W5- L-Spine Reviewing Radiologic Images

Question 1

What are some common views of the L-Spine? (5)

Answer 1

• AP
• Lateral
• R/L Oblique Views
• Coned lateral views L5-S1
• Lateral view standing flexion/extension

Question 2

What are some common views of the SIJ? (3)

Answer 2

• AP axial
• R/L Oblique Views

-Lateral view: coccyx

Question 3

With an AP projection of the L-Spine, the central ray is aimed between L_-L_.

Answer 3

L3-L4

Question 4

What are some things we can see in an AP view of the L-Spine? (9)

Answer 4

• pedicles
• SP (alignment and distance between pedicles)
• interpedicular distance compared to normative values
• box-like vertebral bodies
• disc-space preservation
• distance from SP to SP
• shadow from Psoas Muscle
• TP
• partial view of SI

Question 5

What are some things we can see in a lateral view of the L-Spine? (5)

Answer 5

• 3 parallel lines (anterior body, posterior body, spinolaminar line)
• lateral neuroforamen
• disc space
• superimposed pedicles
• shape of body

Question 6

Dropping a line down the center of ___ should fall within the anterior 1/3rd of sacrum. Too far forward could mean what?

Answer 6

-L3, could mean excessive lordosis

Question 7

Which view of the L-Spine is most able to see Scotty Dog?

Answer 7

R/L Posterior Oblique Projections

Question 8

What are some things we can see in R/L Posterior Oblique views of the L-Spine?

Answer 8

• articulating processes
• z-joints
• pars interarticularis
• Scotty Dog

Question 9

With a L Posterior Oblique image, what z-joint is seen?

Answer 9

• L Posterior Oblique = L Z-joint
• R Posterior Oblique = R Z-joint

**C-spine reverse

Question 10

Scotty Dog:

• Nose = _________
• Ear = ________
• Front Leg = __________
• Tail = _________
• Lower Leg = _________
• Eye = ________
• Body = _________
• Neck = _________

Answer 10

• Nose = TP
• Ear = Superior Articular Process on same side
• Front Leg = Inferior Articular Process on same side
• Tail = Superior Articular Process on other side
• Lower Leg = Inferior Articular Process on other side
• Eye = Pedicle
• Body = Lamina
• Neck = Pars Interarticularis

Question 11

What is a scotty dog collar indicative of?

Answer 11

Spondylolysis or spondylolisthesis

Question 12

What are the (3) parallel lines we want to see in the lateral view of the L-Spine?

Answer 12

• Anterior body
• Posterior body
• Spinolaminar line

Question 13

What are the (2) lumbosacral angles? Explain each.

Answer 13

Barge’s Angle

• Line parallel to sacral base.
• Second line at anterior of sacrum going straight up.
• Angle ~53 degrees is normal.

Ferguson’s Angle

• Line parallel to sacral base.
• Second line at anterior of sacrum, going horizontally.

Question 14

Spondylolisthesis Grading. (5)

Answer 14

• G1 = 0-25%
• G2 = 25-50%
• G3 = 50-75%
• G4 = 75-100%
• G5 = >100%

Question 15

What are some things we can see in an AP axial view of the SIJ? (5)

Answer 15

• articular surfaces superimposed
• smooth osseous margins
• symmetry SIJs
• L5/S1
• coccyx