuum phenomenon- radiolucent collections of nitrogen gas within annular fissures

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4
Q

Where is Knutson’s phenomenon best seen?

A

Anterior margin of IVD on extension films

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5
Q

What are 4 radiologic findings of DDD?

A

Decreased disc height
Osteophytes
End plate sclerosis
Vacuum phenomenon

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6
Q

What is an increased bone density or thickening of the subchondral layer that may appear exaggerated or mimic an infection or blastic tumor

A

Endplate (subchondral) sclerosis

Hemispheric spondylosclerosis

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7
Q

Which modic change represents marrow edema/ inflammation and where is it most common?

A

Modic type 1

MC in cervicals

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8
Q

What does a modic type 1 change suggest?

A

Hypermobility

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9
Q

Which modic change represents marrow replacement/ fat and where is it more common?

A

Modic type 2

MC in lumbars

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10
Q

Which modic change represents thick woven sclerotic bone?

A

Modic type 3

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11
Q

CT and x-ray represent what type of change?

A

Trabeculation changes

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12
Q

MR reflects what type of change?

A

Marrow changes

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13
Q

If fatty marrow disappears it could mean?

A

More unstable or possible infection

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14
Q

Which radiologic test is best for evaluating obvious defects in the pars?

A

Plain radiographs

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15
Q

What test do we use to evaluate for active spondylolysis or stress reaction in non-fracture pars?

A

SPECT bone scan

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16
Q

What is becoming the gold standard for evaluating spondylolysis and pars defects?

A

MR

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17
Q

What is an abrupt focal radiolucent IVD displacement into the cancellous bone of an adjacent vertebra?

A

Schmorl’s node

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18
Q

Who do you typically see Schmorl’s nodes in?

A

Children- usually insignificant

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19
Q

When you see a schmorl’s node in an adult what does it usually represent?

A

Significant end plate fracture

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20
Q

Where is Scheurermann’s disease typically seen in the spine?

A

T7-T12

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21
Q

What is thoracolumbar scheurermann’s disease called?

A

juevenile discogenic disease

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22
Q

With a posterior subluxation what is the diagnosis?

A

DDD- MC annulus

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23
Q

What is an anterior subluxation?

A

Spondylolisthesis- posterior joint arthrosis MC cause

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24
Q

What is the #1 cause of anterior subluxation in kids?

A

Stress fracture- L5 in females MC

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25
What is the #1 cause of anterior subluxation in adults?
Posterior joint arthrosis- females L4 middle age MC
26
Where is the MC degeneration of the cervicals?
C5/6
27
Where does the MC uncovertebral degeneration occurs?
C3-C7
28
With uncovertebral degeneration, a frontal projection=
Bulbous osteophytes
29
With uncovertebral degeneration, a lateral projection=
Pseudofracture **sign of uncinate hypertrophy
30
Why are nerve roots rarely effected with uncovertebral degeneration?
They lie in superior aspect of IVF
31
If nerve roots are affected with uncovertebral degeneration what is the MC cause?>
Facet hypertrophy
32
Where is zygapophyseal degeneration most common?
Lower lumbar Middle cervical Upper/middle thoracic
33
What is the MC cause of disc calcification?
Idiopathic
34
Where is the bifurcation of the aorta?
L4/5
35
Sacroilitis is unique to what?
Ankylosing spondylitis
36
What percentage of DISH patients will have OPLL?
40-50%
37
When the PLL ossifies in the cervical region, their is often a decrease in sagittal canal diameter with resultant ______
Myelopathy
38
What is the cause of anterior cord syndrome?
Stenosis- OPLL
39
What is the cause of posterior cord syndrome?
Compression
40
In the cervical spine, midline herniations create _____
Myelopathies
41
In the cervical spine, lateral herniations ______
Compress the NR BELOW
42
In the lumbar spine, midline/ paracentral herniations compress _____
The NR BELOW
43
In the lumbar spine, foraminal herniations involve the NR _____
At the same level
44
The gold standard for imaging for herniations is _____
MRI
45
What are the 3 types of annular tears?
Circumferential, radial, transverse
46
Natural cohesion of the nucleus is denatured by _____
Endplate fracture and blood exposure
47
Herniation only happens if?
Annulus pathway is present
48
If no annulus pathway is present then there is?
An internal disruption
49
What are the contents of the spinal canal?
``` Thecal sac Epidural fat Internal vertebral plexus Ligamentum flavum PLL ```
50
What allows direct drainage from the pelvis via the spinal canal? It is a common site allowing cancer into the canal?
Batson's venous plexus
51
Which types of herniations can be seen on mid-sag MRI cuts?
Central and paracentral
52
what is a very dense central/nucleus pulposus disc calcification?
onchronosis
53
which conditions do you see annulus fibrosis calcification?
CPPD haemochromatosis hypervitaminosis D
54
when is transient IVD calcification commonly seen and where?
in children in cervical spine; usually spontaneously regresses
55
what is a pathological osseous proliferation at tendon or ligament insertion that can be degenerative or inflammatory?
enthesopathy
56
what is one of the key features differentiating DISH from DDD?
DISH preserves disc height and osteophytes more pronounced (candle wax)
57
with OPLL what are some of the secondary symptoms?
sensory and motor disturbances- especially legs progressive difficulty walking paresthesia and diminished tactile senses
58
what is the common tx for OPLL?
laminectomy
59
what percentage of back pain patients suffer from herniation?
5%
60
what percent of mechanical LBP is from sprain/strain?
70%
61
what is the lifetime prevalence of mechanical LBP in the US?
60-80%
62
what is the MC cause of work-related disability in persons under 45 in the US?
mechanical LBP
63
presence of herniations among asymptomatic population is estimated at what percent?
20-35%
64
CT is inferior to MRI for ______ but superior for _____
soft tissue (herniations); bone imaging
65
with a decrease in O2, chondrocytes, proteoglycans and H2O you have an increased risk of?
annular stress which leads to annular fissures and tears
66
theca =
meninges
67
what is an area of increased signal intensity on a T2 image usually referring to outer annulus and may reflect fissure or tear?
high intensity zone
68
what are the 2 types of spinal stenosis?
congenital- achondroplasia | acquired- spondy, spondylolisthesis, lig flav hypertrophy, IVD herniation etc.
69
what are the 3 spinal canal parameters?
central- spinal canal neuroforaminal- lateral zone of IVF lateral recess- medial zone of IVF
70
cervical and lumbar spine stenosis measurements
cervical- less than 12 mm | lumbar- less than 15 mm
71
what are the sagittal canal measurements?
anterior line- posterior vertebra posterior line- spinolaminar line stenosis under 12mm- disc facet degeneration or herniation
72
lateral recess stenosis measurement
3mm
73
what procedure would be done for stenosis?
laminectomy
74
what are common signs of cervical spine stenosis?
long tract and radicular sx, HA, neck pain, + lhermitte's
75
what 2 conditions does cervical spine stenosis mimic?
MS and ALS
76
what are common sx of lumbar spine stenosis?
radicular s&s, back pain, neurogenic claudication
77
what is neurogenic claudication?
LE pain and numbness exacerbated by standing and alleviated by flexion; simian stance; alleviation with exercise DDx: vascular claudication- intermittent and usually in calf

Diagnostic imaging exam 3 extra stuff (5 decks)

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