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53 Cards in this Set
- Front
- Back
If multiple lesions are seen of the spine that are non-contiguous what is in more lilkely; infectious, neoplastic, osteoportotic
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neoplastic
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When looking at a post contrast images what should you compare with
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the precontrast to see if there is a visible mass that is present that might be enhancing
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If there is posterior element involvement what is the most likely causse; infectious, neoplastic, osteoportotic
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neoplastic
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If there is involvement of the ligamentous what is the most likely cause;infectious, neoplastic, osteoportotic
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infectious such as osteomyelitis
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Does the disc always enhance in osteomyelitis
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no
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If all the marrow of a compression fracture is abnormal what does that tell you about the etiology of the fracture
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that is most likely related to infection bc in osteoporotoic compression fractures there is often a component that is not abnormal
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What is the brighter on a T1 MR; vetebral body or disc
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vetebral body and the disc is dark
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What happens to the vetebral body in a compression fracture
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it will become darker on T1 (infection is more likely to make it homogenously dark where an osteoporotic compression fracture is more likely to have a component of normal appearing vetebral body)
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Does a neoplastic process of the spine tend to affect the anterior longitudinal ligament
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no, but sometimes lymphoma does
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What are two tumors that may cause an expansile lesion of the vetebral body
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renal and plasmacytoma
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What is it called when a compression fracture moves posterior into the spinal canal
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retropulsion
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Can RA cause a fluid collection (bright signal on T2 ) infront of the odontoid
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yes
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What should be done if you are unsure if a compression fracture is secondary to infection or osteoporosis what should be done
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biopsy
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What is the best technique to dermine if bright signal on T1 is due to tumor or fat
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fat sat sequence
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What is the ddx for drop mets that looks like multiple nodules surrounding the spinal cord
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normal pial vessels on post contrast (if you wait 20 min and reimage the mets will still be there and the vessels will wash out)
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What is the normal location of pial vessels
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12 and 6 oclock
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Can lymphoma invade the neuroforaminal canal
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yes
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Where do older people tend to get AVMs of the spine
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spinal (pia)- dural fistulas
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When do intramedullary AVMs occur
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these are typically congenital
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Are intramedullary AVMs worrisome
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yes, they are at risk of bleeding
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What is the cause of conus edema and multiple dilated vessels in the subarachnoid space
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spinal dural fistula (extramedullary AVM)
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What is a cause of venous hypertension of the cord
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spinal dural fistula
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Can an LP create an epidermoid
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yes
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What is the ddx of a cerebellar pontine angle lesion
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epidermoid
dermoid arachnoid cyst schwannoma lipoma melanoma aneurysm |
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What are the MR characteristics of an epidermoid
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T1-dark
T2-bright no enhancement DWI- bright |
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What are the MR characteristics of a arachnoid cyst
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T1-dark
T2-bright no enhancement DWI- dark or isointense |
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Are dermoids fat containing and therefore bright on T1
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yes
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Do dermoids contain calcium
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yes
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What are the MR characteristics of a schwwanoma
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T1-dark
T2-bright enhances |
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What is the ddx of congenital scoliosis
7 |
chiari malformation
hydromyelia segmental anomalies diastematomyelia tethered cord lipoma meningoclees |
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what is diastematomyelia
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is a congenital disorder in which a part of the spinal cord is split, usually at the level of the upper lumbar vertebra.
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Do pt with diastematomyelia have abnormal bony component
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yes, this condition occurs in the presence of an osseous (bone), cartilaginous or fibrous septum in the central portion of the spinal canal which then produces a complete or incomplete sagittal division of the spinal cord into two hemicords.
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Chiari 1; say 2 things
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low cerebellar tonsil
syrinx |
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What is a syrinx that is located in the center of the cord
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hydromyelia
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Can a syrinx occur following trauma or from a tumor or arachnoiditis
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yes, it is called syringomyelia
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What is a term used to describe both a hydromyelia and syringomyelia
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syringohydromyelia (bc sometimes they are undistinguishable)
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What does chiari 1 result in
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dilation of the central canal (hydromyelia)
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What is a myelocoele
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just neural tissue sticking out posteriorly
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What is a myelomeningocele
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CSF, neuro tissue and menininges
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How do you tell the difference btwn a myelocele and a myelomeningocele
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On T2 imaging the CSF will be bright and seen posteriorly where as in a myelocele that will not be seen
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What is a ddx of a myelomenigocele
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a lipoma
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What are 3 different types of spinal lipomas
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intradural lipoma
lipomyelocele lipomyelomeningocele |
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A hypodense lesion on T1 and hyperdense lesion on T2 located centrally within the spinal cord following trauma is most likely what
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a syrinx
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Can you get a spinal concussion
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yes, this can be the result of trauma that causes temporary paralysis and no radiographic findings
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What is the best way to see a small hemorrhage of the spinal cord
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GRE
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What is the differential of acute injury of the spine
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concussion of spine (stinger) sometimes with no radiographic findings
contusion with or without hemorrhage transection |
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What is the ddx of traumatic injury that results in chronic changes
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cystic myelomalacia
syrinx scoliosis? |
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What is another name for myelomalacia
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gliosis
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What is a potetial complication of a jumped facet
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disc extrussion
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Why is disc extrusion so problematic with jumped facet
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because if closed reduction of the jumped facet is done if can cause the disc to be pushed back into the spinal cord and cause paralysis
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When is a jumped facet seen most obviously
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on axial imaging
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What type of hematoma of the spine is more common; epidural or subdural
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epidural
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What is a major cause of an epidural hematoma of the spine
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LP and myelograms (especially if the pt is on coumadin)
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