3/3/2017. Acute spine disorder (< 4weeks duration) Subacute spine disorder (4-12 weeks duration) Chronic spine disorder (>12 weeks duration)
|
|
- Jodie Kelly
- 6 years ago
- Views:
Transcription
1 William Hsu BSc DC DACBR March 4, 2017 Acute spine disorder (< 4weeks duration) Subacute spine disorder (4-12 weeks duration) Chronic spine disorder (>12 weeks duration) Neurologic symptoms and signs pain radiating below the knee or beyond the elbow, as intense as the low back or neck pain, often radiating into the foot or hand with numbness or paresthesia in a dermatomal distribution with positive nerve root tension signs, abnormal motor power, sensation or deep tendon reflexes (MSR) 1
2 T - Trauma R Range of motion A Alcohol/smoking U Unresponsive to care/unusual natural history/symptoms M Motor/sensory/reflexes A - Age 16 year old avid female snowboarder collided with and flipped over another snowboarder and landed hard on her buttocks on March 15/05. Pain in the lower thoracic spine. Presented to our clinic on March 23/05. 2
3 Acute mild compression fractures from T10 to T12. Referral to emergency room. Plain films of the thoracic spine were taken on March 24/05. 3
4 Patient was told the plain films are inconclusive. Patient is scheduled for CT on March 30/05. 4
5 T8 T8-9 disc T9-10 disc T11-12 disc T10-11 disc The patient was told that there is no compression fracture. CD containing CT images of the thoracic spine was submitted for second reading. Lets have a closer look at the CT images. 5
6 T8 T8-9 disc T9-10 disc T11-12 disc T10-11 disc Sclerosis of the trabeculae is present at the superior portion of the vertebral bodies, beneath the superior endplates from T9 to T12 Acute endplate impaction fractures from T9 to T10. 6
7 Because of the natural thoracic kyphosis, fracture that do occur at these levels are usually caused by flexion forces and often not associated with any neurological deficit. As at other levels, these wedge fractures appear on CT as alterations in the density and trabecular pattern of the spongiosa Can be quite subtle on axial projections; however, sagittally reconstructed views, the loss in height of the vertebral bodies is much more apparent. 74 year-old man with left interscapular pain after tripping while going upstairs two weeks ago Recent blood test shows excessive protein being investigated Ordered rib series to check for rib fracture Courtesy of Intern Doucet Nov. 25,
8 A well-defined lucent lesion at the medial humeral neck with endosteal thinning A missing pedicle at left T3 No rib fracture Additional thoracic and left shoulder views for closer look 8
9 Looks like there is a pedicle at left T3, but can not explain why the missing pedicle on oblique rib view asked for an AP spot view of the upper thoracic spine T2 looks squished on AP view 9
10 The missing left T3 pedicle is still seen on one of the left shoulder views Lucent lesion in the medial humeral neck is still visible 10
11 The AP spot view confirms the missing left T3 pedicle as well as the deformed T2 vertebral body Lytic metastasis or multiple myeloma 11
12 Called family GP to inform the x-ray findings GP responded that the further lab test shows abnormal electrophoresis for M protein and confirming the diagnosis of multiple myeloma 75 year-old male with mild thoracic pain Recent contracted C. Difficile and is currently undergoing weekly kidney dialysis secondary to the damage caused by the infection Courtesy of Dr. Nadine Ellul July 12,
13 Suggestion of endplate destruction is detected at T9 anteroinferior corner. The AP view shows the absence of right lateral half of T9 inferior endplate where the ossified anterior longitudinal ligament is also seen. Blunting of the right posterior costophrenic sulcus is visualized. Radiographic suggestion of endplate destruction at the right lateral half of T9 inferior endplate. In light of the recent C. Difficile infection, the findings are suggestive of early stage of spondylodiscitis. Confirmation with a CT scan is recommended 13
14 Thoracic x-ray were taken 2 days later which showed no endplate destruction; however, persistent pleural effusion with blunting of the right posterior costophrenic sulcus is seen. 72 year old woman with 6 weeks of progressively worsening thoracic pain Seen at Emergency room 3 weeks ago Physical exam and x-ray thoracic spine Was told to have degenerative disc disease Given medication and to check back in 6 weeks Worsening thoracic pain prompted the patient to seek alternative care 14
15 Diffuse pain in the thoracic spine A mild kyphosis in the mid thoracic spine Unremarkable neurological exam Intern wish to treat the patient, but the clinician decided to x-ray the patient despite the fact the patient was x-rayed 3 weeks ago 15
16 Severe destruction of inferior ½ of T6 and superior ½ of T7 vertebral bodies with nonexisting intervening disc A focal kyphoscoliosis Questionable left paraspinal soft tissue swelling DDx: Aggressive neoplasms or infection Ask the intern to obtain previous films from the Emergency room at the hospital Review that afternoon Minimal disc narrowing at T6-7 with a very faint endplate erosion With rapid destruction of adjacent vertebrae and disc, infection was considered the diagnosis Tuberculous spondylodiscitis 16
17 31 year-old female with thoracic pain after a T- bone accident 1 year ago (Dec. 2014). Chiropractor questions if the deformity of T8 vertebral body on MRI study on August 26, 2015 is associated with the car accident. Chest x-ray images 7 years ago are available for comparison. Courtesy of Dr. O Neill December 14, 2015 Sag T1 Sag T2 Sag STIR August 26, 2015 (one year after MVA) 17
18 18
