Bone Infarction
Not osteonecrosis (Kümmell disease) Imaging • Well-defined, geographic signal abnormality, which tends to involve anterior 1/3 to 1/2 of vertebral body • T2WI shows increased signal in multiple bodies, with abrupt transition…
Fibrous Dysplasia
However, matrix may range from purely lytic to purely sclerotic lesion • Narrow zone of transition ± sclerotic margin • Low to intermediate signal intensity on T1WI, heterogeneous on T2WI, STIR, variable…
Median Neuropathy
Fascicles indistinct • Perineural enhancement • ± mass compressing nerve • Denervation changes in muscles distal to entrapment Top Differential Diagnoses • Cervical radiculopathy • Tenosynovitis • Peripheral nerve sheath tumor • Thoracic outlet syndrome Pathology • Overuse…
Bow Hunter Syndrome
Motor or sensory deficits, ataxia, diplopia, dysarthria, dysmetria, vertigo, visual field deficit, cranial nerve dysfunction, syncope • Treatment Brace to restrict head motion, surgical fusion to prevent atlantoaxial rotation, vertebral artery…
Paraneoplastic Myelopathy
Antibodies against intracellular antigens Older individuals, resistant to treatment Mediated by T-cell mechanisms • Most common with lung and breast cancer • Most common antibodies causing myelopathy Amphiphysin-IgG Collapsin response-mediator protein-5 (CRMP-5)…
Myelofibrosis
Slightly higher on T2WI, STIR than on T1WI Abnormalities may be diffuse or patchy Signal intensity does not change between in- and out-phase imaging Minimal or no enhancement with gadolinium…
Cervical Hyperextension-Rotation Injury
Pedicolaminar fracture-separation Imaging • Asymmetric hyperextension pattern of injury to posterior column • Below C2; most common at C6 and C7 • Fracture of articular facet Associated with radiculopathy • Fracture of articular pillar…
Normal Variant
Cervical vertebral pseudosubluxation Incomplete C1 ring Cervical ribs Transitional vertebral anatomy Focal fatty marrow Ectopic kidney Conjoined nerve root Incomplete posterior lumbar elements High thecal sac termination Imaging • Multiplanar MR…
Femoral Neuropathy
(Left) Coronal graphic shows the normal course of the femoral nerve relative to the psoas muscle and inguinal ligament . The femoral nerve produces multiple peripheral branches to the anterior…
Occipitocervical Fixation
Injury to cord, cranial nerve 12, C1 and C2 roots Incidence of cord injury in OCF very low • Vertebral artery (VA) injury primarily from screw placement (4%) If intraoperative injury…
