Deck 3: Spine and Spinal Cord

Question 1

The image of this patient shows that the patient has what type of injury?

A) Hangman's fracture
B) Jefferson Burst fracture
C) Herniated C2 disk
D) C7 vertebral arch fracture

Answer 1

Jefferson Burst fracture

Question 2

The patient in this image has which of the following?

A) A fractured arch at C1
B) A fractured hyoid bone
C) A vertebral body compression fracture
D) A spinal metastatic disease

Answer 2

A vertebral body compression fracture

Question 3

Which type of fracture(s) does the image indicate?

A) Chance fracture
B) Clay-shoveler's fracture
C) Hangman's fracture
D) Cervical facet fractures

Answer 3

Clay-shoveler's fracture

Question 4

This image shows that the patient has which of the following?

A) Severe dehydration of the vertebral disks
B) Transected spinal cord
C) Spinal cord tumor
D) Cerebrospinal fluid (CSF) infection

Question 5

The arrow in the above image indicates:

A) a pars interarticularis defect.
B) a Chance fracture.
C) an arthritic facet joint marginal osteophyte.
D) a calcified herniated disk.

Question 6

This image likely shows a patient with:

A) lytic bone disease.
B) scoliosis.
C) vertebral body compression fracture.
D) degenerative disk disease.

Question 7

The above image depicts a patient with:

A) spondylolisthesis.
B) DISH.
C) lytic bone disease.
D) degenerative disk disease.

Question 8

The above image depicts a patient with:

A) degenerative disk disease.
B) DISH.
C) lytic bone disease.
D) facet joint osteoarthritis.

Question 9

Which defect is portrayed in the image of this patient?

A) An L2 pars defect
B) An L3 pars defect
C) An L4 pars defect
D) An L5 pars defect

Question 10

The image shows that this patient has:

A) anterolisthesis of the sacrum.
B) retrolisthesis of L5 in relation to the sacrum.
C) bamboo spine.
D) sacral fracture.

Question 11

In a patient with back pain and fever, this fat suppressed T2-weighted MRI would suggest:

A) degenerative disk disease.
B) metastatic disease to the spine.
C) spondylolysis.
D) diskitis/osteomyelitis.

Question 12

Your diagnosis based on the image shown is:

A) C4/C5 disk herniation.
B) dens fracture.
C) metastatic disease of the spine.
D) soft tissue neck injury.

Question 13

What would be your diagnosis based on the image of this patient?

A) The patient has disk herniation with nerve compression.
B) The patient has left L5/S1 facet joint osteoarthritis.
C) The patient has bilateral L5 pedicle fractures.
D) The patient has cauda equina impingement syndrome.

Question 14

The CT shown is from a patient who presented with sciatica. Your diagnosis is most likely:

A) aortic aneurysm.
B) tumor in a pedicle.
C) herniated disk.
D) spina bifida.

Question 15

Which of the following is NOT true of degenerative disk disease?

A) It is typically associated with marginal osteophytes.
B) It is typically associated with disk dehydration.
C) It is always associated with back pain.
D) It does not require advanced imaging, such as MRI, for diagnosis.

Question 16

Which of the following radiographic views BEST displays a pars interarticularis fracture?

A) AP
B) PA
C) Lateral
D) Oblique

Question 17

In patients who have severe spine trauma but do not show neurologic signs, the procedure of choice is:

A) CT.
B) MRI.
C) radiography.
D) ultrasound.

Question 18

Which of the following cervical fractures are typically stable?

A) Teardrop
B) Bilateral facet
C) Anterior wedge compression
D) Hangman's

Question 19

In a patient with a Chance fracture, you would also likely suspect injury to the:

A) ribs.
B) lungs.
C) pancreas.
D) liver.

Question 20

In a patient with low back pain with or without lumbar radiculopathy, standing radiographs may be helpful because they:

A) may provide functional information regarding the alignment of vertebrae when weight bearing.
B) provide better bone detail.
C) enable more vertebrae to be seen.
D) require less ionizing radiation to produce a comparable image.

Question 21

Which radiographic view is BEST for evaluating suspected rotational subluxation at C1/C2?

A) Open-mouth odontoid
B) Lateral C-spine with flexion and extension
C) AP view with cephalad angulation
D) Posterior oblique views

Question 22

Which of the following is NOT associated with an osteoarthritic facet joint?

A) Decreased density of subchondral bone
B) Osteophytes
C) Reduction in joint space
D) Narrowing of the neuroforamen

Question 23

The pedicle sign refers to which of the following?

A) An increase in the visibility of a pedicle due to blastic disease
B) A decrease in the visibility of a pedicle due to lytic disease
C) The loss of contrast between a pedicle and the spinal canal due to an infection
D) The increase in contrast between a pedicle and the spinal canal due to hyperthyroidism

Question 24

DISH is radiologically defined by the presence of:

A) overhanging osteophytes on four or more contiguous facet joints.
B) spondylolisthesis in four or more contiguous vertebrae.
C) bridging syndesmophytes on four or more contiguous vertebral bodies.
D) vacuum disks in four or more sequential disks.

Question 25

Which of the following is NOT associated with a bamboo spine?

A) Bridging syndesmophytes
B) Sacroilitis
C) Facet joint hypertrophy
D) HLA-B27 genotype

Question 26

Modic changes refer to:

A) facet joint osteoarthritis.
B) vacuum disks.
C) bone marrow changes associated with disk degeneration.
D) annular fibrosis tears.

Question 27

In a patient with radiculopathy whose MRI reveals only an associated annular tear, you would most likely attribute the patient's pain to:

A) inflammatory changes in an adjacent nerve root.
B) nerve compression caused by neuroforaminal stenosis.
C) facet joint arthritis.
D) adhesive arachnoiditis.

Question 28

A sequestered disk fragment refers to:

A) a disk that is both herniated and bulging.
B) a disk fragment resulting from an annular tear.
C) a disk fragment that is pressing directly on the spinal cord.
D) a disk fragment that is separated from the parent disk.

Question 29

Which of the following statements about disk herniations is INCORRECT?

A) Larger disk herniations always produce more severe radiculopathy than smaller disk herniations.
B) Midline disk herniations may produce less severe symptoms than foraminal herniations.
C) Chronic disk herniations are more likely to be associated with spondylosis than soft herniations.
D) They may contribute to the development of spinal stenosis.