19 Mild anterior wedged deformity of T8 is visualized with Schmorl s nodes at superior and inferior endplates. Smaller Schmorl s nodes are also detected at the inferior endplates of T9 and T10. There is no marrow edema associated with these Schmorl s nodes. A focal posterolateral disc protrusion is seen at left T11-12 with slight extension into the entrance of left T11-12 intervertebral foramen; however, no neural compression is seen. Old Schmorl s nodes at T8, 9 and 10 with wedged deformity of T8. A left posterolateral disc protrusion at T11-12 with no neural compression. Clinical significance of this finding is unknown. Clinical correlation is recommended. 6 years prior to the MVA 19
20 6 years prior to the MVA 6 years prior to the MVA August 26, 2015 (one year after MVA) Same deformities of T8, T9 and T10 with same location and magnitude of deformities on chest x- ray obtained 6 years prior to the MVA. Not related to the MVA in December
21 53 year-old male with chronic stiffness in mid thoracic spine. Chiropractor suspects DISH Courtesy of Dr. Rebecca Scott August 21,
22 Anterior vertebral squaring or barrelling with bridging syndesmophytes 22
23 Suggestive of seronegative spondyloarthropathy. Recommended lumbar study to confirm. Fusion of both sacroiliac joints. Syndesmophytes with anterior vertebral squaring. Facet fusion. 23
24 Findings are consistent with longstanding seronegative spondyloarthropathy. 24 year-old motorcross athlete Vertical impact on dirt bike. Approximately 40 feet. Complaining pain in mid thoracic. No neuro. Courtesy of Dr. Mark Symchych 24
25 Moderate anterior wedged deformities of T7, T8 and 9 with no obvious step defect or a zone of condensed trabeculae. These are associated with irregular endplates, osteophytosis and disc narrowing and a prominent thoracic kyphosis These findings are consistent with Scheuermann s disease An abrupt angulation of the right lateral vertebral border is seen at T9. In addition, there is a focal bulge of the left paraspinal soft tissue stripe. Frontal and lateral alignment of the thoracic vertebral bodies is maintained. The pedicles are intact on the frontal view. There is mild anterior wedging of the T7 vertebral body, height loss approximately 10%. There is moderate anterior wedging of the T8 and T9 vertebral bodies, height loss approximately 30-40%. Slight bowing of the posterior vertebral cortex of T9 suggests this may represent an acute injury. There is mild compression of the superior endplate T10, height loss less than 10%. As there are no prior studies for comparison, a CT may assist in further evaluation and confirmation. 25
26 26
27 27
28 Mild anterior wedge compression deformities of T8 and T9 are identified. Maximal loss of vertebral body height is estimated at 33% or less. I suspect that the compression injuries are remote in nature. No paravertebral soft tissue hematoma is identified, nor definite fracture line. Schmorl's nodes are identified from T6-T7 to T11-T12. Anterior marginal osteophyte is seen from T4-T5 to T9-T10. IMPRESSION: Remote, mild anterior wedge compression injury of the T8 and T9 vertebral bodies. There is no definite evidence for acute bony or facet injury. 28
29 An obvious step defect is seen at the right lateral vertebral body of T9 with a similar but more subtle cortical disruption on the left. Furthermore, a subtle zone of condensed trabeculae is seen beneath the T9 superior endplate Recent compression fracture of T9 with subtle cortical disruptions and a zone of condensed trabeculae in addition to the Scheuermann s disease involving T6 to T10 vertebral bodies. 28 year-old female with thoracic pain after a MVA. Chiropractor would like to know the age of the T6 compression fracture. Courtesy of Dr. Nejad February 26,
30 30
31 A bony deformity of T6 is visualized with opposing V-shaped endplates, slightly larger pedicles, anterior wedged deformity and wider interpediculate distance with kyphosis. No paraspinal soft tissue swelling is seen. A congenital butterfly vertebra at T6 with associated kyphosis. 42 year-old male with 4.5 months of mid thoracic pain. Started after landing from jumping up to shoot a basketball. Intense pain initially; now constant mid T/S pain (5-6/10). Tightness in chest. Pain with deep inspiration, lifting small objects and landing off curb. Minimal and temporary relief with physio and acupuncture. Feels better with traction exercise. X-ray 1 month after onset was read as normal. Courtesy of Dr. Melanie Lopes 31
32 Onset of symptom is July 23, Who would go head a give a trial of spinal manipulation? Give your reason. 2. Who would reassess the patient? Give your reason. 3. Who would re-x-ray? Give your reason. 4. What else would you do? Why? X-ray 1 month after onset of symptoms 32
33 X-ray 1 month after onset of symptoms Mild anterior wedged deformity of T5 vertebral body with indistinct cortical borders of the pedicles and inferior endplate. Minimal paraspinal soft tissue swelling lateral to T5. Mild anterior wedged deformity of T5 with indistinct pedicles and inferior endplate with mild left paraspinal soft tissue swelling. The findings are very suggestive of aggressive bony lesion such as lytic metastasis or plasmacytoma. Further imaging investigation such as a CT scan is recommended. 33
34 Dec. 11/15 T5 T10 Dec. 11/15 T5 T10 34
35 Dec. 11/15 T5 T10 35
36 Dec. 11/15 36
