Cervical spondylodiskitis and calvarial hemangioma

Case contributed by Dr Ammar Haouimi

Presentation

Painless swelling of the right parietal region with recent neck pain.

Patient Data

Age: 40 years
Gender: Female

There is an expansile coarse trabeculated intraosseous lesion of the right parietal bone with thinning of the internal and external skull tables. It appears non-homogeneously, hypo-to-isointense on T1WI, hyperintense on FLAIR and T2WI with inhomogeneous enhancement following IV contrast. A mass effect is noted on the adjacent parietal lobe as well as the superior sagittal sinus which remains patent. No intra-axial extension seen.

In the cervical region on the sagittal T1 sequence, there is an abnormal appearance at the C4-C5 level.

The patient was called and an MRI of the cervical spine was performed 5 days later. It shows a subtle narrowing of C4-C5 disc space of intermediate signal intensity on T1WI with area high signal intensity on T2WI and STIR. The C4 and C5 vertebral bodies appear of low signal intensity on T1WI, high signal intensity on T2WI with enhancement on post-contrast sequences (bone marrow edema). No evidence of destruction of the neighboring endplates. Note a fusiform soft tissue mass in the anterior epidural space at the C4-C5 level of intermediate signal intensity on both T1WI and T2WI with homogeneous enhancement following IV contrast (epiduritis).

Case Discussion

MRI features of a C4-C5 spondylodiskitis in a patient with skull vault hemangioma

In such case, it is important that the radiologist must take in consideration the clinical data during the visualization and interpretation of any radiological examination.

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Case information

rID: 64317
Published: 16th Nov 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria

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