Chronic back pain.
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1.3 cm well-circumscribed T1 and T2 isointense homogeneously enhancing intradural, extra-meduallary lesion at the origin of the filum terminale.
Minor displacement of the cauda roots, but no impingement.
The remainder of the spine is normal.
A good fellowship examination case as:
- Good for candidate to describe
- Analyze the analytical skills to determine its anatomical origin
- Provide a sensible differential
- Probe as to which is the most likely pathology
Although ependymoma, schwannoma and neurofibroma are apt differential diagnoses, the signal characteristics are most fitting with a meningioma. This is the only one which is not typically hyperintense on the T2 sequences.
This was re-imaged 2 years later and was unchanged.