37 Plain films August 30/15 Second interpretation Dec. 10/15 Chiro phoned family GP Dec. 10/15 CT Dec. 11/15 MRI + Surgery Dec. 12/15 Histology from T5 pedicle/body plasma cells Diagnosis multiple myeloma Chemotherapy January, 2016 Solitary, monoclonal plasma cell tumor of bone or soft tissue, with no evidence of multiple myeloma (MM) elsewhere Often represent early (stage 1) MM Present with focal bone pain Conversion Convert to MM after radiation tx ~ 50% Extramedullar plasmacytoma: 36% conversion Median time to conversion is 2-3 years Demographic Mean age 55 ( younger than MM) Higher incidence in men and African Americans Most common skeletal site Vertebral body Pathological fracture is common May confuse with hemangioma 37
38 ~50% of bony destruction must occur before there are radiographic abnormalities 75% of patients with MM with have positive radiographic findings The presence of 2 clearly defined lytic lesions indicates high tumor burden and Stage III disease PET/CT has been found to aid in detection of unsuspected sites of medullary and extramedullary disease Treatment Isolated plasmacytoma without systemic MM Radiation therapy 2/3 of solitary plasmacytoma of bone have complete response 1/3 has partial Indolent course: median survival ~ 10 yrs When to reassess/when to image Trauma - seizure Range of motion significant loss Alcohol/smoking Unresponsive to care/unusual natural history/symptoms M Motor/sensory/reflexes A - Age 38
39 39
ESSENTIALS OF PLAIN FILM INTERPRETATION: SPINE DR ASIF SAIFUDDIN
ESSENTIALS OF PLAIN FILM INTERPRETATION: SPINE DR ASIF SAIFUDDIN Consultant Musculoskeletal Radiologist Royal National Orthopaedic Hospital Stanmore,UK. INTRODUCTION 2 INTRODUCTION 3 INTRODUCTION Spinal
More informationImaging of Trauma to the Spine. Orthopedic Diplomate Program University of Bridgeport College of Chiropractic
Imaging of Trauma to the Spine Orthopedic Diplomate Program University of Bridgeport College of Chiropractic Jefferson Fracture Yee, LL: The Jefferson Fracture, Radiology Cases in Pediatric Emergency Medicine.
More informationEpidemiology of Low back pain
Low Back Pain Definition Pain felt in your lower back may come from the spine, muscles, nerves, or other structures in that region. It may also radiate from other areas like the mid or upper back, a inguinal
More informationA Patient s Guide to Diffuse Idiopathic Skeletal Hyperostosis (DISH)
A Patient s Guide to Diffuse Idiopathic Skeletal Hyperostosis (DISH) 6565 Fannin Street Houston, TX 77030 Phone: 713-790-3333 DISCLAIMER: The information in this booklet is compiled from a variety of sources.
More informationCase Report: CASE REPORT OF FACET ARTHROPATHY INDUCED NERVE ROOT COMPRESSION RESULTING IN MOTOR WEAKNESS AND PAIN
Cox Technic Case Report #100 published at www.coxtechnic.com (sent October 2011 on 10/11/11 ) 1 Case Report: CASE REPORT OF FACET ARTHROPATHY INDUCED NERVE ROOT COMPRESSION RESULTING IN MOTOR WEAKNESS
More informationFunctional Anatomy and Exam of the Lumbar Spine. Thomas Hunkele MPT, ATC, NASM-PES,CES Coordinator of Rehabilitation
Functional Anatomy and Exam of the Lumbar Spine Thomas Hunkele MPT, ATC, NASM-PES,CES Coordinator of Rehabilitation Disclosure Anatomical Review Quick Review of Bony and Ligamentous structures Discal anatomy
More informationLUMBAR SPINAL STENOSIS
LUMBAR SPINAL STENOSIS Always occurs in the mobile segment. Factors play role in Stenosis Pre existing congenital or developmental narrowing of the lumbar spinal canal Translation of one anatomic segment
More informationImaging of Cervical Spine Trauma Tudor H Hughes, M.D.
Imaging of Cervical Spine Trauma Tudor H Hughes, M.D. General Considerations Most spinal fractures are due to a single episode of major trauma. Fatigue fractures of the spine are unusual except in the
More informationHidayatullah Hamidi. MD Consultant Radiologist. Lumbar Spine MR Imaging Interpretation
Hidayatullah Hamidi. MD Consultant Radiologist Lumbar Spine MR Imaging Interpretation 13/12/2018 Presenter Hidayatullah Hamidi Consultant Radiologist, Radiology PGME program director, FMIC, Kabul, Afghanistan
More informationOutline. Epidemiology Indications for C-spine imaging Modalities Interpretation Types of fractures
C-Spine Plain Films Outline Epidemiology Indications for C-spine imaging Modalities Interpretation Types of fractures Epidemiology 7000-10000 c-spine injuries treated each year Additional 5000 die at the
More informationREVIEW QUESTIONS ON VERTEBRAE, SPINAL CORD, SPINAL NERVES
REVIEW QUESTIONS ON VERTEBRAE, SPINAL CORD, SPINAL NERVES 1. A 28-year-old-women presented to the hospital emergency room with intense lower back spasms in the context of coughing during an upper respiratory
More informationObjectives. Comprehension of the common spine disorder
Objectives Comprehension of the common spine disorder Disc degeneration/hernia Spinal stenosis Common spinal deformity (Spondylolisthesis, Scoliosis) Osteoporotic fracture Destructive spinal lesions Anatomy
More informationCase Studies: Low Back Pain in the Athlete. Jim Messerly DO
Case Studies: Low Back Pain in the Athlete Jim Messerly DO Nothing to disclose Case #1 History 15 y/o male presents for evaluation of his low back pain. His pain has been present for several months. The
More informationSpine. Neuroradiology. Spine. Spine Pathology. Distribution of fractures. Radiological algorithm. Role of radiology 18/11/2015
Spine Neuroradiology Spine Prof.Dr.Nail Bulakbaşı X Ray: AP/L/Oblique Vertebra & disc spaces CT & CTA Vertebra, discs, vessels MRI & MRA Vertebra, disc, vessels, meninges Spinal cord & nerves Myelography
More informationRad Lab 6 Unknowns: Musculoskeletal
Rad Lab 6 Unknowns: Musculoskeletal Peter Clarke MD Associate Clerkship Director for Radiology Harvard Medical School Brigham and Women s Hospital Dana Farber Cancer Institute Here are two men, one 70,
More informationSCIWORA Rozlyn McTeer BSN, RN, CEN Pediatric Trauma Coordinator Trauma Services OBJECTIVES DEFINITION 11/8/2017. Identify SCIWORA.
