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Questions and Answers
Anterior slippage of L5 as a result of a congenital anomaly or malformation of the posterior arch would be classified as _________ according to the Wiltse classification.
Anterior slippage of L5 as a result of a congenital anomaly or malformation of the posterior arch would be classified as _________ according to the Wiltse classification.
Dysplastic
Which radiographic line of mensuration is used to determine the presence of a spondylolisthesis or anterolisthesis?
Which radiographic line of mensuration is used to determine the presence of a spondylolisthesis or anterolisthesis?
Ullmann's line
Utilizing Myerding's method, an anterior displacement of L5 on S1 measuring 27% would be classified as a grade _________ spondylolisthesis.
Utilizing Myerding's method, an anterior displacement of L5 on S1 measuring 27% would be classified as a grade _________ spondylolisthesis.
Grade 2
Using the Wiltse classification, what type of spondylolisthesis is present in a patient with anterolisthesis of L5 due to a fractured lamina?
Using the Wiltse classification, what type of spondylolisthesis is present in a patient with anterolisthesis of L5 due to a fractured lamina?
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A degenerative spondylolisthesis is most commonly observed at what level?
A degenerative spondylolisthesis is most commonly observed at what level?
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The most common type of spondylolisthesis seen in patients less than 50 years of age is _____________________.
The most common type of spondylolisthesis seen in patients less than 50 years of age is _____________________.
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The term spondylolisthesis traditionally refers to vertebral slippage in which direction?
The term spondylolisthesis traditionally refers to vertebral slippage in which direction?
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A radiolucent line seen through the region of the pars interarticularis is known as ______________________.
A radiolucent line seen through the region of the pars interarticularis is known as ______________________.
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What is the most common level for an isthmic spondylolisthesis?
What is the most common level for an isthmic spondylolisthesis?
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Based on the description, what type of spondylolisthesis is present in the patient with anterolisthesis of L4 of 18%?
Based on the description, what type of spondylolisthesis is present in the patient with anterolisthesis of L4 of 18%?
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The presence of a unilateral spondylolysis with stress hypertrophy of the opposite pedicle is characteristic and is also known as _____________ syndrome.
The presence of a unilateral spondylolysis with stress hypertrophy of the opposite pedicle is characteristic and is also known as _____________ syndrome.
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Complete slippage of L5 on S1, greater than 100%, is termed _____________.
Complete slippage of L5 on S1, greater than 100%, is termed _____________.
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A vertebral body with a persistent midline-sagittal cleft in an adult appears radiographically as a _____________.
A vertebral body with a persistent midline-sagittal cleft in an adult appears radiographically as a _____________.
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The pressure from the superior gluteal arteries can create a groove at the lateral aspect of the inferior sacroiliac joint. This groove is called ____________.
The pressure from the superior gluteal arteries can create a groove at the lateral aspect of the inferior sacroiliac joint. This groove is called ____________.
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Herniation of disc material into the vertebral body resulting in a short-based endplate depression surrounded by a thin sclerotic rim is known as what?
Herniation of disc material into the vertebral body resulting in a short-based endplate depression surrounded by a thin sclerotic rim is known as what?
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The condition in which the S1 segment develops partial or complete lumbar type morphology is referred to as ____________.
The condition in which the S1 segment develops partial or complete lumbar type morphology is referred to as ____________.
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The absence of a spinolaminar line at any given level in the cervical spine is suggestive of what condition?
The absence of a spinolaminar line at any given level in the cervical spine is suggestive of what condition?
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Widening of the transverse processes of L5 greater than 19 mm vertically with no articulation with the sacrum is referred to as ______________.
Widening of the transverse processes of L5 greater than 19 mm vertically with no articulation with the sacrum is referred to as ______________.
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Small round calcific densities within the pelvic basin representing calcified thrombi in the walls of the pelvic veins are called _____________.
Small round calcific densities within the pelvic basin representing calcified thrombi in the walls of the pelvic veins are called _____________.
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Which imaging modality is usually the first and most extensively used for the evaluation of arthritic conditions?
