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Skel Rad 2


Line from posterior margin of hard palate to inferior surface of occiput McGregor's Line
Xray view of McGregor's Line LCN
Values of McGregor's Line Odontoid should not be above line by more than 8mm in males and 10mm in females
Use McGregor's line is most reliable for what indication Basilar Impression
Line from posterior margin of the hard palate to posterior aspect of foramen magnum Chamberlain's Line
Xray view of Chamberlain's Line LCN
Values of Chamberlain's Line Odontoid process should not be above line by more than 3mm. 7mm is most likely abnormal
Use Chamberlain's Line is most reliable for what indication Basilar Impression
Which line is used more for basilar impression McGregor's Line
Distance between the posterior margin of the anterior arch of C1 to the anterior cortex of the dens ADI space
Values of the ADI space 3mm in adults and 5mm in kids with no difference between flexion and extension
Increased ADI space indicates what? Rupture or laxity of transverse ligament
Lines along posterior aspect of vertebral bodies and connecting superior and inferior body corners George's Line
Indications of George's Line Anterolisthesis and Retrolisthesis!
Divide superior surface of S1 into four quadrants Myerding's Grading Scale
Value of Myerding's Grading scale Posterior corner of L5 should align with posterior corner of S1
Indications of Myerding's Grading scale Spondylolisthesis graded 1-5 of L5
Grade 5 spondylolisthesis is called what spondyloptysis(completely fallen off)
First line drawn parallel and through sacral base with 2nd line perpendicular to first at anterior margin of the sacral base? Ullmann's line
Normal range of Ullmann's Line L5 should lie posterior or just contact this line
Ullmann's Line is used to indicate what? Look for subtle spondylolisthesis
Advanced imaging that determines areas of metabolic activity and is very sensitive but not very specific Bone Scintigraphy(Bone Scan)
Bone Scan confirms the presence of what? Acute Fx, Stress Fx, Metastasis, Infection, Paget's Disease, Child Abuse
Tracer used for a bone scan Tc 99
What are patients injected with in a PET scan? Glucose
PET scans are very sensitive to detecting what cancer, coronary heart disease, brain disorders such as Parkinson's, Alzheimer's, Seizures
Advanced imaging that adds anatomical information to physiologic information PET scan
Advanced imaging that uses ionizing radiation to obtain cross-sectional images while patient lies within a gantry(tube) with the x-ray traveling around them CT scan
CT Scan's shows the cortex of bone to be what color white
CT Scan is good in identifying what Fine bony detail, liver, GI-GU Tracts, Acute head trauma
Advanced imaging that is most widely used method to measure bone mineral density DEXA scan
Comparison of bone from the patient to a young adult of the same gender, with peak bone density. T Score
T score levels -1 is normal -1 to -2.5 is osteopenia >-2.5 is osteoporosis
Comparison of bone between patient and other people within the same gender, not used to diagnose Z Score
Advanced imaging that measures the unpaired protons/neutrons spin of angular momentum, which element is used and why? MRI; H+ because they are highly magnetic and abundant
Explain how and MRI works First external magnet causes protons to line up on the horizontal plane, second external magnet flips the protons into the transverse plane, protons than give up their energy as a RF signal
Times between RF Pulses Repetition Time(TR)
Times between RF Pulse and Measurement of Energy Released Echo Time(TE)
T1 weighted images <1000 TR and <20 TE
T2 weighted images >1000 TR and >100 TE
On films what refers to the amount of blackness Density
On films what refers to the shades of grey Contrast
Underexposed films are what? White
Overexposed films are what? Black
Low contrast films are what? Have more shades of grey
Flattening of the skull base, how is it diagnosed? Platybasia; MRI
Associated anomalies of Platybasia basilar impressioin, occipitalization, block vertebrae, Klippel-Feil
Causes of Platybasia skeletal dysplasia or bone softening disorder
Superior position of upper cervical vertebrae with relation to the skull Basilar Impression; Congenital
Causes of Basilar Impression congenital and bone softening
When Basilar Impression is congenital what's its associated with? occipitalization of atlas, spina bifida occulta of atlas, odontoid abnormalaties, cervical block
Symptoms and when does somebody notice basilar impression? 3-4 decades; occiptal headaches, visual disturbances, dysphagia, facial pain, unsteady gait
Basilar impression is diagnosed how? Abnormal McGregor's Line and Chamberlain's Line as well as an MRI
What's diagnosed by MRI or CT and the findings are low-lying cerebellar tonsils, trianguler shaped cerebellar tonsils, and kinking of the 4th ventricle? Arnold-Chiari Malformation Type 1
Congenital synostosis(fusion) of the atlas to the occiput secondary to failure of separation of the most inferior occipital sclerotome Occipitalization of the Atlas
Most common anomaly of the craniovertebral junction Occipitalization of the Atlas
Presentation of Occipitalization of the Atlas low hairline, short neck, restricted ROM; neck pain, dysfunction at 30-40 yrs
