Lea Alhilali, MD Profile picture
Jun 22, 2022 9 tweets 6 min read Read on X
1/Understanding cervical radiculopathy is a pain in the neck! But knowing the distributions can help your search
A 🧵to help you remember cervical radicular pain distributions #medstudenttwitter #medtwitter #radres #FOAMed #FOAMrad #neurorad #Meded #backpain #spine #Neurosurgery
2/First, a rule of thumb—or rather a rule of elbow! You have 10 fingers. If you divide that in half, you get 5. Similarly, if you divide your arm in half at the elbow, you get 5--C5 that is! C5 radiates towards the elbow. So if it radiates below this, it is > C5 & above is < C5
3/So let’s start with C2. C2 predominantly radiates along the dorsal aspect of the scalp, as it supplies the greater occipital nerve. I remember this bc the number 2 has a swan like neck that mimics the contour of the back of the head and its distribution
4/Next is C3. C3 starts radiating right around the ear and circles around to the front of the neck, as it is a contributor to the great auricular nerve and anterior cutaneous nerve of the neck. I remember how it starts bc the number 3 looks like those big grandpa ears.
5/C4 radiates along the suprclavicular fossa, as it helps innervate the supraclavicular nerve, and goes towards the deltoid. I remember this because the triangular part of the number 4 looks the bulging deltoids that you always see on TV, but never in real life 😂
6/I remember C5 using that general rule that half of the number of fingers (5) equals halfway down the arm (elbow). C5 radiates towards the elbow.
7/C6 radiates to the thumb. I remember this because when you count to 6, you use up all the fingers on one hand and then end on the thumb of the next hand. So you end on a thumb when you count to 6 and C6 radiates to the thumb
8/We only have two cervical nerves left (C7, C8) for the 4 fingers left. So we will just use every other finger. So starting with C6 at the thumb—skip a finger gets you to the middle finger, that’s C7, skip the next finger gets you to the pinky, and that’s C8!
9/Now you know where in the c-spine to look when a patient has pain radiating from the neck—but remember there are subtleties to this & these are general guidelines to help you. Hopefully, remembering cervical radicular pain distributions will no longer be a pain in the neck!

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Lea Alhilali, MD

Lea Alhilali, MD Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @teachplaygrub

Jun 23
1/Do you get a Broca’s aphasia trying remember the location of Broca's area?

Does trying to remember inferior frontal gyrus anatomy leave you speechless?

Don't be at a loss for words when it comes to Broca's area

Here’s a 🧵to help you remember the anatomy of this key region! Image
2/Anatomy of the inferior frontal gyrus (IFG) is best seen on the sagittal images, where it looks like the McDonald’s arches.

So, to find this area on MR, I open the sagittal images & scroll until I see the arches. When it comes to this method of finding the IFG, i’m lovin it. Image
3/Inferior frontal gyrus also looks like a sideways 3, if you prefer. This 3 is helpful bc the inferior frontal gyrus has 3 parts—called pars Image
Read 13 tweets
Jun 19
1/Feeling intoxicated trying to remember all the findings in alcohol use disorder?!

Here’s something to put you in high spirits!

This month’s @Radiographics has the important neuroimaging findings alcohol use disorder!



@cookyscan1 @RadG_editor #RGphx pubs.rsna.org/doi/10.1148/rg…Image
2/There’s an easy rhyme to help you remember the important neuroimaging findings of alcohol use disorder

“Basal ganglia is white...”

Get intrinsic T1 shortening in the BG that makes it look white as a ghost! Image
3/Next “...Cortex is bright”

Acute hyperammonemic encephalopathy cause cortical restricted diffusion, especially the insula, so that it looks as bright as a light bulb! Image
Read 8 tweets
Jun 9
1/Need help reading spine imaging? I’ve got your back!

It’s as easy as ABC!

A thread about an easy mnemonic you can use on every single spine study you see to increase your speed & make sure you never miss a thing! Image
2/A is for alignment

Look for:
(1) Unstable injuries

(2) Malalignment that causes early degenerative change. Abnormal motion causes spinal elements to abnormally move against each other, like grinding teeth wears down teeth—this wears down the spine Image
3/B is for bones.

On CT, the most important thing to look for w/bones is fractures. You may see focal bony lesions, but you may not

On MR, it is the opposite—you can see marrow lesions easily but you may or may not see edema associated w/fractures if the fracture is subtle Image
Read 11 tweets
Jun 6
1/Raise your hand if you’re confused by the BRACHIAL PLEXUS!

I could never seem to remember or understand it—but now I do & I’ll show you how!

A thread so you will never fear brachial plexus anatomy again! Image
2/Everyone has a mnemonic to remember brachial plexus anatomy.

I’m a radiologist, so I remember one about Rad Techs.

But just remembering the names & their order isn’t enough.

That is just the starting point--let’s really understand it Image
3/From the mnemonic, we start with the roots—the cervical nerve roots.

I remember which roots make up the brachial plexus by remembering that it supplies the hand.

You have 5 fingers on your hand so we start with C5 & we take 5 nerve roots (C5-T1). Image
Read 20 tweets
Jun 4
1/Having trouble remembering what to look for in vascular dementia on imaging?

Almost everyone w/memory loss has infarcts. Which are important?

The latest @theajnr SCANtastic has what you need to know:

ajnr.org/content/46/5/1…Image
@TheAJNR 2/Vascular cognitive impairment, or its most serious form, vascular dementia, used to be called multi-infarct dementia.

It was thought dementia directly resulted from brain volume loss from infarcts, w/the thought that 50-100cc of infarcted related volume loss caused dementia Image
@TheAJNR 3/But that’s now outdated. We now know vascular dementia results from diverse pathologies that all share a common vascular origin.

It’s possible to lose little volume from infarct & still result in dementia.

So if infarcts are common—which contribute to vascular dementia? Image
Read 20 tweets
Jun 2
1/Having trouble remembering how to differentiate dementias on imaging?

Is looking at dementia PET scans one of your PET peeves?

Here’s a thread to show you how to remember the imaging findings in dementia & never forget! Image
2/The most common functional imaging used in dementia is FDG PET. And the most common dementia is Alzheimer’s disease (AD).

On PET, AD demonstrates a typical Nike swoosh pattern—with decreased metabolism in the parietal & temporal regions Image
3/The swoosh rapidly tapers anteriorly—& so does hypometabolism in AD in the temporal lobe. It usually spares the anterior temporal poles.

So in AD look for a rapidly tapering Nike swoosh, w/hypometabolism in the parietal/temporal regions—sparing the anterior temporal pole Image
Read 16 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!

:(