Which imaging modality is usually the first and most extensively used for the evaluation of arthritic conditions?
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What is the other name for subchondral cysts, which are frequently seen in degenerative arthritis?
What is the other name for subchondral cysts, which are frequently seen in degenerative arthritis?
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For the ABCS search pattern used to describe radiographic findings, which description is a good example for 'C'?
For the ABCS search pattern used to describe radiographic findings, which description is a good example for 'C'?
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Calcification within the annular fibers of the intervertebral disc is known as a/an
Calcification within the annular fibers of the intervertebral disc is known as a/an
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Subchondral sclerosis is also known as ____________.
Subchondral sclerosis is also known as ____________.
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Degeneration and osteoarthrosis are examples of which type of arthritic condition?
Degeneration and osteoarthrosis are examples of which type of arthritic condition?
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Non-union of the secondary growth center of an inferior articulating process within the lumbar spine is known as
Non-union of the secondary growth center of an inferior articulating process within the lumbar spine is known as
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What is herniation of the cerebellar tonsils below the foramen magnum termed?
What is herniation of the cerebellar tonsils below the foramen magnum termed?
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A lumbar transitional segment with expansion of the transverse processes resulting in an accessory articulation with the sacral ala is classified as a Castellvi type ____
A lumbar transitional segment with expansion of the transverse processes resulting in an accessory articulation with the sacral ala is classified as a Castellvi type ____
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Most common cause of work disability among US adults?
Most common cause of work disability among US adults?
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A disc herniation which remains covered by the posterior longitudinal ligament is categorized as?
A disc herniation which remains covered by the posterior longitudinal ligament is categorized as?
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On MRI, increased T1 signal and decreased T2 signal at vertebral endplates is consistent with?
On MRI, increased T1 signal and decreased T2 signal at vertebral endplates is consistent with?
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The findings on the radiograph ARE NOT an absolute contraindication to chiropractic manipulation.
The findings on the radiograph ARE NOT an absolute contraindication to chiropractic manipulation.
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Extension of disc material beyond the vertebral confines with the largest measurement being that of the depth of the displaced material is best termed a?
Extension of disc material beyond the vertebral confines with the largest measurement being that of the depth of the displaced material is best termed a?
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Which of the following causes of spinal stenosis is more common in women?
Which of the following causes of spinal stenosis is more common in women?
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What other condition may be seen in patients with diffuse idiopathic skeletal hyperostosis?
What other condition may be seen in patients with diffuse idiopathic skeletal hyperostosis?
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What is the most common location for a synovial cyst?
What is the most common location for a synovial cyst?
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Select the correct statement below regarding osteophytes.
Select the correct statement below regarding osteophytes.
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A nuclear vacuum phenomenon is a reliable sign of early degenerative disc disease.
A nuclear vacuum phenomenon is a reliable sign of early degenerative disc disease.
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What is the most common cause of neuropathic arthropathy of the upper extremity?
What is the most common cause of neuropathic arthropathy of the upper extremity?
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Forestier's disease is another name for which condition?
Forestier's disease is another name for which condition?
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What diagnosis would explain the pseudo-fracture appearance seen in a patient with chronic neck pain?
What diagnosis would explain the pseudo-fracture appearance seen in a patient with chronic neck pain?
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What is the term for a free fragment of a herniated disc?
What is the term for a free fragment of a herniated disc?
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What type of signal intensity is expected in the nucleus pulposus of a desiccated intervertebral disc on MRI?
What type of signal intensity is expected in the nucleus pulposus of a desiccated intervertebral disc on MRI?
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Which joint complex of the spine is a fibrocartilaginous joint?
Which joint complex of the spine is a fibrocartilaginous joint?
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Which radiographic view is best to evaluate for ossification of the posterior longitudinal ligament?
Which radiographic view is best to evaluate for ossification of the posterior longitudinal ligament?
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The finding of para-endplate bony sclerosis is consistent with?
The finding of para-endplate bony sclerosis is consistent with?
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Which type of Modic change is visible on conventional radiographs?
