Head and Neck Flashcards
What is Clay- Shoveler’s Fracture
- Oblique fracture through the spinous process of C6-T3
- Common C6 and C7
- Caused by hyperflexion
- Can caused by direct blow injury
Extra:
- Hyperflexion of the neck combined with contraction of the paraspinous muscles cause alvusion fracture
- Best view is Neutral Lateral
- AP shown ghost sign (double spinal process due to displaced fractured spinous process)
What is Os Odontoideum
Failure of he odontoid process to unite with the body of C2 after 7 years
Transverse ligament of C1 is intact. May associated hypoplastic or agenetic posterior arch of C1
The bony defect is usually higher than site of cartilagious disc between odontoid process and C2 body (neurocentral synchondrosis)
What is Os Terminale
Failure of fusion of the secodnary ossification centre at the tip of the odontoid
Radiographic Signs for Os odontoideum
- Wide bony defect between the body of C2 and the odontoid process
- Hypoplastic odontoid process
- Hypertrophy of the anterior tubercle of C1
- Corticated margins
What is Congenital Block Vertebra
Failure of segmentation of somites
This results in two or more vertebrae forming as single (fused)
Radiographic Sign for Congenital block vertebra
- Decrease AP diameter of vertebra body (C shaped concavity or wasp waist deformity)
- Hypoplastic disc space within the block
- Facet joint fusion
- Spinous process malformation or fusion
General and Unique Imaging Signs in Osteoarthritis
General:
- Narrowed disc space
- Osteophytes
- Misalignment
- Erburnation (sclerosis
Unique:
- Vacuum phenomenon
- Hemispherical spondylosclerosis
What can be found of Degenerative in intervertebral disc
Increased loss of disc height leads to increased loading and subsequent degeneration of facet uncovertebral joints
Osteoarthritis in uncovertebral joint will show?
Normal:
Cat ear shaped
Degenerated
- Hooked uncoverterbal process, Dog ears shaped
- Flattened, bulbous
- loss of disc space cause impaction of uncovertebral process with subsequent remodelling
What can found of degenerative in apophyseal (facet joint)
Spinal canal stenosis, degenerative spondylolisthesis, synovial cyst formation
how spondylosis affect Uncovertebral joint
loss of disc space cause impaction of uncovertebral with subsequent remodelling
What is Diffuse idiopathic skeletal hyperostosis (DISH)
a bony hardening of ligaments in areas where they attach to your spine
Anterior longitudinal ligament ossification
Diagnostic criteria for Diffuse idiopathic skeletal hyperostosis (DISH)
- Calcification or ossification along the anterolateral aspect of at least 4 contigous vertebral bodies
- relative presercation of intervertebral disc height
- Absence of apophyseal joint ankylosis and sacroiliac joint erosion, sclerosis or ankylosis
What is Ossification of the Posterior Longitudinal Ligament (OPLL)
Ossification of PLL
- common in Asian
- 50% of patients with DISH
- May compress the spinal cord cause myelopathy
What is Jefferson’s Fracture
Burst fracture of ring of atlas through both anterior and posterior arches
due to compression on vertex of skull transmits forces through occipital condyles to lateral masses of atlas
