List To Memorise Flashcards
(22 cards)
1
Q
Solitary collapsed vertebra (vertebra plana)
A
- Osteoporosis
- Neoplastic: met, MM/plasmacytoma, lymphoma
- Trauma
- Infection (with destruction of adjacent disc spaces, except TB which has preserved disc space)
- Eosinophilic granuloma (common cause in childhood, posterior element usually spared)
- Benign tumour eg: haemangioma, GCT, ABC
- Paget’s disease (neural arch is involved usually)
2
Q
Multiple collapsed vertebrae
A
- Osteoporosis
- Neoplastic
- Trauma
- Infection
- Langerhans cell histocytosis (children and adolescent, disc enlarged)
- Scheuermann’ disease
- Sickle cell anaemia & Gaucher disease (H-shaped vertebrae)
- Osteogenesis imperfecta
- Osteomalacia
- Hyperparathyroidism
3
Q
Enlarged vertebral body
A
Generalised: gigantism, acromegaly
Local:
1. Paget’s disease (picture frame in mixed phase, ivory vertebra in diffuse sclerotic phase)
2. Benign bone tumour (ABC, hemangioma (vertical trabecular pattern), GCT)
3. Fibrous dysplasia
4. Hydatid
4
Q
Squaring of 1/> vertebral bodies
A
- Seronegative spondyloarthropathies
- Paget’s disease
- RA
5
Q
Scoliosis
(Cobb angle > 10) aka spinal asymmetry if < 10 degree
A
- Idiopathic: congenital, juvenile, adolescent
- Congenital: vertebral, neurological (Chiari malformation, syringomyelia, tethered cord)
- Others: developmental dysplasia, neuromuscular, tumour related, degenerative, post-traumatic, infection
6
Q
Erosion/destruction/absence pedicle
A
- Met
- MM
- Intraspinal tumour (eg: ependymoma, nerve sheath tumour)
- TB, other infection
- Radiotherapy
7
Q
Solitary dense pedicle
A
- Osteoblastic metastasis
- Osteoid osteoma
- Bone island
- Unilateral spondylolysis
- Congenitally absent/hypoplastic contralateral posterior elements
- Osteoblastoma
- Other sclerotic bone lesions eg: Paget’s disease, fibrous dysplasia, sarcoidosis, tuberous sclerosis
8
Q
Block vertebrae
A
- Klippel-Feil syndrome (C2/3, C5/6)
- Isolated congenital
- Juvenile idiopathic arthritis
- Ankylosing spondylitis
- Infectious spondylodiscitis
- Surgical fusion
- Post-traumatic
9
Q
Ivory vertebral body
A
- Met
- Paget’s disease
- Haemangioma
- Low grade infection eg: TB
- Lymphoma
- Sarcoidosis
- SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, osteitis)
10
Q
Intervertebral disc calcification
A
- Degenerative spondylosis
- Post-spinal fusion
- Ankylosing spondylitis
- DISH
- CPPD
- HADD
- Haemochromatosis
- Gout
- Hyperparathyroidism
- Amyloidosis
- Alkaptonuria/ochronosis
- Juvenile chronic arthritides
- Idiopathic
11
Q
Atlantoaxial subluxation
>3mm adult, >5mm child
A
- Osseous or ligamentous injury (eg: transverse ligament)
- RA
- Psoriatic arthropathy
- CPPD
- HADD
- SLE
- AS
- Juvenile idiopathic arthritis
- Infection eg: epidural phelgmon/abscess
- Congenital hypoplasia
- Griselda syndrome (laxity of transverse/alar ligament
12
Q
Bony outgrowth of spine
A
- Osteophytes
- Syndesmophytes (AS, CPPD, haemachromatosis, onchronosis)
- Non-marginal osteophytes / paravertebral ossification (psoariatic arthropathy, chronic reactive arthropathy, SAPHO)
- Undulating anterior or posterior ossification (DISH - anterior ossificatio, >3 contiguous vertebrae, dish height preserved; ossification of PLL)
13
Q
Posterior scalloping of vertebral bodies (SALMON) - Mnemonic
A
S: spinal cord tumour (astrocytoma, ependymoma, schwannoma)
A: achondroplasia, acromegaly
L: Loeys-Dietz syndrome (and other connective tissue disorder)
M: Marfan’s syndrome, mucopolysaccharidoses
O: Osteogenesis imperfecta
N: neurofibromatosis type 1
14
Q
Posterior scalloping of vertebral bodies
A
- Spinal cord tumour: ependymoma, dermoid, lipoma, nerve sheath tumour, meningioma
