Radiology II - Spine

Question 1

Spine Radiography indications

Answer 1

• Pain
• Trauma
• Arthritis
• Infection
• X-ray for low injury suspicion, CT for high suspicion

Question 2

Advantages of cervical spine x-ray

Answer 2

• Quick, cheap
• Low radiation
• Can see displaced fractures

Question 3

Disadvantages of cervical spine x-ray

Answer 3

• Many fractures can be occult. *CT is standard
• Cannot evaluate spinal cord, ligaments, discs, central canal
• Uses radiation
• Challenging in large, uncooperative, or patients w/ deformity
• Interpretation requires experience

Question 4

Hangman fracture

Answer 4

• “Hangee” fracture
• Extreme hyperextension
• Bilateral pars interarticularis fracture
• Usually due to MVC

Question 5

Jefferson fracture

Answer 5

• Burst fracture of C1 ring
• “Axial loading”
• Ex. Dive into shallow H2O headfirst

Question 6

Standard cervical spine views

Answer 6

• Lateral
• AP
• Odontoid (peg)

Question 7

Additonal cervical spine views

Answer 7

• Swimmers (lower cervical spine)

- Oblique (facets, uncovertebral joints, foramina)

Question 8

Odontoid fracture types

Answer 8

• TypeI (tip) – rare
• Type II (base) – unstable, most common
• Type III (below base) - stable if not displaced

Question 9

Standard thoracic spine views

Answer 9

• Lateral
• Swimmers
• AP

Question 10

Standard lumbar spine views

Answer 10

• Lateral
• AP
• +/- L5-S1 (lateral view centered on L5-S1)