Spine Imaging

Spine Imaging

By
Dr. Firas Abdullah
Thiqar college of medicine

Aims of our lecture:

 To know the different radiological techniques used in
spine imaging
 To know the signs of abnormality seen at spine
 To discuss some spinal pathologies

I) Radiological techniques used in

spine imaging:
 Plain X ray
 MRI
 Radionuclide bone scanning
 CT scan
 Myelography

Plain X ray

MRI

II) Signs of abnormality:

 Disc space narrowing:
 Collapse of vertebral bodies: most easily appreciated on
plain lateral radiographs of the spine , look to the
adjacent disc and pedicle. Common causes include:
❖ Metastases and myeloma .
❖ Infection
❖ Osteoporosis and osteomalacia
❖ Trauma
❖ Eosinophil granuloma: vertebra plana

II) Signs of abnormality:

 Pedicles:
 Dense vertebrae:
❖ Metastases ‚
❖ Malignant lymphoma .
❖ Paget’s disease
❖ Hemangioma
 Lysis within a vertebra: metastasis, MM, infection,
lymphoma.
 Paravertebral shadow

III ) Pathologies:

Metastasis, multiple myeloma, lymphoma:
 Metastasis can involve the pedicle, as well as vertebral body.
 Collapse occur in all.
 Intervertebral disc.
 Radionuclide imaging
 MRI
Infection:
 IVD, end plates destruction, body.
 Pyogenic or TB

III ) Pathologies:

Spinal trauma:
 Plain films are the initial investigation for trauma
 CT is indicated in patients with a high risk of spinal injury or with a
neurological deficit .
 In the unconscious patient with a head injury, CT of the cervical
spine is carried out at the same time as a head CT
 MRI: spinal cord injury, hematoma, disc bulge
 Jefferson fracture : fractures of the lateral masses of C1.
 hangman’s fracture : fracture of the arch of C2 .

III ) Pathologies:

Degenerative disc disease
 Spondylosis occurs maximally in the lower cervical and lower
lumbar regions .
 Plain film signs: disc space narrowing, osteophytes, sclerosis.
 MRI: IVD shows loss of height, reduced hydration (low T2). Disc
bulge or protrusion.
 Spinal canal stenosis.

III ) Pathologies:

Ankylosing spondylitis
 Affects principally the sacroiliac joints and the spine
 The earliest radiological change is fuzziness of the joint margins, followed
by frank erosions. Eventually, the process leads to obliteration of the joint
space .
 Syndesmophytes .
 In advanced cases, the whole spine is rigidly fused and becomes a solid
block of bone . Known as a ‘bamboo spine ’.

III ) Pathologies:

Spondylolisthesis:
 Forward slip of one vertebral body on the one below.
 Occurs most frequently at the lumbosacral junction and between
L4 and L5 vertebral bodies.
 The defect in the pars interarticularis is thought to be a stress
fracture which can usually be identified on the lateral projection.
 Spondylolysis: is the term given to a defect in the pars
interarticularis without a forward slip of one vertebral body on the
other.

Best regards