- Neurofibromatosis: due to mesodermal dysplasia and dural ectasia
- Syringomyelia
- Communication hydrocephalus (if severe and untreated)
- Acromegaly
- Achondroplasia
- Other congenital syndromes: Ehlers-Danilo’s/Marfan, osteogenesis imperfecta
15
Q
Anterior vertebral scalloping
A
- Aortic aneurysm
- Lymphadenopathy
- Delayed motor development eg: Down syndrome
16
Q
Widened interpedicular distance
A
- Myelomeningocele (Spina bifida cystica)
- Intraspinal mass
- Diastematomyelia
- Trauma
17
Q
Diffuse low marrow T1 signal
Normally should be greater signal than disc
A
- Red marrow conversion (chronic anaemia, increased oxygen demand, pt on GCSF)
- Diffuse malignant infiltration (met, myeloma, lymphoma, leukaemia)
- Haemosiderosis (due to haemolytic anaemia or recurrent blood transfusion; low signal also in liver/spleen supportive dx)
- Disorders causing diffuse bony sclerosis (myelofibrosis, mastocytosis, osteoporosis)
- Gaucher disease
18
Q
Intraspinal masses - extradural origin
A
- Disc herniation/sequestration
- Met, myeloma, lymphoma
- Synovial cyst (related to facet joint arthrosis located in posterolateral epidural space
- Extradural meninges cyst (perineural cyst along spinal nerve, extradural arachnoid cyst within posterior spinal cord, Tarlov cyst)
- Epidural phelgmon/abscess
- Epidural fibrosis (post-op)
- Neurofibroma: nodular or plexiform-enhancing mass related to nerve root +/- dumbbell configuration
- Schwannoma (more commonly intradural)
- Epidural haematoma
- Epidural lipomatosis (steroid, obesity)
- Discal cyst (young Asian men)
- Other facet joint related lesion (gout tophi, calcinosis)
- Extramedullary haematopoiesis (epidural or paravertebral)
- Angiolipoma
- Neuroblastoma and ganglioneuroma (childhood tumour arising from adrenal or paravertebral sympathetic chain)
- Hydatid cyst (usually epidural or intraosseous)
- Sarcoidosis
19
Q
Intraspinal mass- intradural, extramedullary mass
A
- Schwannoma
- Meningioma
- Neurofibroma
- Arachnoid cyst
- Leptomeningeal met (haematogenous or drop met)
- Other leptomeningeal processes eg: sarcoidosis, meningitis
- Dilated vessel (dural AVF, collateral)
- Lipoma
- Epidermoid cyst (congenital or acquired, lumbosacral region)
- Dermoid cyst (lumbosacral region, contains fat +/- calcification)
- Neurenteric cyst (thoracic/cervical region anterior to cord)
- Malignant peripheral nerve sheath tumour
- Melanocytoma (mimic melanoma met, rare benign tumour)
- Cysticercosis
20
Q
Intraspinal mass- intradural, extramedullary mass (mneumonic)
A
No More Spinal Masses
- Neurofibroma
- Meningioma
- Schwannoma
- Metastasis
21
Q
Intramedullary mass
A
- Ependymoma (cervical > thoracic)
- Astrocytoma (thoracic > cervical)
- Haemangioblastoma (posterior cord, eccentric, exophylic)
- Metastases (eg: lung, breast)
- Lymphoma (non-Hodgkin more common)
- Ganglioglioma (cervical > thoracic)
- Demyelination (MS, ADEM, neuromyelitis optica*, transverse myelitis**)
- Other myelopathies eg: vasculitis, radiation, vitamin B12 def, schistosomiasis
* >3 vertebral segments
* *>2 vertebral segments involving > 2/3 cross sectional area - Acute cord infarct
- Vascular malformation (eg: AVM, cavernoma ‘pop-corm appearance’)
- Spinal cord abscess
- Dermoid/epidermoid/neurenteric cyst
- Sarcoidosis
22
Q
Lesions related to cauda equina
A
- Any intramedullary mass
- Myxopapillary ependymoma
- Paraganglioma
- Film terminals lipoma
- Guillain-Barré syndrome
- Chronic inflammatory demyelination polyneuropathy (CIDP)
- Hereditary polyneuropathies (eg: Charcot-Marie-Tooth disease)
- Other radiculopathies (viral, chemo/radiation-induced)
