Jai’s Di Imaging 2 - Exam 1 flip cards

What is the diagnosis?

Grade 1 degenerative spondylolisthesis of L4

What is the finding, Dx, and follow up?

Pars fx without anterior displacement

Dx: Spondylolysis

Take obliques

What is the most likely etiology of a pathological fx in a 68 year old patient?

Osteoporosis

(lytic mets and multiple myeloma)

What is the diagnosis?

Bursting fx of L1

What is the diagnosis?

Open book fx

What is the diagnosis?

Left ASIS avulsion fx

Patient has low back pain, what is the diagnosis?

Old right ischial tuberosity avulsion fracture

What is the diagnosis?

Grade 1 degenerative spondylolisthesis of L4

What is the finding and what is the diagnosis?

Finding: One eyed pedicle sign at L2 on the right with contralateral hypertrophy

Dx: Agenesis of the pedicle at L2 on the right

What is the diagnosis in this pediatric patient with pain?

Pathological fx → MC due to Eosinophilic granuloma (EG)

Is this fracture old or new?

New

What is the diagnosis?

Superior and inferior pubic rami fxs

What does the increased interpeduncular distance indicate?

Neural arch fx and/or posterior body fx

What is the Dx?

Spondylolytic spondylolisthesis of L3

What type of study is this?

CT

Bilateral lateral mass offset of C1 relative to the superior facets of C2 would indicate a/an _____

Jefferson’s fx of C1

What is the most common fx of C1?

Posterior arch fx

What are the upper limits of the size of the RPI and RTI?

RPI: 7mm

RTI: 22mm

What does an increase in the retrotracheal interspace indicate?

Space occupying lesion (blood, pus, tumor, or edema)

Is an increase in the ADI considered stable or unstable and why?

Unstable → gross ligamentous damage with or without neurological compromise

What is the most common fx of the thoracic and lumbar spine?

Compression fxs

According to the 3 column method of determining spinal stability, is a burst fx stable or unstable

Unstable

What is the mechanism of injury for a Chance fx?

Flexion distraction

According to the 3 column method of determining spinal stability, is a compression fx stable or unstable?

Stable

What is the DDx for a dense pedicle/pars/lamina redion?

Primary bone tumor, secondary tumor, sclerosis due to agenesis on contralateral side, sclerosis from a contralateral pars defect, or an ongoing stress fracture on the dense side

Anterior displacement that is due to facet arthrosis is called a/an _____

Degenerative spondylolisthesis

What roentgenometric is used to grade a spondylolisthesis?

Myerding’s method

What muscles are involved with the following pelvic avulsion fxs?

ASIS: ______

AIIS: ______

Ischial tuberosity: ______

ASIS → Sartorius

AIIS → Rectus femoris

Ischial tuberosity → Hamstring

Pars defect with anterior displacement is called a/an _____

Spondylolytic spondylolisthesis

What is a Malgaigne fx?

Ipsilateral double vertical shearing fx of the superior and inferior pubic rami with fx or dislocation about the ipsilateral SI joint

What is a straddle fx of the pelvis?

Bilateral superior and inferior pubic rami fxs

What is type 1 Neuman/Wiltse classification?

Congenital

What is type 2 Neuman/Wiltse classification?

Spondylolytic

What is Type 3 Neuman/Wiltse classification?

Degenerative

What is Type 4 Neuman/Wiltse classification?

Traumatic

What is Type 5 Neuman/Wiltse classification?

Pathological

What is Type 6 Neuman/Wiltse classification?

Iatragenic

Which type of spondylolisthesis is most common at L4?

Degenerative

Which type of spondylolisthesis is most common at L5?

Spondylolytic

What is the etiology of a degenerative spondylo of L4?

Facet arthrosis

What does a post traumatic posterior vertebral body convexity suggest?

Burst fx

What does a post-traumatic increase in the interpedicular distance indicate?

Neural arch and/or back of body fx

What is the etiology of a isthmic spondylo of L5?

Stress fx of the pars from hyperextension activities

What is the mechanism of injury for a compression fx?

Flexion

What is the mechanism of injury for a Jefferson fx of C1?

Axial compression

Does an epidural hematoma typically have arterial or venous involement?

Arterial

Does a subdural hematoma typically have arterial or venous involvement?

Venous

What is a bucket-handle fx of the pelvis?

Contralateral double vertical fx of the superior and inferior pubic rami with fx or dislocation about the contralateral SI joint

What are the red arrows pointing at? What is the green arrow pointing at?

Red = Left paraspinal line

Green = Aortic knob

What is the Dx, is it stable or unstable, and is it new or old?

Compression fx

Stable

New

What is the diagnosis?

Avulsion fx of the ASIS on the left d/t sartorius muscle

What is the diagnosis?

Avulsion fx of the ischial tuberosity d/t hamstring

What does the convex appearance of the back of the vertebral body indicate?

What does the increased interpedicular distance indicate?

Burst fx

Posterior body and/or neural arch is fx

What is the diagnosis?

Degenerative spondylo of L4

What is the sign/finding and what is the diagnosis?

Inverted Napoleon hat sign

Isthmic spondylo of L5

What is the doagnosis?

TVP fx of L3 and L4

What is the diagnosis?

Spondylolytic spondylo of L5

What is the diagnosis?

Burst fx of L1

What is the Dx or DDx?

Pathological fx → osteoporosis, lytic mets, or multiple myeloma

What is the diagnosis?

Spinous process fx of C7

Is this fracture old or new and why?

Old → bone marrow signal intensity is bright on a T1 MRI

What is the diagnosis and what is the mechanism of injury?

Posterior arch fx of C1 → extension

What is the finding and what is the diagnosis?

Bilateral lateral mass offset relative to superior facets of C2

Jefferson’s fx of C1

Is this fx old or new and why?

New

T1 has low signal intensity and T2 has a high signal intensity

What is the diagnosis?

Burst fx

What is the diagnosis?

Spinous fx of C6

What is the sign/finding and what is the likely diagnosis?

Double spinous sign at C6

Spinous process fx of C6

What is the diagnosis?

Epidural hematoma

What is the diagnosis?

Chance fx

What is the diagnosis?

Burst fx

What is the diagnosis?

Compression fx of C6

What is the diagnosis?

Pathological spondylo

Sandwich vertebra appearance → osteopetrosis

What is the finding and diagnosis?

Increased ADI

Atlantoaxial instability

What is the diagnosis?

Type 2 odontoid fx

Neck pain following a MVA. What is the diagnosis?

Partial/focal agenesis of the posterior arch of C1

MVA, what is the diagnosis?

Hangman’s fx of C2

What is the diagnosis?

Type 3 dens fx

What is the diagnosis?

Flexion teardrop fx at C4

What is the diagnosis?

Bilateral facet dislocation at C5 (interlocking)

What is the finding/sign and what is the diagnosis?

Bow tie sign at C4

Unilateral facet dislocation at C4

What is the likely diagnosis?

Extension teardrop fx at C2

What is the diagnosis?

Malgaigne fx (ipsilateral double vertical shearing fx)

T/F: A congenital spondylo is rare

True

What is the diagnosis?

Grade 1 isthmic spondylo of L5

What is the diagnosis?

Extension tear drop fx of C2

Is this fx old or new and why is it old or new?

Old

Bone marrow signal intensity is bright on T1 MRI

What is the diagnosis?

Spinous process fx at C7

What is the diagnosis?

Saddle fx

Bilateral superior and inferior pubic rami fx