Differential Diagnosis- Exam 1- Cervical Spine Notes- Clicker Questions

Radiographic features of severe sprain

Winding of interpsinous spacing

Loss of parallelism between facets

Horizontal displacement greater than 3.5 mm

Angular displacement (hyper flexed) greater than 11 degrees compared with the adjacent interspaces

Bursting fx (Jefferson fracture)

What is the most significant Dx

Traumatic spondyloisthesis of C2 (or bilateral pedicle fracture of C2)

Aka hangman fracture of C2

22 yr old patient with neck pain following a motor vehicle accident yesterday. What is the diagnosis

Odontoid fracture

-type III odontoid fracture (disruption of the Harrison's ring)

62 yr old with neck pain after MVA. What is the most significant Dx?

Type II cause Harris ring is still intact

Disruption of Harris` ring?

X rays first then MRI`s

59 yr old with neck pain that occasionally radiates into both arms when he flexes his head, what does he need?

OPLL

-ossification of the posterior longitudinal ligament

Needs an MRI/CT

What is the most significant Dx

What does he need

C7

-big disc herniation of C6 so C7 nerve root

-tricep reflex might be affected

What nerve root is most likely affected

7 mm

RTI is 22mm

What is the normal maximum upper limit for the RPI measurement

What about the RTI

DDD

Intracallery ossicles from DDD

35 with neck pain after MVA? What is the most significant Dx

Also what are those orange things marked

Extension teardrop fracture

-if it was flexion then there would be interspinous widening

What is this

Extension teardrop fracture

What is this

Flexion teardrop fracture cause of the interspinous widening

-the worst injury to the neck. Almost always paralyzes

What is this

Calcination of the thyroid cartilage

What it this

Os odontoideum

No needs flexion/extension

What is this

What do they need now

Kipper-Feil

-multiple levels of fused cervical segments

-need to see if they have at least a test to see if they have 2 functional kidneys

What is this

Unilateral facet dislocation of C4

Block vertebra at C2-C3

DDD at C7 and less at C6

Diagnosis

AS (ankylosing spondylitis)

With ankyloses at C2-C7

Bamboo spine

Needs HLAB27 test

AS on the left

DISH on the right

-check the SI joints to really tell the different between the 2, AS loves the SI

Traumatic sondylolisthesis at C2 (bilateral pedicle fractrue at C2, hangman fracture of C2)

Compression fracture at C5

Post MVA neck pain, what is the most significant DX

Uncinate hypertrophy at C7

Lytic Mets

Most likely due to

Extension teardrop fracture at C3

Type II odontoid fracture (harris` ring still intact)

Clayshoveler`s fracture at C7

Bilateral cervical ribs

Aneurysmal bone cyst

Most likely form infection because both end plates effected

Sondylodiscitits