Which type of Modic change is visible on conventional radiographs?
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A 78-year-old female presents with low back pain. What motion is likely to be most painful for this patient based on radiographic findings?
A 78-year-old female presents with low back pain. What motion is likely to be most painful for this patient based on radiographic findings?
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A 58-year-old female presents with chronic, moderate neck pain. What is the diagnosis based on her cervical spine radiographs?
A 58-year-old female presents with chronic, moderate neck pain. What is the diagnosis based on her cervical spine radiographs?
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The findings of para-endplate bone marrow edema and inflammation on MRI are consistent with?
The findings of para-endplate bone marrow edema and inflammation on MRI are consistent with?
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Which of the following statements is TRUE regarding DISH?
Which of the following statements is TRUE regarding DISH?
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Which category of arthritis is most often encountered in chiropractic practice?
Which category of arthritis is most often encountered in chiropractic practice?
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Rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis are all examples of which category of arthritis?
Rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis are all examples of which category of arthritis?
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Gout, calcium pyrophosphate, and hydroxapatite are all examples of which category of arthritis?
Gout, calcium pyrophosphate, and hydroxapatite are all examples of which category of arthritis?
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Which condition is described as having one facet joint oriented in the sagittal plane while the other side is oriented in the coronal plane?
Which condition is described as having one facet joint oriented in the sagittal plane while the other side is oriented in the coronal plane?
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A triangular ossicle that occurs as a result from herniation of nuclear disc material through the cartilaginous junction zone of the ring apophysis during childhood is known as?
A triangular ossicle that occurs as a result from herniation of nuclear disc material through the cartilaginous junction zone of the ring apophysis during childhood is known as?
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What radiographic entity is seen dorsal to the cervical spinous processes?
What radiographic entity is seen dorsal to the cervical spinous processes?
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Which radiographic view is most beneficial for seeing a paracondylar process?
Which radiographic view is most beneficial for seeing a paracondylar process?
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According to the Castellvi classification, a transitional segment that has a pseudoarticulation between an enlarged transverse process and the sacral would be classified as which type?
According to the Castellvi classification, a transitional segment that has a pseudoarticulation between an enlarged transverse process and the sacral would be classified as which type?
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Which radiographic finding is associated with thoracic outlet syndrome?
Which radiographic finding is associated with thoracic outlet syndrome?
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A transverse, short radiolucent line seen in the midportion of a lower thoracic vertebra is called?
A transverse, short radiolucent line seen in the midportion of a lower thoracic vertebra is called?
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If a radiographic series demonstrates six distinct lumbar vertebrae on the film, which anomaly is present?
If a radiographic series demonstrates six distinct lumbar vertebrae on the film, which anomaly is present?
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Which anomaly/normal variant causes absence of the spinolaminar line?
Which anomaly/normal variant causes absence of the spinolaminar line?
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A split cord by either an osseous bar or a fibrous septum is known as?
A split cord by either an osseous bar or a fibrous septum is known as?
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What is the term for downward displacement or elongation of the brainstem and cerebellar tonsils through the foramen magnum?
What is the term for downward displacement or elongation of the brainstem and cerebellar tonsils through the foramen magnum?
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Small round radiopaque densities within the pelvic basin representing calcified thrombi in the walls of the pelvic veins are called?
Small round radiopaque densities within the pelvic basin representing calcified thrombi in the walls of the pelvic veins are called?
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Which radiographic sign is most suggestive of a congenital block vertebra?
Which radiographic sign is most suggestive of a congenital block vertebra?
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The most cephalic intervertebral disc of the spinal column is found at which level?
The most cephalic intervertebral disc of the spinal column is found at which level?
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Which condition is associated with secondary basilar impression?
Which condition is associated with secondary basilar impression?
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The clinical triad of a short webbed neck, low posterior hairline, and reduced cervical motion is classic for which condition?
The clinical triad of a short webbed neck, low posterior hairline, and reduced cervical motion is classic for which condition?
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Anterior displacement of a vertebral body in relation to its subjacent segment is known as?
