UNC MSK Course Day 4 Lab XR UNKNOWNS (for self study)

2. UNC MSK Course Day 4 Lab XR UNKNOWNS (for self study)

3. Anatomy?

4. Anatomy? Odontoid Pedicle Vertebral body Facet joint Lateral mass Spinous process

5. Name of view? What passes through this opening?

6. Name of view? Oblique view of cervical spine. What passes through this opening? Right C5 nerve root

7. Name of View? Anatomy?

8. Name of View? Open mouth view Anatomy? Lateral mass of C1 Odontoid C1-2 facet jt.

9. Anatomy?

10. Anatomy? Odontoid Lateral mass of C1

11. Anatomy?

12. Anatomy? Vertebral body Pedicle Lamina Spinous process

13. Pathology?

14. Pathology? Osteoarthritis C-Spine Healthy disc Note osteophytes and disc space narrowing

15. Name of view?

16. Name of view? “Swimmer’s view” One arm is up to allow xray penetration of the junction of the lower C-spine and upper T-spine Humerus

17. Pathology?

18. Normal canal has more room for cord Pathology? Osteoarthritis again. Vertebral body osteophytes are encroaching on the spinal canal

19. Pathology? Osteoarthritis again. Vertebral body osteophytes are encroaching on the spinal canal and on the foramen for the nerve root

20. Pathology?

21. Note wide space between odontoid and lateral mass Pathology? Fracture of C1 with extrusion of lateral masses laterally Note lateral mass of C1 overhanging lateral mass of C2

22. Note wide space between odontoid and lateral mass Coronal plane CT Fracture of C1 with extrusion of lateral masses laterally Note lateral mass of C1 overhanging lateral mass of C2

23. Pathology? Fracture of C1 with extrusion of lateral masses laterally Fracture of ring of C1 which allows the lateral masses to slide laterally (there are other fractures in the ring but only one is visible on this CT slice).

24. Pathology?

25. Pathology? C4-5 anterior subluxation Note: Wide gap in C4-5 posterior elements, break in smooth alignment of anterior and posterior surfaces of vertebral bodies

26. Pathology? C4-5 anterior subluxation Note: Wide gap in C4-5 posterior elements, break in smooth alignment of anterior and posterior surfaces of vertebral bodies C4-5 interspinous ligament must be torn to produce this large gap

27. Pathology? C4-5 anterior subluxation Note: Facet subluxation Normal facet alignment

28. Pathology?

29. Pathology? Osteoporosis Note preservation of cortical bone with loss of internal cancellous bone from vertebrae. C5 & C6 have spinous process fractures

30. Pathology? Osteoporosis Note preservation of cortical bone with loss of internal cancellous bone from vertebrae. C5 & C6 have spinous process fractures

31. Anatomy?

32. Anatomy? T-Spine Pedicles (end on) Spinous process

33. Anatomy?

34. Anatomy? T-Spine Pedicles Spinous process Vertebral body

35. Pathology?

36. Pathology? Scoliosis

37. Anatomy? Do you see the owl?

38. Anatomy? Do you see the owl?

39. Anatomy? Do you see the owl? Eyes = pedicles Beak = spinous process Ear tufts = transverse processes Cheeks = lamina

40. Anatomy? Do you see the owl? Eyes = pedicles Beak = spinous process Ear tufts = transverse processes Cheeks = lamina

41. Anatomy?

42. Anatomy? Vertebral body Pedicle Pars Intraarticularis Spinous process

43. Anatomy?

44. Anatomy? Vertebral body Pedicle Facet joint Transverse process Lamina Spinous process

45. Abnormality?

46. Abnormality? Lumbosacral transitional vertebra (on R it is like a sacral vertebra while on L it has a transverse process like a lumbar vertebra). The patient also has a fracture of the iliac wing.

47. Anatomy?

48. Aorta Anatomy? Vertebral body Psoas Nerve root Dural Sac Facet joint

49. Pathology?

50. Pathology? Herniated Nucleus Pulposus (HNP) impinging on nerve root