Articles

Articles are a collaborative effort to provide a single canonical page on all topics relevant to the practice of radiology. As such, articles are written and edited by countless contributing members over a period of time. A global group of dedicated editors oversee accuracy, consulting with expert advisers, and constantly reviewing additions.

33 results found
Article

Nerve root enhancement

Nerve root enhancement is a phenomenon described on post-contrast MRI scans that can be observed in a number of situations. Common causes post-operative nerve root enhancement 6 arachnoiditis leptomeningeal metastases disseminated spinal leptomeningeal metastases neurolymphomatosis HIV va...
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Diffuse T1 bone marrow signal loss

Diffuse T1 vertebral bone marrow signal loss is associated with replacement of fatty marrow by edema or cellular tissue.  Radiographic features MRI T1-weighted imaging without fat suppression is one of the most important sequences for distinguishing between normal and abnormal bone marrow. Ab...
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Cervical spine injury

Cervical spine injuries can involve the cervical vertebral column, intervertebral discs and cervical spine ligaments, and/or cervical spinal cord. The cervical spine accounts for ~50% of all spinal injuries.  Epidemiology 5-10% of patients with blunt trauma have a cervical spine injury 1.  Pa...
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Spinal vascular malformations

Spinal vascular malformations are rare but knowledge of them is important as if undiagnosed and untreated they can lead to serious complications. The main types are arteriovenous fistulae, arteriovenous malformations, cavernous malformations, and capillary telangiectasia. Pathology Classificat...
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Torticollis

Torticollis, also known as wry neck, is a clinical finding of head tilt with or without rotational spinal malalignment. It is not a diagnosis in itself and there are a wide range of underlying conditions. It is most common in the pediatric age group.  Pathology Torticollis can be acute (<1 wee...
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Loss of intervertebral disc space (differential)

Loss of intervertebral disc space can be due to a variety of causes: degenerative disc disease of the spine: most common cause trauma discitis neuropathic spondyloarthropathy dialysis related spondyloarthropathy ankylosing spondylitis ochronosis crystal deposition diseases sarcoidosis ...
Article

Craniovertebral junction anomalies

Craniovertebral junction (CVJ) anomalies can be congenital, developmental or due to malformation secondary to any acquired disease process. These anomalies can lead to cranial nerve compression, vertebral artery compression, and obstructive hydrocephalus. Pathology The craniovertebral junction...
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Parasyndesmophytes

Parasyndesmophytes or floating syndesmophytes are, as the name suggests, paravertebral dystrophic soft tissue calcifications or heterotopic ossifications. Pathology Etiology They are known to be seen in 4:  psoriatic arthritis reactive arthritis Radiographic features Initially they begin ...
Article

Syndesmophyte

Syndesmophytes are calcifications or heterotopic ossifications inside a spinal ligament or of the annulus fibrosus.​ They are seen in only a limited number of conditions including:  ankylosing spondylitis ochronosis fluorosis reactive arthritis psoriatic arthritis They can be classified as...
Article

Longitudinally extensive spinal cord lesion

Longitudinally extensive spinal cord lesions (LESCL), also known as longitudinally extensive transverse myelitis (LETM), represent extensive involvement of the spinal cord, with abnormal T2 signal traversing at least three vertebral body segments in length. Differential diagnosis They are typi...
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Vertebral lesion (differential)

Differential diagnosis of vertebral lesions is very wide. Differential diagnosis Vertebral body origin intraosseous hemangioma metastases Paget disease multiple myeloma osteonecrosis vertebral body osteomyelitis lymphoma plasmacytoma giant cell tumor Langerhans cell histiocytosis fi...
Article

Holocord presentation

Holocord presentation refers to a process which involves the spinal cord, from cervicomedullary junction to the tip of the conus. It does not relate to a specific condition nor does it distinguish between involvement by cystic expansion or solid tumor, or by a combination of both. It merely deno...
Article

Neoplasms of the cauda equina (differential)

The differential diagnosis for masses of the cauda equina region is often considered separately to the remainder of the spinal cord. It is often difficult to determine whether masses in this region are intramedullary or intradural-extramedullary. Most common tumors myxopapillary ependymoma by...
Article

Intradural extramedullary spinal tumors

Intradural extramedullary neoplasms are located outside the spinal cord but within the dural sheath.  Epidemiology The majority (70-80%) of spinal canal tumors are intradural extramedullary 1. Clinical presentation Patients present with signs and symptoms of spinal cord or nerve root compres...
Article

Vertebral body mass

The differential diagnosis for a vertebral body mass is broad and may range from a completely benign, sclerotic enostosis (bone island) to a malignant primary bone tumor. Classification Broadly, these lesions can be separated into: non-neoplastic lesions primary bone tumors secondary metast...
Article

Winking owl sign (spine)

The (absent) pedicle sign, also called the winking owl sign, occurs on plain radiograph of the spine when a pedicle is absent 5. The term, winking owl sign, where the missing pedicle corresponds to the closed eye, the contralateral pedicle to the other round open eye, and the spinous process to...
Article