Anterior displacement of a vertebral body in relation to its subjacent segment is known as?
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The line drawn between the basion and the opisthion is called?
The line drawn between the basion and the opisthion is called?
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Which radiographic line of mensuration is demonstrated?
Which radiographic line of mensuration is demonstrated?
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When using the canal-to-body ratio in the cervical spine, which of the following would be considered an indicator of spinal stenosis?
When using the canal-to-body ratio in the cervical spine, which of the following would be considered an indicator of spinal stenosis?
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The curvilinear line drawn at the posterior aspect of the vertebral bodies is called ______________ line.
The curvilinear line drawn at the posterior aspect of the vertebral bodies is called ______________ line.
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Spinal stenosis in the cervical spine, at the C6 level, is suggested when the sagittal canal dimension measures less than ______ mm.
Spinal stenosis in the cervical spine, at the C6 level, is suggested when the sagittal canal dimension measures less than ______ mm.
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Which of the following is the correct way to draw the ______?
Which of the following is the correct way to draw the ______?
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The sagittal spinal canal dimension measurement of the lumbar spine, using Eisenstein's method, has a minimum measurement of ______ mm.
The sagittal spinal canal dimension measurement of the lumbar spine, using Eisenstein's method, has a minimum measurement of ______ mm.
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Which radiographic line of mensuration is demonstrated?
Which radiographic line of mensuration is demonstrated?
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Which line is considered the most accepted method for measuring a scoliotic spinal deviation?
Which line is considered the most accepted method for measuring a scoliotic spinal deviation?
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The presacral space should NOT exceed more than ____ cm in adults.
The presacral space should NOT exceed more than ____ cm in adults.
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The maximum measurement for the sella turcica is?
The maximum measurement for the sella turcica is?
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The cervical prevertebral (retropharyngeal) soft tissue at the level of C2 should measure no greater than _________ mm.
The cervical prevertebral (retropharyngeal) soft tissue at the level of C2 should measure no greater than _________ mm.
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Which radiographic line is considered the most accurate and reproducible measurement of basilar impression?
Which radiographic line is considered the most accurate and reproducible measurement of basilar impression?
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Cerebral palsy, syringomyelia, and poliomyelitis would be examples of which kind of scoliosis?
Cerebral palsy, syringomyelia, and poliomyelitis would be examples of which kind of scoliosis?
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A 15-year-old female complains of back pain. On physical exam, a noticeable 'rib humping' is seen during the Adam's sign, so radiographs were obtained to investigate a possible scoliosis.
A 15-year-old female complains of back pain. On physical exam, a noticeable 'rib humping' is seen during the Adam's sign, so radiographs were obtained to investigate a possible scoliosis.
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A thoracic scoliosis would have an apex at which of the following levels?
A thoracic scoliosis would have an apex at which of the following levels?
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Spinal curves are classified in three ways: 'cause', location, and direction of the curvature. Which of the following would be considered a 'cause' classification?
Spinal curves are classified in three ways: 'cause', location, and direction of the curvature. Which of the following would be considered a 'cause' classification?
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A spinal curvature measuring 14 degrees with the apex vertebra at L1 is classified as which type of scoliosis?
A spinal curvature measuring 14 degrees with the apex vertebra at L1 is classified as which type of scoliosis?
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The most deviated vertebra from the vertical axis of the patient, or the most rotated vertebra in a curve is defined as __________ vertebra.
The most deviated vertebra from the vertical axis of the patient, or the most rotated vertebra in a curve is defined as __________ vertebra.
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In general, scoliosis is defined as spinal curvature in which plane?
In general, scoliosis is defined as spinal curvature in which plane?
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A spinal curvature with the convexity directed to the left side of the body is defined as a?
A spinal curvature with the convexity directed to the left side of the body is defined as a?
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A 15-year-old female complains of back pain. On physical exam, she has a noticeable 'rib hump', so X-rays were obtained to investigate a possible scoliosis. Her radiograph measures a curvature of 43.1 degrees.
