Diagnostic discography

Case contributed by Dr G Balachandran

Presentation

Referred for evaluation of chronic low backache.

Patient Data

Age: 35
Gender: Female
MRI

Isointense extradural mass close to L4/L5 disc.

X-ray

Contrast shown extravasating around extruded L4/L5 disc. No evidence of tumour.

CT

Contrast encircling disc material.

Case Discussion

The most common cause of extradural mass in lumbar region is disc material. The morphology of the lesion depends upon whether it is the disc protrusion, extrusion or sequestration. Moreover a tumour has to be ruled out before surgery.

In our case L4 / L5 disc was degenerated with a mass attached to it indicating disc extrusion. We wanted to rule out any possibility of a tumour. So we performed a discography under fluoroscopy guidance which unequivocally confirmed the disc extrusion and ruled out any tumour. CT axial images were also obtained to cross check discography findings. At surgery a 17 x 16 mm disc extrusion was confirmed.

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Case information

rID: 19588
Case created: 27th Sep 2012
Last edited: 30th Jan 2016
Tag: spine
Inclusion in quiz mode: Included

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