SPINE

“END-PLATE DEGENERATION”

“ Connected to back pain, though the precise link is controversial. MRI •  Disc degeneration with signal change paralleling the end plates.•  Signal characteristics are commonly classified according to the Modic system” For Radiology Cases, Discussion join: Radiology Made Easy on Facebook  Subscribe to our youtube channel for FRCR radiology case discussion  Join our Telegram …

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TERMINOLOGY FOR DESCRIBING THE LOCATION OF DEGENERATIVE DISC PATHOLOGY

“ Central Overlying the posterior longitudinal ligament. Protrusion tends to be either side of this. Central protrusions are more common in the cervical spine, especially at C6-7 and C5-6. Paracentral/lateral recess This is the most common site for disc protrusion. Foraminal Disc material is present in the intervertebral foramen with inevitable compromise of the exiting …

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“OSSIFIED POSTERIOR LONGITUDINAL LIGAMENT”

“ Represents heterotopic bone from repeated trauma to the PLL. It tends to occur in the cervical spine, causing canal stenosis and myelopathy. CT •  CT preferred for pre-operative planning•  Multilevel ossification of the PLL with narrowing of the spinal canal•  Typically minimal disc disease” For Radiology Cases, Discussion join: Radiology Made Easy on Facebook  …

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TERMINOLOGY FOR DESCRIBING DEGENERATIVE DISC PATHOLOGY

“ Focal protrusion Disc material protrudes so that the displaced material is <25%/90° of the body circumference on axial slices. Broad-based protrusion Disc material protrudes so that the displaced material is >25%/90° of the body circumference on axial slices. Bulge Annulus extends >3 mm beyond the vertebral body margin >50%/180° of the body circumference. Extrusion Disc material is expelled …

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“SPONDYLOLISTHESIS”

“ Mostly due to either degenerative disease (facet joint hypertrophy and slip) or, in 10%, pars defects (i.e. spondylolysis).  It is commonly asymptomatic. Pars defects are thought to arise from microtrauma in childhood (e.g. gymnastics, etc.).  The defect in the pars contains fibrous material. PLAIN FILM •  Scotty dog sign on oblique lateral, Napolean’s hat …

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“SPINAL STENOSIS”

“ This often coexists with disc disease. Central stenosis is mostly the result of bilateral facet joint degeneration causing a slip. Other than degeneration, possible causes include Paget disease, spondylolisthesis and trauma. Superior facet hypertrophy may cause a lateral recess stenosis. MRI •  Facet joint degeneration (loss of disc space) and hypertrophy•  Spondylolisthesis•  Thickening/buckling of …

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FIVE THINGS TO LOOK FOR IN THE CERVICAL SPINE WITH RHEUMATOID ARTHRITIS (RA)

“ 1.  Atlantoaxial instability (C1 transverse ligament destruction by pannus). Frank instability in 5% with RA. Shown by pre-dentate space >2.5 mm in adult. 2.  Atlantoaxial impaction: severe atlantoaxial subluxation with collapse of the C1-2 facets and basilar invagination. Look for anterior slip of C1 so the anterior border of C1 lies anterior to the inferior border …

FIVE THINGS TO LOOK FOR IN THE CERVICAL SPINE WITH RHEUMATOID
ARTHRITIS (RA)
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FACETAL CYSTS

Facet joints degenerate like any other synovial joint. Facetal cysts may form containing fluid, blood or air and thus demonstrate a variable signal on magnetic resonance imaging. For Radiology Cases, Discussion join: Radiology Made Easy on Facebook  Subscribe to our youtube channel for FRCR radiology case discussion  Join our Telegram group: Radiology Made Easy   

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