RAD-MSK-LE Flashcards
(51 cards)
What’s the most common fracture in the thoracic spine?
Compression fractures from a significant mechanism
What percentage of thoracic spine fractures/dislocations involve a spinal cord injury?
60-70%– get an MRi. CT -FX
What’re the standard films for lumbar spine?
-standard: AP + lateral
-special: lumbosacral spot and oblique.
LS NOT Common ordered plain films
What’s the approach to reaching lumbar films?
ABC's: alignment, bones, cartilage and soft tissue AP-1. spinous process alignment 2. intrapedicular distance 3. traverse processes 4. vertebral body width
LATERAL 5. vertebral body height, width and cortex
- posterior vertebral line
7. disc spaces
- posterior vertebral line
BOTH-
- soft tissue
- freebies
What’s that cause of a wedge compression fracture?
hyperflexion from a fall, pathological, or osteoporosis
What is a wedge compression fracture?
- loss of height *anterior vertebral body only (anterior column)
- **posterior body height and post vertebral line intact
- greater loss of height = greater severity
- 25% 75yo
- CT to r/o burst fracture
What is a burst fracture?
Axial load like a jump or fall
- comminuted both anterior and middle columns -***posterior vertebral line disruption
- inter-pedicle space disruption
- **unstable=posterior column fx
- fx fragment *retropulsion into spinal cord -CT, MRI if neuro deficit
What is a chance fracture?
seatbelt fracture hyperflexion at the thoracolumbar junction
- Horizontal fx thru body, post arch, spinous process Ligamentous injury retropulsion of fragments
- unstable.
What is spondylolysis?
- bony defect of the pars interarticularis
- non-displaced fracture
- MC L4/L5 + L5-S1
- repetitive stress, congenital
- FX results in a collar around pars/neck of the scotty dog in an LATERAL oblique view
What is spondylolisthesis?
- anterior slippage of the vertebral column relative to the vertebral body below it
- usually a result of bilateral spondylolysis
- MC occurs at L3/4, L4/L5 or L5-S1
- results in spinal stenosis
What’s a true spondylolisthesis?
UNSTABLE Fracture of pars interarticularis *with displacement
w. Step off ABOVE slippage level
What’s a pseudo-spondylolisthesis?
*no pars interarticularis fx present
w/ STEP off BELOW slip level
What is DJD?
Degenerative joint disease aka spondylosis- cortical sclerosis(outer edges white irreg), disc space narrowing, spurs
What is seen with Ankylosing Spondylitis?
VB narrowed towards edges,
long oval, with bulge.
Fusing together
Bamboo spine
What’s the judet view, special view w/ AP?
It’s supine, hip at 45 deg.
viewing the acetabulum.
What’s the inlet view?
40d caudad to see the pelvic ring
What’s the outlet view?
40d cephal to see the sacroiliac. Ideal POST op
What’re the stable pelvis fractures?
-avulsion(ASIS),
-Ramus
-Duverney-iliac wing,
-sacral
Coccyx -2/3
ARDS
What’re the unstable pelvic fractures?
M-algaigne- 1 side SI dislocation FX 1 side
O-PEN BOOK–diastasis (separation) of the SI joint or pubic symphysis
Bucket handle-1 SI jt and ramus opp side
-pelvic ring dislocated in 2+ places
Straddle-B/L FX rami
Dislocation
What causes of hip fractures?
Trauma, osteoporosis, steroids. High risk bleeder to nearby vessels and nerves
If one hip hurts what should you order?
*AP to compare.
Toe touching- IR see Great troch.
Frog Leg- ER absent greater troch
What line is drawn from Less troch of hip to superior rami?
Shenton’s line- if shortent or neck w/in line, +Femoral neck FX
What are the types of Proximal Femur FX with AVN risk?
Capital-top of femur,
Subcapital-below capital,
Transcervical-neck*
Displaced femoral neck FX
Are hip dislocations usually posterior or anterior?
90% are posterior
