Medical Apparatus: Imaging Guide to Orthopedic Devices
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Medical Devices of the Neck & Spine


by Tim B Hunter, MD, MSc and Mihra S Taljanovic, MD, PhD

 

Introduction

A large variety of medical apparatus is used in the treatment of spinal disease and injuries. New devices are constantly being introduced. Most have been used for years, and many of the newest devices are variations on a previous theme. Knowing the specific name of a device is not important; in fact, it is sometimes impossible, because a slight modification of a device design usually leads to a new name. However, it is important to recognize the presence or absence of a device (if the patient’s history suggests one is present), to understand its function, and to identify any complications associated with its use.

 

Overlying Materials

Normal everyday items carried or worn by patients - eyeglasses, earrings, hearing aids, and jewelry - may be mistaken for a medical device or foreign body; or, they may interfere with radiographic evaluation of the underlying soft tissue and bony structures. Earrings often show up on head and neck radiographs. They usually cause no confusion, but at times they can resemble electronic apparatus or even cervical spine fixation apparatus (figure: earrings). The combination of frontal and lateral views help to correctly identify earrings from medical apparatus. Even if there are frontal and lateral views, it may be difficult to distinguish unusual earrings from hearing aids.

Dental and facial apparatus often is present on cervical spine radiographs and should be evaluated as best as possible even though its evaluation was not the original intent of the imaging study. It is not all that uncommon for important maxillary, mandibular, or dental disease to be incidentally noted on routine imaging of the head, neck, or cervical spine.

Earrings: lateral view Earrings: AP view Eyeglasses Necklace
Earrings lateral view Eyeglasses Necklace
  These earrings resemble cervical spine apparatus on the lateral view.   Note right axillary arterial stent (arrow)
Tongue ring which showed on odontoid view of a cervical spine series Mandibular and maxillary wiring Pantopaque in the base of the cranium Hair overlying the neck and cervical spine
Tongue ring Mandibular wiring Pantopaque in the skull Hair overlying cervical spine and neck
  The mandibular and maxillary wires were placed to treat the bilateral mandibular fractures. Residual Pantopaque in the base of the cranium from a myelogram performed with Pantopaque many years prior. From Hunter, 1994 The hair simulates foreign material or soft tissue abnormality.
Gown snaps simulating cervical spine apparatus      
Cervical spine proud screw and gown snaps      
70 year-old woman with severe rheumatoid arthritis and chronic atlantoaxial subluxation. There is occiput to T1 posterior spinal fusion and anterior spinal fusion from C3 to C7. One of the occipital screws is "proud" (white arrow). Two gown snaps (black arrows) simulate dislodged apparatus. A tracheostomy tube is also present.      
 

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Neck Apparatus


Author contact information

Tim Hunter
Email: hunter@radiology.arizona.edu


COPYRIGHT 2013: TBH
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