Imaging the Spinal Cord Flashcards
What modality is best choice in trauma?
CT
3 standard views of the cervical spine
Lateral (need to see C7/T1 junction)
Frontal
Open mouth
What are the standard views of the thoracic and lumbar spine?
Frontal
Lateral
3 places to check for alignment on lateral cervical spine
Anterior spinal line (front of vertebral bodies)
Posterior spinal line (back of vertebral bodies)
Spinolaminar line
Upper cervical prevertebral soft tissues should not be wider than..
Half the width of the adjacent vertebral body
What do you want to assess for on the open mouth view?
Ensure the dens is intact
Evaluate the atlanto-axial joint (equal and symmetric distance between lateral masses of C1 and C2)
Ensure the lateral margins of C1 and C2 are aligned normally
T1 vs T2 weighted
T1: CSF (water) is black
T2: CSF (water) is white
How do we describe black and white in terms of intensity?
Black = hypointense Gray = isointense White = hyperintense
Why do all patients with CT evidence of spine trauma need to receive an MRI?
To assess the ligaments (CT does not show them)
Burst fracture
Height loss
Uneven disc space
Interrupted cortex
Spinal stability
- What is it
- What does it depend on
- The ability of the spine to protect the neural elements
2. Dependent on at least 2 intact columns (anterior, middle, posterior)
6 red flag symptoms with lower back pain
Unexplained weight loss Fever Loss of control of bowel or bladder Loss of feeling or strength in legs Abnormal reflexes History of cancer
Lytic metastases
Radiolucent
Eats away at the bone (looks darker)
Ex: kidney, thyroid, lung
Blastic metastases
Radiodense
Produces more bone (looks extra white)
Ex: prostate, breast
Atlanto-axial joint
Between C1 and C2 vertebral bodies
