Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Bone & Joint > Thoracic & Lumbar Anomalies/Variants > Flashcards

Thoracic & Lumbar Anomalies/Variants Flashcards

(63 cards)

Start Studying
1
Q

What would be on your differential diagnosis of a hemivertebra?

A
  • Fracture
  • Malignancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Lateral hemivertebrae tend to cause what sort of curve?

A

High curve scoliosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Dorsal hemivertebrae tend to cause what sort of curve?

A

Angular kyphosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Ventral hemivertebrae tend to cause what sort of curve?

A

Angular lordosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which type of hemivertebra is the most common?

A

Lateral hemivertebra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How might the appearance of a vertebral disc be affected by a lateral hemivertebra?
How might the appearance of the vertebra be affected?

A
  • Y or V shaped disc
  • 1 vertebra with 3 pedicles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Butterfly vertebrae tend to cause what sort of curve?

A

Kyphoscoliosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a butterfly vertebra?

A

Presence of sagittal cleft within vertebral body due to incomplete fusion, giving it a butterfly appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the clinical significance of butterfly vertebrae?

A
  • Incidental finding
  • Can be seen with other defects e.g. lateral hemivertebra, third pedicle
  • Can be in the spectrum with Klippel Feil
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

During a pubescent growth spurt, vertebral endplates can be weak, leading to intravertebral nuclear herniation.
What would be the term for the acquired indentations in the endplates?

A

Schmorl nodes

DDx nuclear impressions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a Schmorl node?

A

Intravertebral nucelar disc herniation that indents into the endplate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most common presentation of Schmorl nodes?

A
  • Occuring during pubescent growth spurt
  • Asymptomatic
  • Incidental finding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In what case are Schmorl nodes more likely to cause pain?

A

When due to axial loading trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How can you make a distinction of Schmorl nodes on x-ray?

A

Cannot; must compare with previous imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do nuclear impressions compare with Schmorl nodes?

A

Nuclear impressions are deeper, not “stepped-off”, and parabolic

indentations of endplates are sloped

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Given that there are nuclear impressions seen on an AP lumbar radiograph, what sign is likely present?

A

Cupid’s bow sign

double hump appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Limbus bones are a variant of the ___.

A

Schmorl node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the term for when nuclear material separates a portion of the ring apophysis and heals non-union?

A

Limbus bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do limbus bones occur?

A

Nuclear material separates a portion of the ring apophysis and heals non-union

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Where do limbus bones most commonly occur?

A

Anterior to endplate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the clinical significance of anterior limbus bones?

A

No significance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the clinical significance of posterior limbus bones?

A

Associated with central canal stenosis

acquired loss of canal diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which type of limbus bone can only be seen by CT?

A

Lateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which type of limbus bone is most clinically significant?