SCIWORA Rozlyn McTeer BSN, RN, CEN Pediatric Trauma Coordinator Trauma Services Identify SCIWORA. OBJECTIVES Identify the population at risk. To identify anatomic and physiologic reasons for SCIWORA. To
More informationEVALUATE, TREAT AND WHEN TO REFER RED FLAGS Mid Atlantic Occupational Regional Conference and Environmental Medicine October 6, 2018
EVALUATE, TREAT AND WHEN TO REFER RED FLAGS Mid Atlantic Occupational Regional Conference and Environmental Medicine October 6, 2018 Marc J. Levine, MD Rothman Institute Director Spine Surgery Program
More informationCox Technic Case Report #169 published at (sent 5/9/17) 1
Cox Technic Case Report #169 published at www.coxtechnic.com (sent 5/9/17) 1 Management of Lumbar Radiculopathy Associated with an Extruded L4 L5 disc and concurrent L5 S1 Spondylolytic Spondylolisthesis
More information102 Results RESULTS. Age Mean=S.D Range 42= years -84 years Number % <30 years years >50 years
102 Results RESULTS A total of 50 cases were studied 39 males and 11females.Their age ranged between 16 years and 84 years (mean 42years). T1 and T2WI were acquired for all cases in sagittal and axial
More informationSPINAL PSEUDOARTHROSIS
485 RDIOLOGIC VIGNETTE NO. 3 SPINL PSEUDORTHROSIS COMPLICTION OF NKYLOSING SPONDYLITIS WILLIM MRTEL Fracture of the cervical spine is a recognized complication of advanced ankylosing spondylitis ( 1 ).
More informationIntroduction to Neuroimaging spine. John J. McCormick MD
Introduction to Neuroimaging spine John J. McCormick MD Neuroanatomy Netter drawings Radiographic Anatomy Cervical Spine Cervical Spine Oblique View Cervical Spine Dens View Thoracic Spine Lumbar Spine
More informationLecture 1 Thoracic Spine
Lecture 1 Thoracic Spine Functional Overview Protects organs e.g. Heart and lungs Limited motion: relatively rigid structure Soft tissue injuries related to: o Sports e.g. Golf, tennis, rowing and cricket
More informationUpper Cervical Spine - Occult Injury and Trigger for CT Exam
Upper Cervical Spine - Occult Injury and Trigger for CT Exam Main Menu Introduction Clinical clearance of C-SpineC Radiographic evaluation Norms for C-spineC Triggers for CT exam: Odontoid Lateral view
More informationSubaxial Cervical Spine Trauma
Subaxial Cervical Spine Trauma Pooria Salari, MD Assistant Professor Of Orthopaedics Department of Orthopaedic Surgery St. Louis University School of Medicine St. Louis, Missouri, USA Initial Evaluation
More informationCase Studies, Impairment of the Spine in Washington State
Case Studies, Impairment of the Spine in Washington State NAOEM at Skamania, 2015 25 Sep, 2015 Tim Gilmore, MD Several Slides from this Presentation Borrowed with permission from the Washington State Department
More informationFISH VERTEBRAE RADIOLOGIC VIGNETTE DONALD L. RESNICK
~ 1073 RADIOLOGIC VIGNETTE FISH VERTEBRAE DONALD L. RESNICK The term fish verfebru is applied to a vertebral body that has an abnormal shape characterized by biconcavity due to depression of its superior
More information1 Normal Anatomy and Variants
1 Normal Anatomy and Variants 1.1 Normal Anatomy MR Technique. e standard MR protocol for a routine evaluation of the spine always comprises imaging in sagittal and axial planes, while coronal images are
More informationCox Technic Case Report #173 published at (sent 9/12/17) 1
Cox Technic Case Report #173 published at www.coxtechnic.com (sent 9/12/17) 1 CASE REPORT: CLINICAL PRESENTATION OF A THORACIC DISC PROTRUSION, CERVICAL SPONDYLOSIS, AND SCOLIOSIS IN A 50 YEAR OLD PROFESSIONAL
More informationPrimary care referral criteria for musculoskeletal MRI scans
Appendix 1 Primary care referral criteria for musculoskeletal MRI scans Accepted Criteria for Direct Access MRI Body Part Symptoms Imaging indicated Lumbar Spine Low Back Pain with adverse symptoms or
More informationFractures of the thoracic and lumbar spine and thoracolumbar transition
Most spinal column injuries occur in the thoracolumbar transition, the area between the lower thoracic spine and the upper lumbar spine; over half of all vertebral fractures involve the 12 th thoracic
More informationSubaxial Cervical Spine Trauma. Introduction. Anatomic Considerations 7/23/2018
Subaxial Cervical Spine Trauma Sheyan J. Armaghani, MD Florida Orthopedic Institute Assistant Professor USF Dept of Orthopedics Introduction Trauma to the cervical spine accounts for 5 of all spine injuries
More informationComprehension of the common spine disorder.
Objectives Comprehension of the common spine disorder. Disc degeneration/hernia. Spinal stenosis. Common spinal deformity (Spondylolisthesis, Scoliosis). Osteoporotic fracture. Anatomy Anatomy Anatomy
More informationRADICULOPATHY AN INTRODUCTION TO
AN INTRODUCTION TO RADICULOPATHY This booklet provides general information on radiculopathy. It is not meant to replace any personal conversations that you might wish to have with your physician or other
More informationDo you want to be an excellent Radiologist? - Focus on the thoracic aorta on lateral chest image!!!
The lateral chest radiograph: Challenging area around the thoracic aorta!!! Do you want to be an excellent Radiologist? - Focus on the thoracic aorta on lateral chest image!!! Dong Yoon Han 1, So Youn
More information4/28/2010. Fractures. Normal Bone and Normal Ossification Bone Terms. Epiphysis Epiphyseal Plate (physis) Metaphysis
Fractures Normal Bone and Normal Ossification Bone Terms Epiphysis Epiphyseal Plate (physis) Metaphysis Diaphysis 1 Fracture Classifications A. Longitudinal B. Transverse C. Oblique D. Spiral E. Incomplete
More informationCervical Spine in Baseball
Cervical Spine in Baseball Robert G Watkins, IV, MD Co-Director, Marina Spine Center Marina del Rey, CA Vice Chief of Staff Cedars-Marina del Rey Hospital Disclosures n Pioneer / RTI Consulting, Royalties
More informationVertebral and Paravertebral Diseases
Department of Radiology University of California San Diego Vertebral and Paravertebral Diseases John R. Hesselink, M.D. Vertebral / Paravertebral Disease (Extradural) Metastatic disease Primary bone tumors
More informationProperties of Purdue. Anatomy. Positioning AXIAL SKELETAL RADIOLOGY FOR PRIVATE PRACTITIONERS 11/30/2018
AXIAL SKELETAL RADIOLOGY FOR PRIVATE PRACTITIONERS Anatomy Complex Text book is needed Species Contrast Positioning Painful/ non cooperative Sedation General anesthesia Species Contrast 1 Slightly oblique
More informationChapter 2 Diagnostic Algorithms. 3 Thoracic Spine Pain Algorithm
Chapter 2 Diagnostic Algorithms 3 Thoracic Spine Pain Algorithm Date revised 2/4/03 Thoracic Spine Pain Algorithm THORACIC SPINE PAIN - ALGORITHM Thoracic spine radiographs for evaluation of spinal infection.
More informationBEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. F ROSA CORTEZ CLAIMANT BRIGHTON HOUSE CARE CENTER OPINION FILED MAY 28, 2004
BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. F309834 ROSA CORTEZ CLAIMANT BRIGHTON HOUSE CARE CENTER ARKANSAS SELF INSURED INSURANCE CARRIER RESPONDENT RESPONDENT OPINION FILED MAY 28,
More informationTOP RYDE CHIROPRACTIC
1. Ankle Pain Conditions Helped by Chiropractic The ankle joint is made up of ligaments, tendons, nerves, and a disc to cushion motion. Distortions of motion of the ankle can strain the ligaments and muscles
More informationChapter 2 Diagnostic Algorithms. 4 Traumatic Neck Pain Algorithm
Chapter 2 Diagnostic Algorithms 4 Traumatic Neck Pain Algorithm Patient presents with a traumatic onset of neck pain. In general, radiographs should be ordered with a history of recent, significant trauma.
More informationSPINAL MAGNETIC RESONANCE IMAGING INTERPRETATION
CLINICAL VIGNETTE 2017; 3:2 SPINAL MAGNETIC RESONANCE IMAGING INTERPRETATION Editor-in-Chief: Idowu, Olufemi E. Neurological surgery Division, Department of Surgery, LASUCOM/LASUTH, Ikeja, Lagos, Nigeria.
More informationSpinal infection. Outline ANATOMY 6/2/2017. Anatomy Pathogen
Outline Spinal infection Pramot Tanutit, M.D. Department of Radiology, Songklanagarind Hospital Faculty of Medicine, Prince of Songkla University Anatomy Pathogen Pyogenic spondylodiscitis Tuberculous
More informationFractures of the Thoracic and Lumbar Spine
A spinal fracture is a serious injury. Nader M. Hebela, MD Fellow of the American Academy of Orthopaedic Surgeons http://orthodoc.aaos.org/hebela Cleveland Clinic Abu Dhabi Cleveland Clinic Abu Dhabi Neurological
More informationIt consist of two components: the outer, laminar fibrous container (or annulus), and the inner, semifluid mass (the nucleus pulposus).
Lumbar Spine The lumbar vertebrae are the last five vertebrae of the vertebral column. They are particularly large and heavy when compared with the vertebrae of the cervical or thoracicc spine. Their bodies
More informationHISTORY AND CHIEF COMPLAINT:
submitted by Keith M. Bartley, D.C. Jasper, IN 07/21/11 presented at Cox Seminar in Nashville, TN, on October 8 9, 2011 HISTORY AND CHIEF COMPLAINT: 01/21/11 55 year old male press operator for Jasper
More informationCommon fracture & dislocation of the cervical spine. Theerachai Apivatthakakul Department of Orthopaedic Chiangmai University
Common fracture & dislocation of the cervical spine Theerachai Apivatthakakul Department of Orthopaedic Chiangmai University Objective Anatomy Mechanism and type of injury PE.and radiographic evaluation
More information405 Firemans Ave LaVale, Maryland 21502
Dec 19, 2016 CHIEF COMPLAINT: Iris presents with a chief complaint involving her lower lumbar and sacral region, left sacroiliac region and left anterior hip and groin. ONSET OF SYMPTOMS Iris states this
More informationMUSCULOSKELETAL RADIOLOGY
MUSCULOSKELETAL RADOLOGY SECTON www.cambridge.org Achilles tendonopathy/rupture Characteristics Describes pathology of the combined tendon of the gastro-soleus complex, which inserts onto the calcaneum.
More informationRiver North Pain Management Consultants, S.C., Axel Vargas, M.D., Regional Anesthesiology and Interventional Pain Management.
River North Pain Management Consultants, S.C., Axel Vargas, M.D., Regional Anesthesiology and Interventional Pain Management. Chicago, Illinois, 60611 Phone: (888) 951-6471 Fax: (888) 961-6471 Clinical
More informationGillian Wooldridge, DO Houston Methodist Willowbrook Hospital Primary Care Sports Medicine Fellowship May 3, 2018
Gillian Wooldridge, DO Houston Methodist Willowbrook Hospital Primary Care Sports Medicine Fellowship May 3, 2018 Disclosures Neither I nor any family members have financial disclosures Special thanks
More informationfactor for identifying unstable thoracolumbar fractures. There are clinical and radiological criteria
NMJ-Vol :2/ Issue:1/ Jan June 2013 Case Report Medical Sciences Progressive subluxation of thoracic wedge compression fracture with unidentified PLC injury Dr.Thalluri.Gopala krishnaiah* Dr.Voleti.Surya
More informationSUBAXIAL CERVICAL SPINE TRAUMA- DIAGNOSIS AND MANAGEMENT
SUBAXIAL CERVICAL SPINE TRAUMA- DIAGNOSIS AND MANAGEMENT 1 Anatomy 3 columns- Anterior, middle and Posterior Anterior- ALL, Anterior 2/3 rd body & disc. Middle- Posterior 1/3 rd of body & disc, PLL Posterior-
More informationFunctional Orthopedic Imaging Capturing Motion, Flow and Perfusion. Case Study Brochure Centre University Hospital Nancy.
Capturing Motion, Flow and Perfusion dynamic volume CT Case Study Brochure Centre University Hospital Nancy http://www.toshibamedicalsystems.com Toshiba Medical Systems Corporation 2013. All rights reserved.
More information8/4/2012. Causes and Cures. Nucleus pulposus. Annulus fibrosis. Vertebral end plate % water. Deforms under pressure
Causes and Cures Intervertebral discs Facet (zygopophyseal) joints Inter body joints Spinal nerve roots Nerve compression Pathological conditions Video Causes of back pain Nucleus pulposus Annulus fibrosis
More informationA Patient s Guide to Back Pain in Children
A Patient s Guide to Back Pain in Children 2350 Royal Boulevard Suite 200 Elgin, IL 60123 Phone: 847.931.5300 Fax: 847.931.9072 DISCLAIMER: The information in this booklet is compiled from a variety of
More informationRegional Review of Musculoskeletal System: Head, Neck, and Cervical Spine Presented by Michael L. Fink, PT, DSc, SCS, OCS Pre- Chapter Case Study
Regional Review of Musculoskeletal System: Presented by Michael L. Fink, PT, DSc, SCS, OCS (20 minutes CEU Time) Subjective A 43-year-old male, reported a sudden onset of left-sided neck and upper extremity
More informationThe imaging features of spondylolisthesis : what the clinician needs to know
The imaging features of spondylolisthesis : what the clinician needs to know Poster No.: C-1018 Congress: ECR 2011 Type: Authors: Educational Exhibit D. Shah 1, C. J. Burke 1, A. C. andi 2, R. Houghton
More informationNeck Pain: Help! Eric M. Massicotte, MD, MSc, MBA, FRCSC Associate Professor University of Toronto
Neck Pain: Help! Eric M. Massicotte, MD, MSc, MBA, FRCSC Associate Professor University of Toronto Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be reproduced, copied,
More informationSpineFAQs. Lumbar Spondylolisthesis
SpineFAQs Lumbar Spondylolisthesis Normally, the bones of the spine (the vertebrae) stand neatly stacked on top of one another. The ligaments and joints support the spine. Spondylolisthesis alters the
More informationASJ. A Rare Hyperextension Injury in Thoracic Spine Presenting with Delayed Paraplegia. Asian Spine Journal. Introduction
sian Spine Journal 126 Dong-Eun Case Shin Report et al. http://dx.doi.org/10.4184/asj.2013.7.2.126 Rare Hyperextension Injury in Thoracic Spine Presenting with Delayed Paraplegia Dong-Eun Shin, Ki-Sik
More informationOMT for the ACOFP Boards: A Review of Clinical and Basic Information
OMT for the ACOFP Boards: A Review of Clinical and Basic Information Kevin D. Treffer, D.O., FACOFP Associate Professor, Department of OMM and Primary Care Interim Chair, Department of OMM Kansas City
More informationMusculoskeletal Development and Sports Injuries in Pediatric Patients
Dynamic Chiropractic October 21, 2010, Vol. 28, Issue 22 Musculoskeletal Development and Sports Injuries in Pediatric Patients By Deborah Pate, DC, DACBR Physical activity is extremely important for everyone,
More informationInduction and Maintenance of Lordosis in MultiLevel ACDF Using Allograft. Saad Khairi, MD Jennifer Murphy Robert S. Pashman, MD
Induction and Maintenance of Lordosis in MultiLevel ACDF Using Allograft Saad Khairi, MD Jennifer Murphy Robert S. Pashman, MD Purpose Is lordosis induced by multilevel cortical allograft ACDF placed on
More informationRETROLISTHESIS. Retrolisthesis. is found mainly in the cervical spine and lumbar region but can also be often seen in the thoracic spine
RETROLISTHESIS A retrolisthesis is a posterior displacement of one vertebral body with respect to adjacent vertebrae Typically a vertebra is to be in retrolisthesis position when it translates backward
More informationRadiology of Cervical Spine Trauma. Cervical Spine Trauma. Imaging Standards. Canadian C. Spine Rule 11/28/2016
Radiology of Cervical Spine Trauma Dr. Steven J. Gould, D.C. Board Certified Chiropractic Radiologist Cleveland Chiropractic College, KC. MO. Radiology Residency at CCC, KC Cervical Spine Trauma Vertebral
More informationMEDICAL IMAGING OF THE VERTEBRAE
MEDICAL IMAGING OF THE VERTEBRAE Vertebrae are your friends Matthew Harper MS-IV LECTURE OBJECTIVES INTRODUCE THE MOST COMMON MODALITIES OF MEDICAL IMAGING AND BASIC TECHNIQUES FOR READING THESE IMAGES
More informationSuspecting Tumors, or Could it be cancer?
