Properties of Purdue. Anatomy. Positioning AXIAL SKELETAL RADIOLOGY FOR PRIVATE PRACTITIONERS 11/30/2018

Transcription

1 AXIAL SKELETAL RADIOLOGY FOR PRIVATE PRACTITIONERS Anatomy Complex Text book is needed Species Contrast Positioning Painful/ non cooperative Sedation General anesthesia Species Contrast 1

2 Slightly oblique Cervical: gradually wider from cranial to caudal (C5 6 and C6 7 widest) Narrow through thoracic spinal column Cervical: gradually wider from cranial to caudal (C5 6 and C6 7 widest) Narrow through thoracic spinal column Narrow through thoracic spinal column Narrow through thoracic spinal column 2

3 Normal Spinal Canal Width Spinal canal widens from C4 T2 & L2 L5 to accommodate the wider diameter of the cord due to the brachial & pelvic plexus Anticlinal space T10-11 Adjacent spaces wider Spinal canal widens from L2-L5 Ventral margin of L2-4 often indistinct due to diaphragmatic attachments Spinal canal widens from C4-T2 Principle of divergent beam affecting the appearance of disc space 3

4 Principle of divergent beam An evaluation of a new radiographic technique utilizing a concave table Vet Radiol & Ultrasound 2000;41:9 18 Commonly seen changes Degenerative Changes Spondylosis deformans Spondylarthritis DISH Anomalies Discospondylitis Fractures Neoplasia Intervertebral disc disease Spinal cord compression In situ mineralized disc How many regions for a complete spinal evaluation? Cervical Cervicothoracic Thoracic Thoracolumbar Lumbar Lumbosacral Spondylosis deformans Degeneration of the intervertebral disc Osseous proliferation of nearly fusing adjacent vertebrae Normal as well of narrowed disc spaces Caudal thoracic, lumbar and LS 4

5 Normal Spondylosis deformans Ventral bridging Osteophytosis around the articular facets causes irregularity and increased opacity Diffuse Idiopathic Skeletal Hyperostosis Diffuse Idiopathic Skeletal Hyperostosis The presence of flowing calcification and ossification along the ventrolateral aspects of at least 4 contiguous vertebral bodies with or without localized pointed excrescences at intervening vertebral body disc junctions The relative preservation of disc height in the involved areas and the absence of extensive radiographic changes of degenerative disc disease (intervertebral osteochondrosis), including vacuum phenomena and vertebral body marginal sclerosis The absence of apophyseal joint bony ankylosis and sacroiliac joint erosion, sclerosis or intra articular bony fusion Spondylarthritis DISH Does not cause clinical signs Except stiff movement 5

6 Hemivertebrae Transitional Vertebrae Block Vertebrae Atlanto Axial Subluxation Vertebral anomalies often clinically insignificant - screw-tailed dog breeds - may be found in any breed English bulldog Sacralization of the lumbar vertebra (L7) 6

7 Early stage: Subtle widening or collapsed of the disc space Loss of opacity in the vertebral end plate/plates adjacent to the disc involved Marked lysis of end plates, sclerosis of the adjacent vertebral bodies Proliferation of bone around the site: fusion of the vertebral bodies Neoplasia Primary vs Secondary Monostotic VS polyostotic Known primary neoplasia Osteolytic vs osteoproductive Take home message Positioning and collimation to see the disc spaces Changes may be subtle Clinical correlation 7

8 Thank you 8