29 Filum Terminale Lipoma
29.1 Case Presentation
29.1.1 History
A 9-year-old male patient presents with a history of nonspecific back pain.
29.2 Imaging Analysis
Lumbosacral spine MRI from a 9-year-old male patient with nonspecific back pain was performed. Sagittal T1-weighted (T1w; Fig. 29.1a), sagittal short tau inversion recovery (STIR; Fig. 29.1b), axial T1w ( Fig. 29.1c), and axial T2-weighted (T2w) with fat suppression ( Fig. 29.1d) images. An intrathecal linear hyperintensity is seen in T1w sagittal and axial images (arrows in Fig. 29.1a,c), in close relationship with the filum terminale; its high T1w signal intensity is suppressed in the series with fat saturation (arrows in Fig. 29.1b,d). Note the normal morphology and position of conus medullaris (asterisk in Fig. 29.1b) with tip located at the superior end plate of L2 level (arrowhead in Fig. 29.1b).
29.3 Differential Diagnosis
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Filum terminale lipoma:
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Tethered cord with terminal lipoma: