Tracheal Air Shadow
What is seen in an AP view of the Thoracic spine?
What is seen in a Lateral view of the Thoracic spine?
25 to 40 degrees
What is the average range for normal kyphosis in females and males over 10?
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
When evaluating patients with a structural scoliosis, what are the two widely accepted methods of measuring the curve?
The Lippman-Cobb technique
Which method of measuring scoliotic curves has been adopted and standardized by the Scoliosis Research Society?
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
We can see the degree of rotation of the vertebra at the apex of the curve by looking at what in relation to the midline? How is this graded?
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.
When is a Omnovertebral bone present and where is it found?
Block and Multiple Block Vertebrae
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.
Hahns Vascular channel
Pigeon breast. Pectosternal clear space is shown.
Persistent growth center transverse processes
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
L1-L5 Vertebral Bodies
What is seen in AP view of Lumbar spine?
T12-S1 Vertebral Bodies
T12-L5 Disc Spaces
Abdominal Aorta (when atherosclerosis is present)
What is seen in Lateral view of Lumbar spine
Opposite side dogs and marker behind spine.
What to know for Posterior Oblique view of Lumbar spine?
Same side dogs and marker in front of spine.
What to know for Anterior Oblique view of Lumbar spine?
“snout” = transverse process
“eye” = pedicle
“ear” = sup. articular process
“neck” = pars interarticularis
“body” = lamina
“front leg” = inf. articular process
“back leg” = spinous process
What is seen (as Scotty Dog) in a RPO view of the Lumbar spine?
L5-S1 Disc Space
L5 TP’s and SP’s
L5 Vertebral Body
What is seen in the AP Lumbosacral spot view “Tilt up 30-35 degrees”?
36 to 42 degrees
What is the normal range of Ferguson’s Sacral Base Angle (also called the LS angle)?
L3 to sacral promontory (base). Should go through anterior third of the sacral base.
Ferguson’s Gravitational Weight Bearing Line
Shows line down posterior vertebral bodies to see misalignment such as Spondylolisthesis (antero/retro).
George’s Posterior Body Line
45 to 65 degrees
What is the average Lumbar Lordosis curve measurement currently?
S curve = facet sublaxation.
Hadley’s S Curve
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
Pre-vertebral soft tissue spaces
also called the LS angle Range 36-42 degrees
Ferguson’s Sacral base angle
◾Center of L3
◾Should intersect anterior sacral margin +/- 10mm
Ferguson’s Gravitational Weight Bearing Line
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
Martin’s Basilar Angle
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.
Ruth Jackson’s Stress lines
Spinal curve measurements