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Unformatted text preview: NORMAL RADIOGRAPHIC ANATOMY II ANATOMY DR. JILL BRADSHAW CONGENITAL ANOMALIES ANOMALIES OCCIPITALIZATION OCCIPITALIZATION Description: fusion of atlas with the occipital bone Description: (sometimes referred to as the “most cephalic blocked vertebra” vertebra” Children: usually asymptomatic Older children/young adults: (due to compression of Older the medulla oblongata or the proximal spinal cord) the Headaches, decreased range of motion, visual and auditory Headaches, abnormalities, and neural manifestations of the upper extremities extremities Occipitalization (continued) Occipitalization Practice: next protocol would be a flexion and Practice: extension study extension In a board situation: look where the atlas meets In the occiput PLATYBASIA PLATYBASIA Description: flattening of the sphenoid and/or Description: the occiput the Determined by: lines of mensuration called Determined “Martin’s Basilar Angle” “Martin’s Normal range: 123-152 greater than 152 Normal degrees indicated Platybasia degrees Some consider aka with Basilar impression SPINA BIFIDA OCCULTA SPINA Description: small opening due to failure of Description: fusion of the lamina fusion NO clinical significance No symptoms Does not effect treatment of patient Often shows up on board exams SPINA BIFIDA VERA SPINA Description: larger defect with no protection of Description: the spinal cord. This may allow protrusion of the meninges and/or cord the Thought of origin: deficiency of folic acid in Thought the 1st trimester the Usually associated with other congenital Usually anomalies anomalies Usually surgically dealt with early POSTERIOR SPONDYLOSCHISIS POSTERIOR Description: non union of the posterior arch of Description: atlas atlas Considered a contra indication for some upper Considered cervical adjustments cervical On lateral view: missing spinolaminar junction On line line Best view: A-P open mouth view will see the Best small gap small BLOCKED VERTEBRA BLOCKED Description: two or more segments joined Description: together together 2 types Acquired blocked vertebra: done surgically Congenital blocked vertebra: fusion from birth Look for “wasp waist” or concavity on the anterior Look aspect of the vertebral bodies aspect POSTERIOR PONTICUS POSTERIOR Description: calcification of the oblique Description: portion of the atlanto-occipital ligament (across posterior arch to the back of the lateral mass) mass) Forms an arcuate foramen Seen in 14% of population Vascular test may help to eliminate possible Vascular vascular accidents during an adjustment vascular CERVICAL RIB CERVICAL Description: a separate piece of bone that Description: articulates with the transverse process of cervical vertebra and is present in 0.5% of the population population Differentiate: With an elongation of the transverse process Joint space With rudimentary 1st thoracic rib Transverse process point up or down SCHMORL’S NODE SCHMORL’S Description: nucleus pulposus herniates through the Description: vertebral endplate vertebral Triad of features: Usually occur on the anterosuperior 2/3 of body Decreased disc space Increased A-P body distance Differentiate with Nuclear Impression Schmorl’s: looks like pencil eraser pushed through Schmorl’s: endplate endplate Nuclear I: smooth depression that involves entire endplate TRANSITION VERTEBRAE TRANSITION Description: the segment takes on Description: characteristics of another area characteristics Most common area is the lumbosacral Old terms: sacralization and lumbarization Most important to realize that the Most biomechanics is different biomechanics LIMBUS BONE LIMBUS Description: migration and herniation of the Description: nuclear material through the secondary growth center of the vertebral body center Results in non-union of the secondary growth Results center center Differentiate with fracture (avulsion type) Practice: case history and presentation is key Boards: look at edges of the bone KNIFE CLASP KNIFE Description: spina bifida of the 1st sacral segment with enlarged spinous process of L-5 segment Usually asymptomatic until adult Severe stabbing pain BUTTERFLY VERTEBRA BUTTERFLY Description: two triangular pieces with the Description: spinous process has the appearance of a butterfly butterfly Seen on the A-P view Various theories of what is genetically is Various occurring occurring HEMIVERTEBRA HEMIVERTEBRA Descriptions: triangular deformity of the body 3 types Lateral hemivertebra: most common, seen on A-P Lateral view view Dorsal hemivertebra: (posterior aspect of vertebral Dorsal body is present), seen on lateral view body Ventral hemivertebra: (anterior aspect of vertebral Ventral body is present, seen on lateral view body Causes structural scoliosis (look at the apex) ...
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