Suspecting Tumors, or Could it be cancer? Donna E. Reece, M.D. Princess Margaret Cancer Centre University Health Network Toronto, ON CANADA 07 February 2018 Background Low back pain is common However,
More informationNational Imaging Associates, Inc. Clinical guidelines
National Imaging Associates, Inc. Clinical guidelines Original Date: September 1997 THORACIC SPINE CT Page 1 of 5 CPT Codes: 72128, 72129, 72130 Last Review Date: May 2013 Guideline Number: NIA_CG_043
More informationMRI findings in proven Mycobacterium tuberculosis (TB) spondylitis
CASE ORIGINAL REPORT ARTICLE MRI findings in proven Mycobacterium tuberculosis (TB) spondylitis D J Kotzé, MB ChB L J Erasmus, MB ChB Department of Diagnostic Radiology, University of the Free State, Bloemfontein
More informationContiguous Spinal Metastasis Mimicking Infectious Spondylodiscitis 감염성척추염과유사하게보였던연속적척추전이의증례
Case Report pissn 1738-2637 / eissn 2288-2928 http://dx.doi.org/10.3348/jksr.2015.73.6.408 감염성척추염과유사하게보였던연속적척추전이의증례 Chul-Min Lee, MD 1, Seunghun Lee, MD 1 *, Jiyoon Bae, MD 2 1 Department of Radiology,
More informationThe vault bones Frontal Parietals Occiput Temporals Sphenoid Ethmoid
The Vertebral Column Head, Neck and Spine Bones of the head Some consider the bones of the head in terms of the vault bones and the facial bones hanging off the front of them The vault bones Frontal Parietals
More information3D titanium interbody fusion cages sharx. White Paper
3D titanium interbody fusion cages sharx (SLM selective laser melted) Goal of the study: Does the sharx intervertebral cage due to innovative material, new design, and lordotic shape solve some problems
More informationChance Fracture Joseph Junewick, MD FACR
Chance Fracture Joseph Junewick, MD FACR 08/02/2010 History Restrained teenager involved in motor vehicle accident. Diagnosis Chance Fracture (Hyperflexion-Distraction Injury) Discussion Chance-type spinal
More informationFrancine M. Pulver, MD, Clinical Assistant Professor Department of Physical Medicine & Rehabilitation Ohio State University Medical Center
Oh My Aching Back! Francine M. Pulver, MD, Clinical Assistant Professor Department of Physical Medicine & Rehabilitation Ohio State University Medical Center Epidemiology 90% of episodes of LBP resolves
More informationAnkylosing spondylitis: A Pictorial Review
Ankylosing spondylitis: A Pictorial Review Poster No.: P-0009 Congress: ESSR 2012 Type: Scientific Exhibit Authors: J. Acosta Batlle, B. Palomino Aguado, M. D. Lopez Parra, S. 1 2 3 2 4 1 2 Hernandez Muñiz,
More informationthe back book Your Guide to a Healthy Back
the back book Your Guide to a Healthy Back anatomy Your spine s job is to: Support your upper body and neck Increase flexibility of your spine Protect your spinal cord There are 6 primary components of
More informationCERVICAL SPINE: Radiographs and MRI Cases
www.jprad.com Radiology reports with recommendations & clinical information - $30 per region, x-ray - $50 per MRI - Medpay Monthly Newsletter 700 East Redlands Blvd, Redlands CA 92373 909.353.9348 jpedley299@yahoo.com
More informationThoracolumbar Spine Fractures
Thoracolumbar Spine Fractures C. Craig Blackmore, MD, MPH Professor of Radiology Adjunct Professor of Health Services Harborview Injury Prevention and Research Center University of Washington Outline Who
More informationUniversity of Groningen. Thoracolumbar spinal fractures Leferink, Vincentius Johannes Maria
University of Groningen Thoracolumbar spinal fractures Leferink, Vincentius Johannes Maria IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from
More informationCervical Spine: Pearls and Pitfalls
Cervical Spine: Pearls and Pitfalls Presenters Dr. Rob Donkin Functional Anatomy Current research Cervical Radiculopathy Dr. Gert Ferreira Red flags Case Study Kinesio Taping Chris Neethling Gonstead adjusting
More informationPOSTERIOR CERVICAL FUSION
AN INTRODUCTION TO PCF POSTERIOR CERVICAL FUSION This booklet provides general information on the Posterior Cervical Fusion (PCF) surgical procedure for you to discuss with your physician. It is not meant
More informationLumbar Disc Prolapse. Dr. Ahmed Salah Eldin Hassan. Professor of Neurosurgery & Consultant spinal surgeon
Lumbar Disc Prolapse By Dr. Ahmed Salah Eldin Hassan Professor of Neurosurgery & Consultant spinal surgeon 1-What are the Functions of the Spine Structural support for upright posture Protection of Spinal
More informationOsteoporosis. Dr. C. C. Visser. MBChB MMed (Med Phys) Diploma Musculoskeletal Medicine (UK) Member: Society of Orthopaedic Medicine (UK)
