Radiation myelitis

Case contributed by Dr Pankaj Saini


Follow up case of breast carcinoma, with vertebral metastasis at T10 level who received high-dose of radiation therapy. Presented with complaints of pain in dorsal spine and inability to walk. Neurological examination revealed spastic paraparesis (grade: 4/5), sensory deficit below the T10 level.

Patient Data

Age: 30 years
Gender: Female

Radiation myelitis: CT imaging

CT scan imaging shows hyperdense T10 vertebra with focal small hypodensity seen. T8, T9, T11 and T12 vertebrae show reduced attenuation. 


Radiation myelitis: MRI imaging

Vertebral bodies show hyperintense signal on T1 weighted images and intermediate signal intensity on T2 weighted fat saturation images, with T8 vertebral body showing intermediate signal on T1 and suppression of signal on T2 weighted fat saturation images.

Spinal cord shows intramedullary hyperintense signal on T2 weighted images, which is localized in the radiation field.

Case Discussion

Demyelination results from damage to white matter, which is an unavoidable incident due to the varied sensitivity of myelin and surrounding soft tissue.

It is reported that the dorsal segment of spinal cord can tolerate 200cGy per day up to 5000 cGy radiation.

This condition is very well demonstrated on MRI evaluation.


  • Dr. Fazal T. Syed (MD Radiodiagnosis, consultant medical imaging - Artemis health institute)
  • Dr. Saini Pankaj (MD Radiodiagnosis, consultant medical imaging - Artemis health institute)
  • Dr. Mehta Sanjay (MD Radiodiagnosis, head of the department, medical imaging - Artemis health institute)
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Case information

rID: 35311
Published: 28th Apr 2015
Last edited: 7th May 2020
Inclusion in quiz mode: Included

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