A 15-year-old female complains of back pain. On physical exam, she has a noticeable 'rib hump', so X-rays were obtained to investigate a possible scoliosis. Her radiograph measures a curvature of 43.1 degrees.
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What is the proper term for a fracture of abnormal bone that results from normal loading forces?
What is the proper term for a fracture of abnormal bone that results from normal loading forces?
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What is an occult fracture and what should be the clinical course?
What is an occult fracture and what should be the clinical course?
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Which imaging modality is best for demonstrating a bone bruise?
Which imaging modality is best for demonstrating a bone bruise?
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In which stage of fracture healing is clinical union achieved?
In which stage of fracture healing is clinical union achieved?
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Which of the following is an acceptable definition of a comminuted fracture?
Which of the following is an acceptable definition of a comminuted fracture?
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A fracture that does not break the skin is best termed?
A fracture that does not break the skin is best termed?
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Which of the following fractures generates more than two fragments?
Which of the following fractures generates more than two fragments?
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Study Notes
Spondylolisthesis and Related Conditions
- Dysplastic Spondylolisthesis: Anterior slippage of L5 due to congenital anomaly.
- Traumatic Spondylolisthesis: Occurs from injury, evident in car accident patients showing lamina or facet fractures.
- Grade 2 Spondylolisthesis: Identified with a 27% anterior displacement of L5 on S1 using Myerding's method.
- Most Common Levels: Degenerative spondylolisthesis is most often found at L4; isthmic type is most commonly at L5.
- Spondyloptosis: Condition involving complete slippage of L5 on S1 greater than 100%.
- Spondylolysis: Characterized by a radiolucent line at the pars interarticularis, often leading to unilateral spondylolysis syndrome (Wilkinson's).
Imaging Techniques and Findings
- Ullmann's Line: A critical radiographic line for assessing spondylolisthesis or anterolisthesis.
- Conventional Radiography: Primary imaging modality used for assessing arthritic conditions.
- Myerding's Method: Utilized for classification of spondylolisthesis based on percentage of slippage.
- Intercalary Bone: Refers to calcification within annular fibers of an intervertebral disc.
- MRI Signals: Type 2 Modic Change shows increased T1 and decreased T2 signals at vertebral endplates.
- George Line: A curvilinear line drawn posteriorly around vertebral bodies seen in imaging for various assessments.
Degenerative and Metabolic Changes
- Degenerative Disc Disease: Observed through intervertebral disc height loss, endplate sclerosis, and osteophyte formation.
- Phleboliths: Calcified thrombi in pelvic veins, seen as small, round radiopaque densities.
- Eburnation: Another term for subchondral sclerosis, commonly found in arthritis.
Scoliosis and Its Types
- Dextroscoliosis: Rightward spinal curve often diagnosed in young patients with rib humping signs.
- Facial Tropism: A condition where one spinal facet joint is oriented differently than the opposite joint.
- Structural Neuromuscular Scoliosis: Conditions such as cerebral palsy or poliomyelitis lead to this curvature.
Fractures and Healing
- Occult Fracture: A fracture that is not visible on initial x-rays and may require follow-up imaging.
- Insufficiency Fracture: A fracture occurring in abnormal bone due to normal loading forces.
- Bone Bruise: Best demonstrated using Magnetic Resonance Imaging (MRI).
Developmental Anomalies
- Limbus Bone: A triangular ossicle resulting from herniation of disc material.
- Diastematomyelia: Describes a split spinal cord due to osseous or fibrous septum.
Miscellaneous
- Arnold-Chiari Malformation: Refers to the downward displacement of brain structures through the foramen magnum.
- Cobb Angle: The most accepted method for measuring spinal curvature in scoliosis cases.
- Cervical Ribs: Radiographic findings relevant in diagnosing thoracic outlet syndrome.
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Description
Explore the various types of spondylolisthesis, including dysplastic and traumatic cases, as well as their imaging techniques. This quiz will test your knowledge on key concepts, definitions, and imaging methods used in diagnosing spondylolisthesis. Perfect for students and professionals in medical fields.