Osteoporosis Dr. C. C. Visser MBChB MMed (Med Phys) Diploma Musculoskeletal Medicine (UK) Member: Society of Orthopaedic Medicine (UK) Effect of age on trabecular bone. Fatfree dry bone cylinders obtained
More informationSigns of Nature in Spine Radiology
Open Access Review Article DOI: 10.7759/cureus.2456 Signs of Nature in Spine Radiology MN Baig 1, Fergus Byrne 2, A Devitt 3, J P. McCabe 3 1. Trauma & Orthopaedic Surgery, Galway University Hospital,
More informationPhysical and Radiographic Examination of the Spine
Physical and Radiographic Examination of the Spine Christopher M. Bono, MD Assistant Professor, Department of Orthopaedic Surgery Boston University School of Medicine, Boston Medical Center, Boston, MA
More informationDaniel J. Blizzard, MD, MS
Daniel J. Blizzard, MD, MS None Common degenerative (usually) condition caused by compression on the spinal cord that is characterized by clumsiness and difficulty with fine motor tasks in the hands and
More informationSpine Conditions and Treatments. Your Guide to Common
Your Guide to Common Spine Conditions and Treatments The spine is made up of your neck and backbone. It allows your body to bend and move freely. As you get older, it is normal to have aches and pains.
More informationACDF. Anterior Cervical Discectomy and Fusion. An introduction to
An introduction to ACDF Anterior Cervical Discectomy and Fusion This booklet provides general information on ACDF. It is not meant to replace any personal conversations that you might wish to have with
More informationAnnotations Part III Vertebral Fracture Initiative. International Osteoporosis Foundation March 2011
Annotations Part III Vertebral Fracture Initiative International Osteoporosis Foundation March 2011 Slide 1-3 Topics to be covered: What is vertebral fracture assessment? How does VFA compare to standard
More information3/10/17 Spinal a Injury 1
Spinal Injury 1 'Paralysed' Watmough vows he'll have the backbone for Game Two after treatment for neck injury Watmough will have cortisone injected into his spine this morning to speed up the recovery
More informationDifferential Diagnosis: Visceral Conditions Ruled Out
Regional Review of Musculoskeletal System: Presented by Michael L. Fink, PT, DSc, SCS, OCS Chapter 2: Thoracic Spine Differential Diagnosis: Visceral Conditions Ruled Out Ruled Out Early in the Examination
More informationProDisc-L Total Disc Replacement. IDE Clinical Study.
ProDisc-L Total Disc Replacement. IDE Clinical Study. A multi-center, prospective, randomized clinical trial. Instruments and implants approved by the AO Foundation Table of Contents Indications, Contraindications
More informationAxial Skeleton: Vertebrae and Thorax
Axial Skeleton: Vertebrae and Thorax Function of the vertebral column (spine or backbone): 1) 2) 3) Composition of Vertebral column The vertebral column is formed by 33 individual vertebrae (some of which
More informationAm I eligible for the TOPS study? Possibly, if you suffer from one or more of the following conditions:
Am I eligible for the TOPS study? Possibly, if you suffer from one or more of the following conditions: Radiating leg pain Greater leg / buttock pain than back pain Severe pain sets in when walking as
More informationSpine Pain Management Program
Spine Pain Management Program Please complete the following information: Patient Name: Patient ID Number: Patient DOB: The procedure being requested: Facet Injection Please check the indication (reason)
More informationRN(EC) ENC(C) GNC(C) MN ACNP *** MECHANISM OF INJURY.. MOST IMPORTANT ***
HISTORY *** MECHANISM OF INJURY.. MOST IMPORTANT *** Age of patient - Certain conditions are more prevalent in particular age groups (Hip pain in children may refer to the knee from Legg-Calve-Perthes
More informationL5 S1 Extruded Disc Relieved with Cox Technic Decompression Spinal Adjusting
1 L5 S1 Extruded Disc Relieved with Cox Technic Decompression Spinal Adjusting submitted by Joseph d'angiolillo DC 11 Clyde Road, Suite 103 Somerset, NJ 08873 (732) 873 2222 This is a case study of a patient
More informationModule: #15 Lumbar Spine Fusion. Author(s): Jenni Buckley, PhD. Date Created: March 27 th, Last Updated:
Module: #15 Lumbar Spine Fusion Author(s): Jenni Buckley, PhD Date Created: March 27 th, 2011 Last Updated: Summary: Students will perform a single level lumbar spine fusion to treat lumbar spinal stenosis.
More information