Arachnoiditis

Case contributed by A.Prof Frank Gaillard

Presentation

Back pain.

Patient Data

Age: 65 years
Gender: Female
MRI

The conus is normal in appearance and terminates at the T12 level.

The cauda equina demonstrate clumping of the nerve roots seen commencing at the L2/L3 level and extending down to the sacral cul de sac. 

Anatomical variant with sacralisation of the L5 vertebral body. Modic type 2 endplate changes are seen at the L4/L5 level.

T12/L1 & L1/2: Normal appearances.

L2/3: Asymmetric disc bulge extending beyond the left lateral aspect of the vertebral body. No central canal, subarticular recess or neural exit foraminal stenosis.

L3/4: Asymmetric disc bulge with minor central canal and left subarticular recess narrowing. No neural exit foraminal narrowing.

L4/5: Grade 1 retrolisthesis of L4 on L5. Minor symmetric disc bulge without central canal, subarticular or exit foraminal narrowing.

L5/S1: Normal appearances.

Conclusion:

Clumping of the nerve roots is a new finding compared to scan from 5 years ago (not shown) and is consistent with arachnoiditis.  This may relate to any interval spinal intervention, infection or trauma during this period.

Case Discussion

The features are characteristic of arachnoiditis, which is secondary to a wide number of insults. In this patient insufficient information was provided to ascribe these findings to a specific cause. 

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Case information

rID: 33345
Case created: 8th Jan 2015
Last edited: 26th Apr 2017
Inclusion in quiz mode: Included

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