Imaging of the Spine Flashcards Preview

MD1 Endocrine > Imaging of the Spine > Flashcards

Flashcards in Imaging of the Spine Deck (31):
1

Why is the clinical history and examination important in imaging?

Decide which imaging is best
Urgency

2

What are plain films used for in the spine?

Alignment
Sometimes fractures

3

Why do we use MRI in the spine?

Spinal cord
Nerve roots
CSF
Ischaemia

4

Why are the bodies of lumbar vertebrae larger than the others?

Take more weight

5

What foraminae do cervical vertebrae have that others don't?

Transverse foraminae

6

What are the costal facets in the thoracic vertebrae for?

Articulation with ribs

7

What can be accessed via the interlaminar space in the lumbar spine?

Spinal cord via needle

8

What are the features of the lumbar vertebral body in an A-P plain film?

Thin cortical bone
Pedicles look like hollow cylinders
Spinal canal in centres

9

When viewed laterally, what is the direction of the x-ray beam to the lumbar vertebral body in an A-P plain film?

Not entirely tangential
Shows as
- Thick superior cortical margin
- Double line at inferior margin

10

What direction is the x-ray beam in an oblique plain film of the spine?

Parallel to facet joint
45 degrees to body

11

What is the pars interarticularis part of?

Lamina

12

What is the importance of the pars interarticularis?

Thinnest and weakest part
Gets stress fractures

13

Which part of the intervertebral disc usually protrudes: anulus fibrosus or nucleus pulposus?

Nucleus pulposus

14

What is the signal of CSF in a T1 MRI?

Dark

15

What is the signal of CSF in a T2 MRI?

Bright

16

Where does the C1 spinal nerve exit?

Above C1 vertebra

17

Where does the C8 spinal nerve exit?

Below C7 vertebra

18

What is bright on both T1 and T2 MRIs?

Fat

19

What are the advantages of using MRI in the spine?

Shows pathology

20

What are the disadvantages of using MRI in the spine?

Time consuming
Expensive
Hard to access

21

What obscures many structures in the thoracic spine?

Ribs

22

Is irregularity in the endplates of the vertebrae normal or abnormal?

Usually normal in younger people
Can be indicator of pathology

23

Why are disc protrusions more common in the lumbar rather than thoracic spine?

Thoracic spine stabilised by ribs

24

What are the normal curves of the cervical, thoracic, and lumbar spines?

Cervical lordosis
Thoracic kyphosis
Lumbar lordosis

25

What is CT useful for in the spine?

Lumbar disc pathology but not as good as MRI
Bone detail
Complex joints
Multi-planar images

26

Why can the L4 vertebra slip on L5?

Arthritis of facet joint
Defect in lamina = stress fracture

27

What is bone scintigraphy?

Injected technetium emits gamma rays > counted by scanner

28

What takes up technetium?

Osteoblasts

29

What does bone scintigraphy assess?

Vascularity
Osteoblastic activity

30

Which areas show increased uptake of technetium in bone scintigraphy?

Pathology
Bladder because excreted in urine
Injection site

31

What is bone densitometry?

Dual energy x-ray absorptiometry
Low dose x-rays to measure bone mineral density
Compares bone mineral density of femoral neck/lumbar spine with age matched reference ranges/young normals
Combined with other clinical info can give risk of fracture