You are here: Home / Archives for Textbooks / Neuroradiology - The Essentials with MR and CT / Chapter THREE - Spine

Ankylosing spondylitis, chronic disease

October 23, 2014 by
There is marked irregularity and sclerosis of the sacroiliac joints bilaterally. Fatty changes are noted as well, in the sacrum, bordering the joint. There is little edema within the bone adjacent to the sacroiliac joints. All are findings consistent with long standing disease. Part of the on-line supplement to Neuroradiology – The Essentials with MR […] [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Ankylosing spondylitis, hip disease

October 24, 2014 by
One-third of individuals with AS develop hip and shoulder involvement. Bilateral disease, with joint effusions and synovial enhancement are characteristic. Additional less common findings include subchondral bone marrow edema, erosive destruction, and fatty accumulation. (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement to Neuroradiology – […] [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Ankylosing spondylitis, sacroiliac joint disease

October 24, 2014 by
In this patient with long standing disease, joint space irregularity and adjacent fatty changes predominate. (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement to Neuroradiology – The Essentials with MR and CT (© 2015) [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Ankylosing spondylitis, with bony ankylosis of the sacroiliac joints

October 23, 2014 by
In this 44-year-old patient, coronal images of the pelvis reveal fusion of the sacroiliac joints bilaterally. Sagittal images of the lumbar spine show vertebral body squaring and a bamboo like appearance due to diffuse ankylosis (and syndesmophytes). There is vertebral body fusion at multiple levels, with loss of disk space height and abnormal signal intensity […] [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Anterior and posterior fusion defects of C1

October 23, 2014 by
Note the well corticated margins and absence of a discrete fracture line. Such fusion defects are congenital in nature, and are primarily incidental findings. Incomplete posterior fusion can be seen in normal children up to the age of 10, with bony fusion typically occurring by age 5. Clefts of the posterior arch occur in 5% […] [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Cervical cord hemangioblastoma

September 25, 2014 by
Cervical cord hemangioblastoma, in a patient with von Hippel Lindau syndrome. A small enhancing intramedullary lesion is noted at C4, with mild accompanying vasogenic edema. 75% of spinal cord hemangioblastomas are sporadic, 25% occur in association with von Hippel Lindau syndrome. Spinal cord hemangioblastomas most commonly occur posteriorly within the cord, as in this patient. […] [...]
Filed Under: cervical, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Chondrosarcoma of the cervical spine

October 23, 2014 by
The left lamina of C2 is involved by a focal mass lesion, which is slightly expansile in nature. A somewhat characteristic feature of the histologic diagnosis, reflecting hyaline cartilage, is the marked hyperintensity on the T2-weighted scan. There is moderate enhancement post-contrast, which as with the other findings (with the exception of the appearance on […] [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Chronic dens fracture

October 24, 2014 by
A type II odontoid fracture is present, with non-union (pseudoarthosis). (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement to Neuroradiology – The Essentials with MR and CT (© 2015) [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

DISH (diffuse idiopathic skeletal hyperostosis) in the cervical spine

October 23, 2014 by
In DISH (also known as Forestier disease) there is calcification and ossification of ligaments and entheses (the connective tissue between bone and a tendon or ligament) involving the vertebral column. Ossification of the anterior longitudinal ligament is common (and often marked), and may occur in conjunction with ossification of the posterior longitudinal ligament (OPLL). Both […] [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Epidural hematoma, spine, illustrating image composition

October 28, 2014 by
Composed sagittal T2-weighted, T1-weighted, and post-contrast T1-weighted images are presented. Each image is an automatically generated composition of two high-resolution independent cervicothoracic and thoracolumbar image acquisitions. The patient was on aspirin and Plavix, and presented with urinary retention and poor anal sphincter tone, consistent with a lesion compressing the conus medullaris. A predominantly deoxyhemoglobin epidural […] [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Hydatid cysts of the sacrum, ileum and L5

October 24, 2014 by
In the spine, with hydatid disease, there is typically slow resorption of trabeculae, without bony expansion, with a conglomeration of daughter cysts. This accounts for the multilocular appearance on MR, with high signal intensity on T2-weighted sequences. (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement […] [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Hyperflexion injury with a clay-shoveler fracture

October 24, 2014 by
CT depicts an avulsion fracture of the spinous process of C6. MR reveals additional important findings, including the extensive posterior paraspinal muscular injury (edema), disruption of the interspinous ligament, compression fractures (marrow edema) involving multiple contiguous cervical and thoracic vertebral bodies, and extensive prevertebral edema as well as fluid (hemorrhage). Note that the cord appears […] [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Ivory vertebra, metastatic prostate carcinoma

