Radiology Final: Thoracic Spine and some Lumbar

T1-12 bodies
Costovertebral joints
Costotransverse joints
SP’s
Pedicles
TP’s
Posterior Ribs
Tracheal Air Shadow
Medial Clavicles

Vertebral Bodies
Disc Spaces
IVF’s
Scapula
Ribs
Diaphragm
Lung Hila

25 to 40 degrees

the Lippman-Cobb (angle made by the end-vertebrae of the curve to measure concavity) and Risser-Ferguson (angle from middle of vertebral body to middle of curved vertebral body to measure convexity) techniques

The Lippman-Cobb technique

The relation of the pedicles to midline:
+ rotation = pedicle towards midline
++ rotation = pedicle 2/3 towards midline
+++ rotation = pedicle in midline
++++ rotation = pedicle beyond midline

The omovertebral bone is present in 35% of cases of Sprengel deformity.

It runs from the superomedial border of the scapula to the spinous processes, transverse processes or laminae of C4 to C7. The connection from the scapula to the vertebrae may be fibrous or osseous.

Where a vertebra does not form completely and causes the radiographic looks of a scoliotic curve. The vertebra looks like a triangular block located between a vertebra on the top and bottom that seem carved out. The types include: Lateral, butterfly, dorsal, double (different segments).

It is the space where the basivertebral veins will pierce the vertebral bodies.

Sunken chest

Pigeon breast. Pectosternal clear space is shown.

Adjacent ribs fuse.

Partial fusion of 1st and 2nd rib.

Rib is forked at sternal end.

DJD vertebral centrum.

Inflammation of vertebra.

Forward slipping of vertebra.

Pars interarticularis fracture. Scotty Dog sign.

Backward slipping of vertebra.

Spinal column disorder

DJD of posterior facet joints

DJD

L1-L5 Vertebral Bodies
Pedicles
SP’s
Lamina
TP’s
Disk Spaces
Sacral Base
Psoas Shadow

T12-S1 Vertebral Bodies
T12-L5 Disc Spaces
IVF’s
SP’s
Facet Joints
Pedicles
Abdominal Aorta (when atherosclerosis is present)

Opposite side dogs and marker behind spine.

Same side dogs and marker in front of spine.

“snout” = transverse process
“eye” = pedicle
“ear” = sup. articular process
“neck” = pars interarticularis
“body” = lamina
“front leg” = inf. articular process
“back leg” = spinous process

L5-S1 Disc Space
sacroiliac Joints
Sacrum
Sacral Foramen
L5 TP’s and SP’s
L5 Vertebral Body

36 to 42 degrees

L3 to sacral promontory (base). Should go through anterior third of the sacral base.

Shows line down posterior vertebral bodies to see misalignment such as Spondylolisthesis (antero/retro).

45 to 65 degrees

S curve = facet sublaxation.

Also known as Lumbosacral disc angle. Intersect is normally behind the intervertebral foramen. If intersect is before or inside forament, it indicates Imbrication, “facet jamming.”

Old method to determine Spondylolisthesis. Vertical line drawn off the sacral base line (sacral promontory). If there is no forward slip, the 5th lumbar vertebrae should not slide across Ulman’s line.

Using this is more accurate than Ulman’s line and is what is used today. From the front of the sacrum to the back, you make 4 quadrants. Draw a line the back of L5, wherever it intersects, is the grade.

Grade 1 – 1 to 25% (most common)
Grade 2 – 25 to 50%
Grade 3 – 50 to 75%
Grade 4 – 75 to 100%
Grade 5 – 100% total dislocation

also called the LS angle Range 36-42 degrees

◾Center of L3
◾Plumb line
◾Should intersect anterior sacral margin +/- 10mm

Turkish Saddle”, a bony structure at the base of the brain that surrounds and protects the pituitary gland

(or the Posterior Body Line) is a curved line that should touch the posterior body margin of all the segments of the spine in any of the 3 main curvatures

posterior margin of spinal canal

line is drawn from the nasion to the center of the sella turcica. aline is drawn from the basion (ant. foramen magnum) to the center of the sella turcica. 123-152 degrees with the average of 137 degrees

line from posterior hard palate to posterior lip of foramen magnum
if dens > 3mm above line ==> basilar invagination.

Lines are drawn on the posterior body margins of C2 ad C7 and the angle at which they cross.