Spinal cord compression

Spinal cord compression (SCC) is a surgical emergency, usually requiring prompt surgical decompression to prevent permanent neurological impairment. If the spinal roots below the conus medullaris are involved, it is termed cauda equina syndrome. Pathology Etiology There are numerous causes of...
Article

Spinal metastases

Spinal metastasis is a vague term which can be variably taken to refer to metastatic disease to any of the following: vertebral metastases (94%) may have epidural extension intradural extramedullary metastases (5%) intramedullary metastases (1%) Each of these are discussed separately. Below...
Article

Coronal vertebral cleft

Coronal vertebral clefts refer to the presence of radiolucent vertical defects on a lateral radiograph.   Epidemiology It is most often seen in premature male infants 1,3. As they can occur as part of normal variation (especially in the lower thoracic-upper lumbar spine of premature infants) t...
Article

Diffusely increased bone marrow FDG uptake

A diffuse homogeneous bone marrow FDG uptake usually reflects hyperplastic bone marrow which can be seen in the following conditions: therapy-related granulocyte colony-stimulating factor (G-CSF) post-chemotherapy erythropoietin pathological process myelodysplastic syndromes beta-thalasse...
Article

Sacral lesions

A very wide range of lesions can occur in and around the sacrum.  Tumors primary sacral tumors malignant sacral chordoma: most common primary sacral tumor 1 chondrosarcoma Ewing sarcoma / pPNET osteosarcoma: often arises from Paget disease in this location multiple myeloma/plasmacytoma ...
Article

Basilar invagination

Basilar invagination, also called basilar impression, is a congenital or acquired craniocervical junction abnormality where the tip of the odontoid process projects above the foramen magnum.  Terminology The terms basilar invagination and basilar impression are often used interchangeably becau...
Article

Widening of interpedicular distance

The interpedicular distance, which is the distance measured between the pedicles on frontal/coronal imaging, can be widened in a number of situations. Pathology Etiology diastematomyelia syringomyelia conditions that can cause dural ectasia (can potentially cause widening) Marfan syndrome ...
Article

Anterior vertebral body beaking

Anterior vertebral body beaking occurs in a number of conditions and may emanate from the central portion or the lower third of the vertebral body. Middle third Morquio syndrome 1 (middle for Morquio) Lower third Hurler syndrome 2 achondroplasia 3 pseudoachondroplasia 4 cretinism 5 Down ...
Article

Bone within a bone appearance

Bone within a bone is a descriptive term applied to bones that appear to have another bone within them. There are numerous causes including: normal thoracic and lumbar vertebrae (neonates and infants) growth recovery lines (after infancy) cortical splitting and new periostitis sickle cell d...
Article

Gibbus deformity

A gibbus deformity is a short-segment structural thoracolumbar kyphosis resulting in sharp angulation. Pathology Etiology There are a number of causes which can be divided into congenital and acquired. Congenital achondroplasia cretinism (congenital hypothyroidism) Apert syndrome Coffin-...
Article

Dural ectasia

Dural ectasia refers to ballooning or widening of the dural sac which can result in posterior vertebral scalloping and is associated with herniation of nerve root sleeves. Clinical presentation Patients with dural ectasia may present with low back pain or radicular pain in the buttocks or legs...
Article

Vertebra plana

Vertebra plana (plural: vertebrae planae), also known as the pancake, silver dollar or coin-on-edge vertebra, is the term given when a vertebral body has lost almost its entire height anteriorly and posteriorly, representing a very advanced compression fracture. Pathology It can occur in a var...
Article

Vertebral scalloping

Vertebral scalloping is a concavity to the posterior (or less commonly anterior) aspect of the vertebral body when viewed in a lateral projection. A small amount of concavity is normal, as is concavity of the anterior vertebral body (see vertebral body squaring). Posterior scalloping Causes of...
Article

Unilateral facet dislocation

Unilateral facet dislocation is a relatively stable type of facet dislocation. Pathology Mechanism Flexion/distraction associated with rotation. The inferior articular facet of vertebral above moves over the superior facet of the vertebral below and becomes locked. It usually affects C4-C5 or...
Article

Spinal epidural mass

The differential diagnosis for a spinal epidural mass includes: epidural metastasis epidural abscess herniated nucleus pulposus epidural hematoma epidural arteriovenous malformation epidural angiolipoma epidural lipomatosis extramedullary hematopoiesis
Article

Intervertebral disc calcification

Intervertebral disc calcification is a non-specific finding seen in numerous conditions. Epidemiology It may be observed in pediatric 5 as well as adult populations. Pathology Etiology degenerative: relatively common and may occur in up to 6% of routine abdominal radiographs in adults post...
Article

Erosion of the odontoid process (differential)

Erosion of the odontoid peg can result from a number of pathological entities: inflammatory arthropathy rheumatoid arthritis: classic 1,2 systemic lupus erythematosus crystal arthropathy calcium pyrophosphate arthropathy (CPPD): relatively common gout non-inflammatory arthropathy: osteoar...

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