Thoracic and Lumbar Spine

Because of the larger size and widely spaced vertebrae in the lower spine, the small parts of the individual vertebrae are increasingly well delineated as one descends the spinal column toward the sacrum. For a baseline study, the sa

Fig. 4.16A, B Semilateral view of the scapula. A Near lateral pinhole scintigraph of the left scapula reveals intense tracer uptake in the spina scapularis (ss), glenoid process (gp), superior (sa) and inferior angles (ia), and the acro-mion process (ap). The scapular fossa is demonstrated as a large photopenic area below the spina. B Similarly rotated radiograph identifies the spina scapularis (ss), the superior (sa) and inferior scapular angles (fa), and the ac-romion (ap) and glenoid processes (gp)

Fig. 4.16A, B Semilateral view of the scapula. A Near lateral pinhole scintigraph of the left scapula reveals intense tracer uptake in the spina scapularis (ss), glenoid process (gp), superior (sa) and inferior angles (ia), and the acro-mion process (ap). The scapular fossa is demonstrated as a large photopenic area below the spina. B Similarly rotated radiograph identifies the spina scapularis (ss), the superior (sa) and inferior scapular angles (fa), and the ac-romion (ap) and glenoid processes (gp)

Rotated Thoracic Disc

Fig. 4.17A, B Posterior view of the lumbar spine. A Posterior pinhole scintigraph of the lumbar spine demonstrates increased tracer uptake in the apophyseal joints (aj), spinous processes (sp), and vertebral endplates (ep). The intervertebral disk spaces are photopenic. B Antero-posterior radiograph identifies the apophyseal joints (aj), spinous processes (sp), transverse process (tp) and vertebral endplates (ep). The disk spaces appear lucent

Fig. 4.17A, B Posterior view of the lumbar spine. A Posterior pinhole scintigraph of the lumbar spine demonstrates increased tracer uptake in the apophyseal joints (aj), spinous processes (sp), and vertebral endplates (ep). The intervertebral disk spaces are photopenic. B Antero-posterior radiograph identifies the apophyseal joints (aj), spinous processes (sp), transverse process (tp) and vertebral endplates (ep). The disk spaces appear lucent

Apophyseal Joints The Lumbar Spine

Fig. 4.18A, B Posterior view of the midthoracic spine. A Posterior pinhole scintigraph of the midthoracic spine demonstrates minimal, patchy tracer uptake in the costo-transverse joints (ct), spinous processes, and vertebral endplates. On occasion the costocorporeal joints (cc) may be seen in the superomedial aspect of the costotransverse joints. B Anteroposterior radiograph identifies the costo-vertebral joints formed between the costal neck and the transverse process (ct, arrow) and the costal head and the vertebral articular facet (cc)

Fig. 4.18A, B Posterior view of the midthoracic spine. A Posterior pinhole scintigraph of the midthoracic spine demonstrates minimal, patchy tracer uptake in the costo-transverse joints (ct), spinous processes, and vertebral endplates. On occasion the costocorporeal joints (cc) may be seen in the superomedial aspect of the costotransverse joints. B Anteroposterior radiograph identifies the costo-vertebral joints formed between the costal neck and the transverse process (ct, arrow) and the costal head and the vertebral articular facet (cc)

Vertebra Adolescent Radiograph

Fig. 4.19A, B Lateral view of the lumbar spine. A Lateral pinhole scintigraph of the lumbar spine demonstrates the apophyseal joints (aj), pedicles (p), vertebral endplates (ep) and disk spaces (ds). B Lateral radiograph identifies the apophyseal joints (arrowheads), pedicles (p), disk spaces (ds) and endplates (arrows)

Fig. 4.19A, B Lateral view of the lumbar spine. A Lateral pinhole scintigraph of the lumbar spine demonstrates the apophyseal joints (aj), pedicles (p), vertebral endplates (ep) and disk spaces (ds). B Lateral radiograph identifies the apophyseal joints (arrowheads), pedicles (p), disk spaces (ds) and endplates (arrows)

Apophyseal Joints The Lumbar Spine

Fig. 4.20A, B Oblique view of the lumbar spine for demonstration of the apophyseal joints. A Oblique pinhole scintigraph of the lumbar spine delineates the apophyseal joints (aj) as a distinct structure of the vertebra. The joint located inferiorly is located nearer to the pinhole collima-tor, concentrating tracer more intensely than its counterpart further away. B Oblique radiograph identifies the apophyseal joints (aj)

Posterior Images The Lumbar Spine

Fig. 4.21A, B Posterior view of the lumbar spine in a child. A Posterior pinhole scintigraph of the lumbar spine in a 12-year-old girl demonstrates intense tracer accumulation in the growing vertebral endplates (arrows) and spinous processes (arrowheads) and faintly also in the transverse processes (open arrows). The vertebral bodies in adolescence do not appear square as in adults (Fig. 4.17A) because ossification is still in progress. B Anteroposterior radiograph identifies the individual vertebrae with the pedicles (p), neural arch (arrowheads), transverse processes (tp) and spinous process (sp)

Fig. 4.21A, B Posterior view of the lumbar spine in a child. A Posterior pinhole scintigraph of the lumbar spine in a 12-year-old girl demonstrates intense tracer accumulation in the growing vertebral endplates (arrows) and spinous processes (arrowheads) and faintly also in the transverse processes (open arrows). The vertebral bodies in adolescence do not appear square as in adults (Fig. 4.17A) because ossification is still in progress. B Anteroposterior radiograph identifies the individual vertebrae with the pedicles (p), neural arch (arrowheads), transverse processes (tp) and spinous process (sp)

standard posterior scan suffices. In the posterior view the vertebral endplates, the disk spaces, and the spinous processes, and the apophyseal joints are all clearly portrayed (Fig. 4.17). In general the transverse processes accumulate tracer only faintly because they are small and thin. It is to be pointed out that the disk spaces are partly obscured by the spinous process in the midline and the facet joint in the sides. In the thoracic spine, the posterior scan additionally reveals the costovertebral and co-stotransverse joints (Fig. 4.18). The lateral view reveals the vertebral endplates, the intervertebral disk spaces, and the pedicles, and the apophyseal joints. On the lateral view the spi-nous processes are only faintly seen because they are thin in this projection. Typically, the intervertebral disk spaces are indicated by photon defects located between the endplates that concentrate tracer intensely (Fig. 4.19). For an unobstructed viewing of the facet joints, the oblique view is appropriate. The facet joints are distinctly visualized on this view because articular movement stimulates uptake (Fig. 4.20). The pinhole scintigraphic anatomy of pediatric vertebrae is characterized by the "not squared" tracer uptake in the growing endplates (Fig. 4.21).

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Responses

  • Fatima
    What is tracer in the spine?
    8 years ago
  • marko
    Where is the costocorporeal joint?
    7 years ago

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