October 24, 2014 by
The ivory vertebra describes a dense sclerotic vertebral body on plain film or CT, with the correlate on MR being very low signal intensity on both T1- and T2-weighted sequences. L2 and S2 are involved in this fashion in the presented case, with additional metastatic lesions noted posteriorly in L1 and L3, together with mild […] [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Klippel-Feil

October 24, 2014 by
There is vertebral nonsegmentation at two levels, one involving a hemivertebra, together with a prominent scoliosis of the cervical spine. Also present is an anterior fusion defect of C1. (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement to Neuroradiology – The Essentials with MR and […] [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Lipoma, tethered cord, hydromyelia, block vertebrae

October 23, 2014 by
The cord extends at least to the S1 level, with dilatation of the central canal within that portion visualized (hydromyelia). A small lipoma is noted within the bony spinal canal posteriorly at the S1 level. The axial scan at this level reveals the cord near its termination/posterior tethering, with the lipoma immediately contiguous bilaterally. Fusion […] [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Meningioma (WHO grade I, meningotheliomatous in type), cervical spine

October 13, 2014 by
A large, homogeneously enhancing, intradural extramedullary mass lesion is noted anteriorly within the thecal sac at the C2 level. There is prominent deformity and compression of the cord, long standing in nature, without evidence of edema or gliosis. Note the characteristic flat margin of the lesion along the dura. Part of the on-line supplement to […] [...]
Filed Under: Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Migrated disk fragment

October 28, 2014 by
There is mild loss of disk space height (and thus substance) at L5-S1. A left paracentral disk herniation is noted, at this level, together with superior migration. Note the slight hyperintensity of the superiorly migrated portion of the disk on the T2-weighted scan, consistent with a free fragment (which is also suggested by the extent […] [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Multiple sclerosis, cervical and thoracic cord lesions

September 25, 2014 by
An enhancing cervical cord lesion is noted on sagittal and axial images, located at the C2 level, with an additional thoracic lesion (which did not enhance) depicted on a lower axial T2-weighted section. Neither lesion respects gray-white matter boundaries, as seen on the axial T2-weighted scans, a common finding for MR lesions of the cord. […] [...]
Filed Under: Anatomic Regions, cervical, Chapter THREE - Spine, lumbar, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Neurofibromatosis type 1

October 24, 2014 by
Dural ectasia and a lateral meningocele are present. Also noted are scalloped vertebrae and scoliosis. All are characteristic findings. (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement to Neuroradiology – The Essentials with MR and CT (© 2015) [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Paget disease of the lumbar spine and pelvis

October 24, 2014 by
Both the L1 and L2 vertebral bodies (together with their respective posterior elements) are involved, with the vertebral bodies expanded in the antero-posterior dimension and L2 a characteristic “picture frame” vertebra. There is involvement as well of the pelvis together with the sacral vertebral bodies. Coarse and thickened trabeculae are particularly evident in the iliac […] [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Pancoast tumor

October 24, 2014 by
An apical soft tissue mass is present, with invasion of the adjacent vertebral body (visualized by the lucent defect therein). (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement to Neuroradiology – The Essentials with MR and CT (© 2015) [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Scheuermann disease

October 24, 2014 by
Only a sagittal midline T2-weighted scan is presented. However this is sufficient to visualize the characteristic thoracic kyphosis, with involvement of 3 contiguous vertebrae. There is anterior wedging of the vertebral bodies and disk space narrowing, the latter greatest anteriorly. (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of […] [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Schwannoma (WHO grade I)

October 18, 2014 by
A lobulated uniformly enhancing mass lesion is noted with the bulk of the mass paraspinal in location, extending into the foramen at the T4-5 level on the right, with epidural extent and mild displacement of the cord to the left. The intervertebral foramen is enlarged. The well-circumscribed nature of the lesion, and location, favor the […] [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, thoracic, Val M. Runge
Tagged With:

Schwannoma at C3-4 on the left, within the neural foramen and compressing the cord

October 23, 2014 by
An enhancing mass lesion is seen, centered within the neural foramen – the latter is enlarged, indicating that the lesion is long standing in nature. There is marked cord compression, with abnormal high signal intensity within the cord on the T2-weighted exam, indicative of either gliosis or edema. The patient presented clinically with numbness in […] [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With:

Tethered cord

October 24, 2014 by
The cord extends to the sacral region, without a change in caliber or distinct conus. The cord ends in a lipoma, with tethering posteriorly. (Case provided courtesy of Reto Sutter, MD, Leitender Arzt, Radiologie, Uniklinik Balgrist, Zürich) Part of the on-line supplement to Neuroradiology – The Essentials with MR and CT (© 2015) [...]
Filed Under: Anatomic Regions, Chapter THREE - Spine, Meet The Experts, Neuroradiology - The Essentials with MR and CT, spine, Val M. Runge
Tagged With: