Disc Degeneration Overview . Describing morphology alterations seen in degenerative disc disease requires common terminology to standardize communication. A series of pathoanatomic terms and definitions proposed by an interdisciplinary committee and endorsed by multiple societies is summarized here. These general…
KEY FACTS Terminology Hemorrhage into spinal subarachnoid space from variety of etiologies Trauma (> 50%) Aneurysmal subarachnoid hemorrhage (SAH) with spinal extension Spinal arteriovenous malformations – Mainly types II, III, IVc, conus malformations Tumor Anticoagulant therapy Infection (pneumococcal meningitis, herpes)…
KEY FACTS Terminology Accumulation of blood between dura, arachnoid Imaging Intradural collection hyperintense on T1WI, predominantly hypointense on T2WI or gradient-echo imaging Thoracolumbar > lumbar or lumbosacral > cervical Clumped, loculated masses of hemorrhagic density/intensity Top Differential Diagnoses Epidural hematoma…
KEY FACTS Terminology Hemorrhage build-up between dura and spine not caused by significant trauma or iatrogenic procedures Imaging Extradural multisegmental T1 hyperintense fluid collection Thoracic, lumbar > cervical Lentiform or biconvex Outlined by dorsal epidural fat cranially and rostrally T1WI…
KEY FACTS Terminology Spinal cord injury (SCI) Traumatic axonal injury, cord edema, &/or hemorrhage Imaging Abnormal cord signal on MR in setting of trauma Most common level of adult SCI is C4-C6 Commonly associated fracture or subluxation in younger adults…
KEY FACTS Imaging Fusiform intramedullary hyperintensity tracking cerebrospinal fluid (CSF) signal Myelomalacia precedes overt syrinx formation = “presyrinx state” Cystic expansile cord lesion May appear to be “expansile” lesion, relative finding in presence of cord atrophy Consider cine (“dynamic”) PC…
KEY FACTS Terminology Central cord syndrome (CCS), acute traumatic central cord syndrome (ATCCS) Most common partial cord syndrome Traumatic cord injury, with clinical syndrome of Bilateral weakness, arms > legs Bladder dysfunction, variable sensory loss Injury to central gray matter,…
KEY FACTS Terminology Lateral curvature in spine due to degenerative disc and facet disease in older patients Deformity in skeletally mature patient with Cobb angle of > 10° in coronal plane Predominance of lower lumbar curves Imaging Conventional standing full-length…
KEY FACTS Terminology General term for any lateral curvature of spine Imaging Lateral curvature of spine Returns to midline at ends of curve Rotational component common Most commonly thoracic or thoracolumbar Imaging approach Radiography for initial diagnosis Multiplanar MR to…
KEY FACTS Terminology Spinal curvature secondary to vertebral anomalies Hemivertebra: Unilateral or anterior vertebral hypoplasia “Butterfly” vertebra: Central vertebral cleft due to failure of central vertebral body development “Fused” vertebrae: Embryological failure of segmentation rather than fusion Klippel-Feil syndrome: Multiple…