Imaging - Radiologic Evaluation of the Spine Part I: Normal Anatomy

post trauma

Pain

Pre-operatively

Suspected malignancy

Suspected anomaly or abnormality

Suspected instability

Why are C-Spine images ordered?

> 65

Dangerous mechanism

Paresthesia in extremities

What are the high risk factors when determining to take a C-spine radiograph?

Simple mechanism

Delayed onset of pain

Can sit upright

Ambulatory

Absence of midline C-spine tenderness

What are the low risk factors when determining to take a C-spine radiograph?

Yes

Do you take a radiograph of the C-spine if any high risk factors are present?

No

Do you take a radiograph of the C-spine if any low risk factors are present?

Yes

Do you take a radiography if a person can not rotate their C-spine?

No

Do you take a radiography if a person can rotate their C-spine?

Right and left Oblique

In what radiograph view do you see the intervertebral foramina of the cervical spine?

Lateral view with stress

What type of view is this?

Lateral view with stress

What type of view is this?

Oblique view

What type of view is this?

Oblique view

What type of view is this?

Lateral view

What type of view is this?

AP lower C-spine

What type of view is this?

A-P open mouth / odontoid view

What type of view is this?

5 lower cervical vertebrae

Upper thoracic vertebrae and associated ribs

Medial 1/3 of the clavicles

Trachea

What structures do you see in a AP lower C-spine radiograph?

C1-C7

intervertebral disc spaces

articular pillars and facet joints

spinous processes

What structures do you see in a lateral C-spine radiograph?

C1 and C2

What structures do you see in a AP Open-mouth (Odontoid) C-spine radiograph?

intervertebral foramina

facet joints

pedicles

What structures do you see in a R/L Oblique C-spine radiograph?

Axial plane

What type of CT view does 1 show?

Sagittal plane

What type of CT view does 2 show?

Coronal plane

What type of CT view does 3 show?

Alignment

Bone density

Canal space

Disc integrity

Soft tissue

How do you interpret a CT?

axial and sagittal

What are the typical planes an MRI of the spine is taken in?

clarify anatomy

What is a T1 weighted MRI used for?

abnormalities in fluid

What is a T2 weighted MRI used for?

Alignment

Bone signal

Canal space

Disc integrity

How do you interpret a MRI?

AP Thoracic Spine

Lateral Thoracic Spine

What are the standard T-spine projections?

Swimmer's lateral view

Posterior Oblique view

Thoracolumbar

Coned views

PA or AP ribs

What are radiologic evaluations of the T-spine and ribs that are not as common?

Intermediate

What is 1?

Low

What is 2?

Intermediate

What is 3?

Low

What is 4?

Intermediate

What is 5?

Intermediate

What is 6?

High

What is 7?

High

What is 8?

Low

What is 9?

Intermediate

What is 10?

Sagittal

What type of MRI view does this show?

Axial

What type of MRI view does this show?

AP thoracic spine

What type of view is this?

Lateral thoracic spine

What type of view is this?

AP

Lateral

R and L Oblique

Lateral L5-S1

Sacroiliac (AP or oblique)

What are the standard radiologic projections of the lumbar spine?

facet joints

What do you see in a oblique projection of the lumbar spine?

AP lumbar spine

What type of view is this?

Lateral lumbar spine

What type of view is this?

Oblique lumbar spine

What type of view is this?

Lateral L5-S1

What type of view is this?

AP axial/sacroiliac

What type of view is this?

Oblique Sacroiliac

What type of view is this?

lumbar vertebral bodies

SP and TP

Intervertebral disk spaces

What structures do you see in an AP L-spine radiograph?

lumbar vertebral bodies

intervertebral disk spaces

SP

intervertebral foramina

lumbosacral articulation

What structures do you see in an lateral L-spine radiograph?

facet joints

superior and inferior articular process

pars inticularis

pedicles

What structures do you see in an R/L posterior oblique lumbar spine radiograph?

close up or coned view of lumbosacral junction

What structures do you see in an lateral L5-S1 radiograph?

bilateral SI joints

What structures do you see in an AP axial sacroiliac radiograph?

Individual SI joint

What structures do you see in a R/L oblique sacroiliac radiograph?