A

Posterior

associated with central canal stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the DDx for a missing pedicle?
* Agenesis * Metastatic disease
26
There is a missing pedicle on one of your patient's lumbar vertebra. What about their radiograph would hint that this is congenital?
Stress hypertrophy of contralateral pedicle | heavily sclerotic and/or bigger ## Footnote can also be above/below
27
Your 60-year-old patient has a missing pedicle. With no further information, what is your differential diagnosis?
* Metastatic disease * Pedicle agenesis ## Footnote ESR elevated with mets
28
How can you get an absolute answer diagnosing a missing pedicle between agenesis and metastasis?
Bone scan or MRI
29
___% of the population has a L/S transitional vertebra.
4-30%
30
What are the four components of proper nomeclature for LSTV? | L/S transitional vertebrae
1. Lumbosacral transitional segment 2. Morphology: fused, unilateral, bilateral 3. Number lumbar-type vertebrae 4. Number transitional based on its motion and the lumbar vertebra number about: L5, L6, S1
31
If there is LSTV, there is concern for ___ and ___ above the transitional segment.
**DJD** and **IVD herniation** above
32
If LSTV comes with associated pain, it is diagnostic of ___.
Bertolotti syndrome
33
What is the best radiographic view for visualizing LSTV?
Ferguson ## Footnote AP angulated LS spot
34
# Castellvi classification What is the meaning of the letter classifications 'A' and 'B' when referring to LSTV?
A = asymmetric/unilateral B = bilateral
35
# LSTV What is the meaning of 'spatulation'?
Tall (19mm) transverse process
36
# Castellvi classification What is an LSTV 1A?
L/S transitional vertebra with **unilateral spatulation** | no articulation with sacrum
37
# Castellvi classification What is an LSTV 2A?
L/S transitional vertebra with **unilateral accessory joint** | between spatulated TP and sacral ala ## Footnote * most likely to cause Bertolotti syndrome (pain) * higher rate of disc herniation above
38
# Castellvi classification What is an LSTV 3A?
L/S transitional vertebra with **unilateral complete fusion** | between spatulated TP and sacral ala
39
# Castellvi classification What is an LSTV 4?
L/S transitional vertebra with **one complete fusion and one accessory joint**
40
# Castellvi classification What is an LSTV 1B?
L/S transitional vertebra with **bilateral spatulation**
41
# Castellvi classification What is an LSTV 2B?
L/S transitional vertebra with **bilateral accessory joints** | between spatulated TP and sacral ala
42
# Castellvi classification What is an LSTV 3B?
L/S transitional vertebra with **bilateral complete fusion** | between spatulated TP and sacral ala
43
# Castellvi classification Which classification of LSTV is both most common and most clinically significant? What is the clinical significance?
LSTV 2A: * most likely to cause Bertolotti syndrome (pain) * higher rate of disc herniation above
44
With LSTV 2A, what type of joint is found between the spatulated TP and sacral ala?
True synovial joint
45
How do discs typically present with LSTV 2A?
Hypoplastic
46
Someone with LSTV 2A may have pain from the accessory joint or contralateral facet. The pain can be so bad that it ___ sympathetic tone, thus ___ parasympathetic tone. This can lead to ___ peristalsis.
**increases** sympathetic tone **decreases** parasympathetic tone this can lead to **loss of** peristalsis
47
If someone with LSTV 2A has a herniation of the disc above, how might their spinal curvature change?
Loss of lordosis | relief with flexion
48
What is facet tropism?
Asymmetric facets: one more coronal, one more sagittal
49
How is facet tropism best visualized?
CT or MRI
50
What is the clinical significance of facet tropism?
Insignificant | not a pain generator
51
What is the term for the coupled defects SBO at S1 and L5 megaspinous?
Clasp knife syndrome
52
What is the soft tissue component of clasp knife syndrome?
Compression of thecal sac
53
In theory, those with clasp knife syndrome have poor tolerance of ___but you should treat them with whatever makes them feel relief.
lumbar extension
54
If a patient's lower sternum is depressed into their chest, they have ___.
pectus excavatum
55
What are three possible etiologies of pectus excavatum?
* Idiopathic (M/C) * Fetal alcohol syndrome * Connective tissue disorders
56
If a patient is found to have pectus excavatum, which disorders should be ruled out?
Connective tissue disorders: * Marfan syndrome * Ehlers Danlos
57
What are some clinical implications of pectus excavatum?
* Mostly incidental * Decreased rib excursion * Possible cardiopulmonary insufficiency * Possible aneurysm formation
58
What are the effects of pectus excavatum on the ribs?
Lack of bucket handle motion **dimishes vital capacity** ## Footnote comes with exercise intolerance
59
What sort of cardiopulmonary insufficiency is clinically implicated by pectus excavatum?
Compression of right atrium and ventricle | cardiac shift
60
Pectus excavatum has clinical implications that include possible aneurysm formation. This is particularly implicated with ___.
Marfan and EDS
61
What is the most common rib anomaly?
Lushka bifurcated rib
62
What is the appearance of a Lushka bifurcated rib?
Forked anterior aspect | has two articulations
63
Lushka bifurcated ribs are fixated, most likely with what type of pain?
Won't likely hurt

Bone & Joint (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions