Podcast
Questions and Answers
What is Hahn's Venous Clef?
What is Hahn's Venous Clef?
A normal finding. Vertebral vascular foramina for the Basivertebral vein. Not to be confused with a fracture. It is a short transverse lucent line in the mid portion of the vertebral body.
Where are Hahn's Venous Cleft usually found?
Where are Hahn's Venous Cleft usually found?
Most Common in the lower thoracic spine.
Aka for congenital block vertebra?
Aka for congenital block vertebra?
Congenital synostosis or failure of segmentation.
What is a block vertebra?
What is a block vertebra?
Main differential considerations for a block vertebra?
Main differential considerations for a block vertebra?
What imaging is useful for detecting associated anomalies with block vertebra?
What imaging is useful for detecting associated anomalies with block vertebra?
Butterfly vertebra AKA?
Butterfly vertebra AKA?
Where are butterfly vertebra most common?
Where are butterfly vertebra most common?
Characteristic triad of butterfly vertebra?
Characteristic triad of butterfly vertebra?
What is a scrambled spine?
What is a scrambled spine?
Hemivertebrae aka?
Hemivertebrae aka?
What is hemivertebra?
What is hemivertebra?
Three types of hemivertebrae?
Three types of hemivertebrae?
How do all hemivertebrae appear?
How do all hemivertebrae appear?
What view are lateral hemivertebrae best seen on?
What view are lateral hemivertebrae best seen on?
Hemivertebra that is fully segmental or free?
Hemivertebra that is fully segmental or free?
Hemivertebra that is non-segmental?
Hemivertebra that is non-segmental?
Hemivertebra that is semi-segmental?
Hemivertebra that is semi-segmental?
Hemivertebra that is incarcerated?
Hemivertebra that is incarcerated?
Dorsal hemivertebra?
Dorsal hemivertebra?
Ventral hemivertebra?
Ventral hemivertebra?
What is a coronal cleft vertebra?
What is a coronal cleft vertebra?
Gender predominance for coronal cleft vertebra?
Gender predominance for coronal cleft vertebra?
Where are coronal cleft vertebra most common?
Where are coronal cleft vertebra most common?
Clinical significance of coronal cleft vertebra?
Clinical significance of coronal cleft vertebra?
What is a Schmorl's node?
What is a Schmorl's node?
Gender predominance for Schmorl's node?
Gender predominance for Schmorl's node?
Most common location for Schmorl's node?
Most common location for Schmorl's node?
Schmorl's nodes are associated with?
Schmorl's nodes are associated with?
Scheuermann's Disease aka?
Scheuermann's Disease aka?
Scheuermann's Disease gender predominance?
Scheuermann's Disease gender predominance?
Symptoms of Scheuermann's Disease?
Symptoms of Scheuermann's Disease?
Diagnostic criteria for Scheuermann's Disease?
Diagnostic criteria for Scheuermann's Disease?
What is a limbus bone?
What is a limbus bone?
Limbus bone is secondary to?
Limbus bone is secondary to?
Where are limbus bones typically seen?
Where are limbus bones typically seen?
Clinical significance of limbus bone?
Clinical significance of limbus bone?
Posterior limbus bone gender predominance?
Posterior limbus bone gender predominance?
Posterior limbus bones are most common at?
Posterior limbus bones are most common at?
Nuclear impression aka?
Nuclear impression aka?
Nuclear impression is characterized by?
Nuclear impression is characterized by?
Where are nuclear impressions most commonly found?
Where are nuclear impressions most commonly found?
What is a sign of nuclear impression on a frontal radiograph?
What is a sign of nuclear impression on a frontal radiograph?
What is agenesis of a lumbar pedicle?
What is agenesis of a lumbar pedicle?
Most common level for agenesis of a lumbar pedicle?
Most common level for agenesis of a lumbar pedicle?
Clinically it is important to differentiate agenesis of a lumbar pedicle from what other conditions?
Clinically it is important to differentiate agenesis of a lumbar pedicle from what other conditions?
Spina bifida occulta aka?
Spina bifida occulta aka?
What is spina bifida occulta?
What is spina bifida occulta?
Most common level for spina bifida occulta?
Most common level for spina bifida occulta?
How does spina bifida occulta appear on a radiograph?
How does spina bifida occulta appear on a radiograph?
Gender predominance for spina bifida occulta?
Gender predominance for spina bifida occulta?
Diastematomyelia aka?
Diastematomyelia aka?
What is diastematomyelia?
What is diastematomyelia?
Type I diastematomyelia?
Type I diastematomyelia?
Type II diastematomyelia?
Type II diastematomyelia?
Physical findings in diastematomyelia?
Physical findings in diastematomyelia?
What imaging is needed to diagnose diastematomyelia?
What imaging is needed to diagnose diastematomyelia?
What is sacralization?
What is sacralization?
What is lumbarization?
What is lumbarization?
Berolotti syndrome?
Berolotti syndrome?
What classification is used in lumbosacral transitional vertebra?
What classification is used in lumbosacral transitional vertebra?
Type I Castellvi classification?
Type I Castellvi classification?
Type II Castellvi classification?
Type II Castellvi classification?
Type III Castellvi classification?
Type III Castellvi classification?
Type IV Castellvi classification?
Type IV Castellvi classification?
Type A vs. Type B Castellvi classification?
Type A vs. Type B Castellvi classification?
Facet tropism aka?
Facet tropism aka?
What is facet tropism?
What is facet tropism?
Most common level for facet tropism?
Most common level for facet tropism?
Agenesis of the articular pillar aka?
Agenesis of the articular pillar aka?
Most common level for agenesis of the articular pillar?
Most common level for agenesis of the articular pillar?
Bilateral agenesis of the articular pillar predisposes a patient for?
Bilateral agenesis of the articular pillar predisposes a patient for?
What is an Oppenheimer's ossicle?
What is an Oppenheimer's ossicle?
Most common level for Oppenheimer's ossicle?
Most common level for Oppenheimer's ossicle?
Oppenheimer's ossicle gender predominance?
Oppenheimer's ossicle gender predominance?
Clinical significance of Oppenheimer's ossicle?
Clinical significance of Oppenheimer's ossicle?
What is clasp-knife deformity?
What is clasp-knife deformity?
What movement may be painful with clasp-knife deformity?
What movement may be painful with clasp-knife deformity?
Paraglenoid sulci aka?
Paraglenoid sulci aka?
Where does paraglenoid sulci occur?
Where does paraglenoid sulci occur?
What does the paraglenoid sulci transmit?
What does the paraglenoid sulci transmit?
What is a phlebolith?
What is a phlebolith?
Where are phleboliths most frequently seen?
Where are phleboliths most frequently seen?
Primary differential for phleboliths?
Primary differential for phleboliths?
What are injection granulomas?
What are injection granulomas?
Where are injection granulomas most common?
Where are injection granulomas most common?
Study Notes
Thoracolumbar Anomalies and Normal Variants
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Hahn's Venous Cleft: Normal finding representing vertebral vascular foramina for the Basivertebral vein; appears as a short transverse lucent line in the mid-portion of the vertebral body.
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Location of Hahn's Venous Cleft: Commonly found in the lower thoracic spine.
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Congenital Block Vertebra: Also known as congenital synostosis or failure of segmentation; involves fusion of two or more vertebrae due to embryonic failure of somite segmentation.
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Main Differential Considerations: Consider previous infection, trauma, or post-surgical changes for block vertebrae.
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Imaging for Block Vertebrae: CT or MRI recommended to detect associated anomalies.
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Butterfly Vertebra: Also termed sagittal cleft vertebra, most commonly found at the thoracolumbar junction.
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Characteristic Triad: Displays two lateral wedge-shaped halves, a midline hourglass sagittal cleft, and widened interpediculate distance.
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Scrambled Spine: Refers to multiple spinal anomalies or a mixture of different spinal anomalies.
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Hemivertebra: Known as congenital wedge vertebra; results from failure of ossification of part of a vertebral body.
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Types of Hemivertebrae: Include lateral (most common), dorsal, and ventral types; all appear trapezoidal or triangular.
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Best Seen on Imaging: Lateral hemivertebrae are best visualized on AP projection.
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Classification of Hemivertebrae:
- Segmental (free): Not attached to adjacent vertebrae, most concerning.
- Non-segmental: Not separated from adjacent levels, less of a concern.
- Semi-segmental: Half segment fused with adjacent vertebra.
- Incarcerated: Joined by pedicles to levels above and below, less concerning.
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Dorsal Hemivertebra: Deficiency in the anterior portion of the vertebral body, commonly resulting in acute kyphosis.
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Ventral Hemivertebra: Represents absence of the posterior half, least common type.
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Coronal Cleft Vertebra: Characterized by delayed union of anterior and posterior halves, with a male predominance. Commonly found in the lumbar spine.
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Schmorl's Node: Defines intravertebral body herniation of the nucleus pulposus, predominantly affects males, often located at the thoracolumbar junction, and associated with Scheuermann disease.
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Scheuermann's Disease: Also referred to as juvenile kyphosis; characterized by asymptomatic cases but can present with back pain unrelated to deformity severity.
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Diagnostic Criteria for Scheuermann's Disease: Includes hyperkyphosis (>40° thoracic), anterior vertebral body wedging (>5° in three adjacent vertebrae), and irregular end plates or multiple Schmorl's nodes.
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Limbus Bone: Small well-corticated ossicle, typically found anteriorly at lumbar segments L2-L4, often secondary to peripheral intravertebral disc herniation with minimal clinical significance.
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Nuclear Impression: Identified by parasagittal end plate depressions with osseous mound, occurrence primarily at L5, characterized by the "Cupid's bow" sign on frontal radiographs.
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Agenesis of a Lumbar Pedicle: Congenital absence usually at L4, important to differentiate from conditions like osteolytic metastasis.
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Spina Bifida Occulta: Developmental failure of osseous union, most commonly seen at S1, followed by L5 and C1, often presenting as a radiolucent cleft on X-rays.
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Diastematomyelia: Rare dysraphism with two types: Type I (duplicated dural sac with midline spur) and Type II (single dural sac with both hemicords).
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Sacralization: Assimilation of L5 to the sacrum, results in four lumbar vertebrae; lumbarization refers to S1 assimilating into the lumbar spine, leading to six lumbar vertebrae.
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Berolotti Syndrome: Defined by the presence of transitional segment causing sciatic pain.
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Castellvi Classification: Used for lumbosacral transitional vertebra; includes Type I (enlarged transverse process), Type II (pseudo articulation), Type III (fused transverse process), and Type IV (mixed types).
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Facet Tropism: Asymmetrical facets, primarily seen at L5-S1, increasing the risk for conditions like dysplastic spondylolisthesis due to bilateral agenesis of the articular pillar.
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Oppenheimer's Ossicle: Persistent or ununited apophysis at the tip of the superior or inferior facets, most commonly observed at L1-L4 with a male predominance.
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Clasp-Knife Deformity: Combination of elongated L5 spinous process and spina bifida occulta at S1; hyperextension may cause pain.
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Paraglenoid Sulci: Preauricular grooves at the anterior sacroiliac ligament insertion, transmitting the superior branch of the gluteal artery and nerve.
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Phlebolith: Calcified thrombi found in veins, significantly seen within the pelvic basin.
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Injection Granulomas: Calcified masses in muscles post-injection, primarily observed in the posterior lateral gluteal region.
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Test your knowledge on thoracolumbar anomalies and normal variants with these flashcards. Each card highlights critical definitions and key locations related to these anatomical features, offering insights into normal findings such as Hahn's Venous cleft and congenital block vertebrae.