Occipitalization is most common to what gender Males 5:1
Most inferior somite of the occipital bone fails to unite and remains as an ossicle Occipital Vertebrae
Occipital Vertebrae may form what? 3rd condyle, paramastoid, epitransverse process, occipital ossicles
Midline bony projection bridging the anterior aspect of the foramen magnum with the apex of the odontoid process or anterior arch of the atlas. 3rd Condyle
Originates at the jugular process of the occiput and articulates with the TP of C1 and projects downward on an X-Ray Paramastoid Process
Originates slightly medial and anterior to the paramastoid process and articulates with the TP of C1 and projects downward on an X-Ray Paracondylar Process
Originates from the TP of C1 projecting superiorly articulating with the occiput and projects upward on an X-Ray Epitransverse Process
Which occipital vertebrae is generally asymptomatic but may produce muscle spasms and neck pain Epitransverse process
Small bony ossicles occurring in the atlanto-occiptal space Occipital Ossicles
Cleft in the posterior arch of C1, to unilateral agenesis, to complete agenesis. Dense CT is present at the site of bone agenesis Agenesis of Posterior Arch of Atlas
Union of the posterior arch is typically visible by age ____ Age 6
Posterior arch may join SP of C2 Mega spinous sign
Hypoplasia of the posterior arch may present as a thin arch or a short arch Central Stenosis
Failure of mid line ossification of the neural arch, gap is filled with fibrous tissue Posterior/Anterior Spina Bifida Occulta of the Atlas AKA Posterior/Anterior Spondyloschisis
When anterior SB Occulta of the atlas is associated with posterior SB Occulta there may be an offset of what? Lateral Masses of C1 on C2
Ossification of the oblique portion of the atlanto-occipital membrane Posterior Ponticle of the Atlas
Posterior Ponticle of the Atlas may be associated with what? VBI, Barre-Lieou Syndrome, Chronic upper Cervical Syndrome
Failure of the apical ossification center of the dens to unite with the body of the dens, should unite by what age? Ossiculum Terminale Persistens of Bergmann; 12-13 years of age
Non-union of the odontoid process with C2 body Os Odontoideum
Odontoid is considered hypoplastic when its height is less than what? 12mm
Hypoplasia of the Odontoid Process is associated with what? Downs Syndrome, occipitalization, Klippel Feil, skeletal dysplasia and atlanto-axial instability
Fusion of 2 or more vertebrae from failure of somite segmentation in the 3-8 weeks of development Block Vertebrae
Block Vertebrae is most often seen at where? C5/C6, C2/C3, T12/L1, L4/L5
Failure of the scapula to descend during fetal development and more common in m/f bilaterally/unilaterally Sprengels Deformity; females;unilaterally
Sprengels is associated with omovertebral bone
Cartilaginous/fibrous band running from C5/C6 SP to the posterior angle of the scapula Omovertebral Bone
Omovertebral Bone is associated with Sprengles, Raised Scapula, Scoliosis, Hemivertebrae, block vertebrae, cervical rib, SB Occulta
From a cleft in the posterior arch @ C6 and may be mistaken for fracture when found on X-Ray post trauma, asymptomatic Cervical Spondylolisthesis
Cervical Spondylolisthesis is associated with what? SB Occulta
Flat/Squished appearing vertebrae Platyspondyly
2 nerve roots exit from one large foramen, more common inc ____ spine then ____ spine then ____ spine but most common at ____ Absent Pedicle; Cervical; Lumbar; Thoracic; C6
Elongated Anterior Tubercles with Accessory Joint is most common where? C5/C6
What causes dysphagia, feeling of fullness in throat, facial pain and what is this called? Stylohyoid ligament ossification; Eagles Syndrome
Stylohyoid Ligament Ossification may put pressure on what and best seen on what x-ray views? external carotid artery; lateral/oblique views
When less than 80% of the discovertebral junction between two levels is fused in a block vertebra of the thoracic and lumbar spine Unsegmented bar
Anterior unsegmentation + unsegmented bars in a block vertebra of the thoracic and lumbar spine kyphotic deformity
Increase in the interpedicular distance Diastematomyelia(Split Spinal Cord)
Sagittal Cleft in a vertebral body Butterfly Vertebra
Butterfly Vertebra is most common where and may produce what? thoracolumbar jxn; kyphoscoliosis
Failure of ossification of half of a vertebra, triangular shaped and may be located ventrally, dorsally, laterally. Hemivertebra
Adjacent endplates are altered to conform the hemivertebra Incarcerated Hemi
Adjacent endplates are straight resulting in scoliosis Non-Incarcerated Hemi
Fusion of hemivertebra + adjacent segment, no separation Non-Segmented Hemi
Herniation of disc material into vertebral body, most likely during adolescence on immature endplates Schmorls Node
Cause of Schmorls Nodes Weaked cartilaginous endplates and subchondral bone
Schmorls Nodes are more common in ____ @ ____ males; thoracolumbar jxn
Multiple levels of Schmorls Nodes in the mid thoracic spine and lumbar spine Scheuerman's Disease; Juvenile Discogenic Disease
Disc material herniates through the growth center of the ring apophysis, isolating the apophysis from the vertebral body Limbus Bones
Created by: 1277880004