Spinal Artery Aneurysm
Tend to be fusiform in shape, without a defined neck (as seen commonly with intracranial aneurysms) Often unrelated to arterial branching sites Clinical Issues • Presenting symptoms include back pain, headache,…
Epidural Lipomatosis
T6-T8, dorsal to spinal cord Epidural fat ≥ 7 mm thick • Lumbar spine: 39-42% L4-L5, surrounding thecal sac • Y-shaped configuration to lumbar thecal sac on axial imaging • Mass effect on…
Renal Osteodystrophy
Blurred, coarse bone trabeculae • Changes of hyperparathyroidism (HPT) Prominent primary trabeculae Resorption of secondary trabeculae Cortical thinning Erosions at entheses, endplates, sacroiliac (SI) joints Brown tumors: Lytic lesion, no matrix,…
Traumatic Arteriovenous Fistula
DSA demonstration of AVF nidus with enlarged draining veins Unlike spontaneous DAVF (sDAVF), often no cord enlargement/hyperintensity from congestive myelopathy • Angiographic protocol for evaluation of suspected cervical tDAVF includes selective…
Pathways of Spread
(Left) Sagittal graphic shows lumbar disc space infection with vertebral body osteomyelitis with endplate destruction and marrow edema. There are ventral and dorsal abscess collections. (Right) Sagittal T1WI C+ FS…
Grisel Syndrome
Anteriorly rotated side wider and closer to odontoid Opposite side smaller and farther from odontoid • Lateral view: ± widened atlantodental interval • Dynamic CT: Should include occiput C1-C2 Initial scan: Maintain…
Hirayama Disease
2nd to 3rd decades • Avoidance of neck flexion can stop progression • Selected patients treated with posterior decompression with duraplasty Diagnostic Checklist • Asymmetric atrophy of lower cervical cord on routine MR…
Complex Chiari
“Bump” thought to represent aberrant clava, used as marker for cervicomedullary junction Abnormal tonsillar “pistoning” motion, reduced CSF flow around foramen magnum and cerebellar tonsils • ± syringohydromyelia, ventral cervicomedullary compression…
Osteopetrosis
Infantile presentation (“congenita”) Intermediate presentation Adult presentation (“tarda”) • All feature abnormal osteoclastic activity Clinical Issues • Fractures, pain, neurologic symptoms • Growth disturbance in infantile forms Diagnostic Checklist • Osteopetrosis in differential diagnosis…
Anterior Lumbar Radiculopathy
(Left) Sagittal T1WI MR in a leukemia patient with leg weakness following intrathecal chemotherapy shows normal appearance of the conus and cauda equina. (Right) Sagittal T1WI C+ MR in a…
