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Diagnostic Imaging II > Part 2 > Flashcards

Part 2 Flashcards

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1
Q

if there is posterior trauma, where do we see the affected vertebra?

A

relatively anterior

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2
Q

if there is anterior trauma, where do we see the affected vertebra?

A

relatively posterior

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3
Q

describe a hangman’s fracture

A

bilateral pedicle fracture of C2
hyperextension mechanism
possible increased RPI
relative lack of neurological findings

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4
Q

other names for hangman’s fracture

A

traumatic spondylolisthesis of C2
bilateral pedicle fracture of C2
anterior displacement of C2

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5
Q

compression fracture is also known as

A

wedging compression fracture

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6
Q

describe compression fracture

A 
flexion mechanism
predominantly superior endplate
may have a small anterior fragment
stable
zone of impaction possible
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7
Q

what are some helpful ways to determine a new fracture from an old fracture on am MRI?

A 
cortical disruption
blurry or hazy endplates
fracture line
line of impaction
step defect
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8
Q

what is the saying to help determine a new fracture from an old fracture?

A

white is right, black is whack

T1

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9
Q

what are some ways to determine and old fracture from a new fracture?

A

old fracture: old films help, intact cortex

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10
Q

burst fracture

A

vertebral body “explodes” into several fragments
fragments are driven centrifugally
axial compression forces predominate
possible cord compression/CT exam
unstable
may see vertical split of the body on AP film
lateral shows comminuted body flattneed centrally
neurological infovlement is variable

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11
Q

unilateral facet dislocation

A

flexion, rotation mechanism
inferior articular process dislocates into IVF
anterior body displacement
mechanically stable

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12
Q

what sign is associated with a unilateral facet dislocation?

A

bow tie sign

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13
Q

what are the radiographic features of a unilateral facet dislocation

A

abrupt dereased laminar length

spinous rotation to the side of dislocation

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14
Q

what xrays should be taken if you suspect a unilateral facet dislocation?

A

cervical obliques

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15
Q

bilateral facet dislocation

A

hyperflexion mechanism of C4-7 MC
severe soft tissue injury
unstable, high incidence of cord injuries
anterior dislacement typically

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16
Q

ppathological fracture

A 
decreased height of the entire body
implies pathology
MC osteoporosis
also lytic mets, multiple myeloma
proper workup needed
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17
Q

burst fractures in thoracics of lumbars

A 
widened intrapedicular distance
CT exam needed
vertebral body "explodes
axial compression mechanism
may have post. body convexity
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18
Q

widened intrapedicular disttance means there is?

A

neural arch fx or posterior wall fracture

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19
Q

chance fracture

A

horizontal splitting of neural arch and vertebral body
flexion distraction mechanism
seatbelt acts as a fulcrum
MC L1-3

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20
Q

what signs do we see with chance fractures?

A

empty vertebra sign

ghost vertebra sign

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21
Q

findings we can see with chance fracture

A

decreased anterior body height
step defect
zone of impaction
horizontal radiolucent line in neural arch

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22
Q

TVP fracture

A 
2nd most common lumbar fx
direct trauma or avulsion
MC L2 or 3
vertical to oblique in orientation
often unilateral and often milti level
may or may not be displaced
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23
Q

what can TVP fractures be obscured by?

A

gas and fecal material

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24
Q

what else do you need to do with TVP fractures?

A

uninalysis for potential hematuria b/c the kidney could be damaged

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25
sponlylolysis
interruption of the parts
26
spondylolisthesis
anterior displacement
27
osteoporotic compression fractures general features
``` more common after 50 females MC mid thoracolumbar spine dowager's hump resorption of horizontal trabeulae accentuated vertical striations ```
28
osteoporotic compression fractures xray features
decreased anterior body height multiple ones are often contiguous discontiguous raises concerns potential pathology, special imaging
29
most thoracic and lumbar fractures are MC where?
T11-L2
30
contiguous fractures are uncommon or common?
common
31
what kind of thoracic and lumbar fractures are most common?
compression fracture
32
thoracolumbar compression fractures
osteoporotic fx may have no trauma | upper thoracic compression may result from seizures or electrical shock
33
what are some xray features of thoracolumbar compression fractures
anterior wedging depression of superior endplate posterior body height usually maintained may see step defect and zone of impaction
34
what is whiplash?
soft tissue injury (flexion component) disruption of posterior ligament complex abrupt kyphotic spine pain, tenderness, muscle spasm
35
what are the xray features of whiplash?
widened interspinous spaces (fanning) subluxated widened facets (loss of parallelism) flexion and extension views to stress ligaments flexion malposition high riding facets (NOT perched)
36
uncinate fractures
rare stable lateral flexion
37
lateral flexion
unilateral fx of the lateral mass of C1 TVP fx uncinate fx
38
pillar fractures
``` not common fx commonly missed seen on AP and lateral MC C4-7 extension-compression mechanism ```
39
laminar fractures
``` uncomon hyperextension lower cervicals may been CT mechanically stable ```
40
spinous fractures
mid cervical, thoracic (NOT T1) or lumbar
41
clay shoveler's fx is what kind of mechanism?
flexion
42
clay shoveler's fx
fracture at the base of the spinous of C6-T1 only avulsion fracture stable
43
what are the xray signs of clay shoveler's fx?
fracture at base of spinous double spinous sign on AP may or may not be displaced inferior jagged, irregular radiolucency (new)
44
extension teardrop fx
extension mechanism triangular fragment of anterior-inferior body usualy C2 unstable buckling of ligamentum flavum (cord trauma)
45
flexion teardrop fx
``` most severe injury of cervical spine triangular fragment at the anterior inferior body unstable, acute "anterior cord syndrome" flexion mechanism facets "subluxated or dislocated" typically spine considerably flexed ```
46
bilateral facet dislocation
hyperflexion mechanism (C4-7) severe soft tissue injury unstable, high incidence of cord injuries anterior displacement
47
perched facets
incomplete bilateral facet dislocation
48
interlocking facets
complete bilateral facet dislocation
49
unilateral facet dislocation
``` pillars not superimposed (bowtie sign) abrupt decreased laminar length spinous rotation to the side of dislocation cervical obliques should be done flexion rotation mechanism inferior articular process dislocates into IVF anterior body displacement stable ```
50
burst fracture
``` vertebral body "explodes" into several fragments fragments are driven centrifugally axial compression forces predominate pssible cord compression unstable may see vertical split of the body on AP lateral shows comminuted body flattened centrally neurological involvement is variable ```
51
describe ischiopubic rami fractures
stable most common fracture of the pelvis stress fx may occur
52
what part is most commonly fractured in ischiopubic rami fractures?
inferior rami, but superior rami can take part as well
53
who are more likley to get avulsion fractures of the pelvis?
athletic adolescents | sprinters, long jumpers, hurdlers, gymnasts
54
what leads to an avulsion fracture?
muscular traction
55
what kind of avulsions are avulsion fractures of the pelvis?
apophyseal avulsion
56
what muscle cause an avulsion fracture of the ASIS?
sartorius
57
what muscle causes an avulsion fracture of the AIIS?
rectus femoris
58
what muscle causes an avulsion fracture of the ischial tuberosity?
hamstring
59
where do you most commonly get avulsion fx of the pelvis?
ischial tuberosity
60
what are some radiographic signs and treatments for avulsion fractures of the pelvis?
curvilinear calcific densities from conservative to surgical fixation could unite, or not may have enlgargement with healing
61
malgaingne fracture
ipsilateral double vertical shearing fx of superior and inferior pubic rami with fx or dislocation about ipsilateral SI joint
62
what is the most common unstable pelvic fx?
malgaingne fx
63
bucket-handle fracture
contralateral double vertical fx superior and inferior pubic rami fx fx or dislocation about contralateral SI unstable
64
straddle fracture
bilateral superior and inferior rami fx substantial soft tissue injury unstable
65
sprung pelvis
"open book" fx diastasis of pubic symphysis diastasis of one or both SI joints unstable
66
complex pelvic fractures
``` unstable severe injury comminution of the pelvis difficult to classify complex multiple fx ```
67
if an adult has an avulsion fracture of the lesser trochanter, what does this mean?
it's probably lytic mets

Diagnostic Imaging II (19 decks)

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