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22 Cards in this Set

  • Front
  • Back

Thoracic Spine Views

AP: All 12 vertebrae


Lateral: all vertebrae except the T1-T3 because the shoulder obscures them


Oblique View


Thoracolumbar or other coned views


Swimmer's View

Sternum views

Posterior Oblique; Sternum without the spine superimposed?


Lateral: shows the entire sternum in profile

Rib Sections

Anterior/Posterior/Axillary


Subdivided into right and left sides/above diaphragm (1-9) below diaphragm (8-12)



Rib Views

AP: shows posterior ribs


PA: shows Anterior Ribs (hemothorax ot pneumothorax)


AO or PO shows Axillary ribs


May need 2 week follow up for callus formation





Thoracic Alignment and Trauma

Shown by three lines - anterior body, posterior body and spinolaminar junction




Sings: Step defect, wedge deformity, impaction, displaced endplates, loss of disc heights, spinal edema.




Stable unless supra or infra is torn.

Thoracic Spinal Injuries

Highest occurence in T11-T12,L1,L2


Compression Fracture and disolcations commmon with 15-20% neurological injuries

Anterior Vertebral Body Compression factors

Most common spinal injury detectable on radiograph.


Flexion 90% and Exteension 10%


Younger: Falls, MVA


Oldeer: Osteoporosis with minimal forces

What is a Chance Fracture

Flexess the spine and distracts the spine injuring the ligaments and spinal cord.


aka Seat Belt Fracture

Age related compression fractures

Younger:disks are thicker andabsorbforces readily resultingindisk herniation,endplate fractures,and shearingforces


Older:Dehydrated disks and demineralized bone results inwedge deformity

How to asses Compression Fracturess

Stepdefect // Wedgedeformity // Linearzoneof impaction // Displacedendplates // Decreaseddiskheight // Paraspinaledema


Abdominalileus: the edema affects the abdominal ANS and there is increased gas in thebowel.

Thoracic Spine Conditions

Osteoporosis // Scoliosis // Tuberculous Osteomuuelitis // Scheuermann's Disease

Radiographic Signs of Osteoporosis

Increased Radiolucency // Cortex thinning // wedge deformity // schmorl's nodess



Typical Scoliosis Views

Erect AP


Supine AP - asses flexibilitly of the curve


Erect Lateral


Sidebending R and L - Structural vs NonStructural curves


PA view L hand; Compared to Standardized views

What is the Cobb Method

Used to assess the deviation of the spine from the midline. Uses the erect(weight bearing) AP.


ID upper and Lower end Vertebrae // Draw lines extending along the vertebral column // Measure cobb angle

How is Skeletal maturity assessed

–CompareL hand and wrist compared to the population (Greulich & Pyle Atlas is used)


–Apophysisossification to the vertebral body


–Risser’ssign(iliac apophysis fusion to the ilia)

Scoliosis Rotation

0 = No rotation


+1 = pedicle toward midline


+2 = Pedicle 2/3 to midline


+3 = Pedicle in Midline


+4 = Pedicle beyond midline

Risser sign and Mesasurement

After Risser of 5 scoliosis should not progress

What is Tuberculous Osteomyelitis

"Pott's Disease" is always a lesion to TB somewhere else in the body




RG shows destructio nof the vertebral bodies


MRI detects spinal cord compression and to evaluate disk space infection and disease in soft tissue

What is Mycobacterium tuberculosis

Organism that causes TB Osteomyelitis and involves mostly thoracic and lumbar vertebrae.




Extensive necrosis and bony desetruction with compressed fractures and extension to soft tissues including psoas abscess

What is Scheuermanns Disease

-Backacheand thoracic kyphosis are the result of secondary ossification centerosteochondrosis


-irregular ossification of the anterior portions of theepiphysis on at least 3 contiguous bodies


-indentations through the epiphyseal plates (Schmorl’s Nodes).


-MRIdirectly shows the disc herniations

Secondary effects of Scheuermann's Disease

Thoracic outlet syndrome and Brachial Plexopathy

Scheuermann's Patholgenesis

Unknown Etiology


Schmorls nodes are consistently found.


Disk herniation narrows disk space and can interfere with 2ndary ossification centers


--> Osteochondritis of the end plates and deficient growth of the anterior body and normal growth of the posterior body produces the wedge shaped vertebrae