Articles

Articles are a collaborative effort to provide a single canonical page on all topics relevant to the practice of radiology. As such, articles are written and edited by countless contributing members over a period of time. A global group of dedicated editors oversee accuracy, consulting with expert advisers, and constantly reviewing additions.

65 results found
Article

Arachnoiditis

Arachnoiditis is a broad term encompassing inflammation of the meninges and subarachnoid space. Terminology Arachnoiditis affecting the cauda equina may be referred to as spinal/lumbar adhesive arachnoiditis.  Clinical presentation Lumbar spine arachnoiditis can result in leg pain, sensory c...
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Atlanto-occipital dissociation injuries

Atlanto-occipital dissociation (AOD) injuries are severe and include both atlanto-occipital dislocations and atlanto-occipital subluxations. Pathology The tectorial membrane and alar ligaments provide the most stability to the atlanto-occipital joint, and injury to these ligaments results in i...
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Blunt cerebrovascular injury

Blunt cerebrovascular injury (BCVI) is an uncommon but serious consequence of blunt trauma to the head and neck. Epidemiology It is often part of multi-trauma with a significant series of blunt trauma CTA reporting an incidence of approximately 1% 3. A large systematic review and meta-analysis...
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Camptocormia

Camptocormia (bent spine syndrome) is a rare syndrome characterised by involuntary flexion of the thoracolumbar spine with weight-bearing which reduces when laying down, and is due to isolated atrophy of the paraspinal muscles. Associations This condition may be associated Parkinson disease: ...
Article

Cauda equina syndrome

Cauda equina syndrome refers to a collection of symptoms and signs that result from severe compression of the descending lumbar and sacral nerve roots. It is considered a diagnostic and surgical emergency.  Epidemiology Cauda equina syndrome is rare with prevalence estimated at approximately 1...
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Cervical spine floating pillar

A floating pillar, also referred as pedicolaminar fracture-separation injury, is characterised by fractures through the pedicle and lamina of a cervical spine vertebrae creating a free-floating articular pillar fragment. It is an unstable cervical spine fracture that results from hyperflexion–la...
Article

Clasp-knife deformity

Clasp-knife deformity is relatively common congenital anomaly found at the lumbosacral junction.   Clinical presentation Clasp-knife syndrome, is one of many causes of low back pain. It occurs when a clasp-knife deformity is accompanied by pain on extension secondary to protrusion of the enlar...
Article

Coccidioidomycosis

Coccidioidomycosis refers to an infection caused by the dimorphic fungus Coccidioides spp, usually localised to the lungs. This disease is not to be confused with the similarly named paracoccidioidomycosis. Epidemiology The most common forms of Coccidioides spp are Coccidioides immitis and Coc...
Article

Congenital lumbar spinal stenosis

Congenital lumbar spinal stenosis (CLSS) is a type of vertebral central canal stenosis and has a different epidemiology with less severe degenerative change compared to acquired/degenerative lumbar spinal stenosis.  Epidemiology CLSS tends to affect patients at a younger age (30-50 years old) ...
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Conus medullaris syndrome

Conus medullaris syndrome is caused by an injury or insult to the conus medullaris and lumbar nerve roots. It is a clinical subset of spinal cord injury syndromes. Injuries at the level of T12 to L2 vertebrae are most likely to result in conus medullaris syndrome. Pathology The conus medullari...
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Degenerative disc disease

Degenerative disc disease (DDD) is an exceedingly common entity in the spine, encountered with increasing frequency throughout life and becoming almost universal in late adulthood to a varying degree. It is related to a combination biomechanical stresses and genetic predisposition which alter th...
Article

Diastematomyelia

Diastematomyelia, also known as a split cord malformation, refers to a type of spinal dysraphism (spina bifida occulta) when there is a longitudinal split in the spinal cord.  Terminology Although traditionally it has been distinguished from diplomyelia (in which the cord is duplicated rather ...
Article

Diffuse idiopathic skeletal hyperostosis

Diffuse idiopathic skeletal hyperostosis (DISH), also referred to as Forestier disease, is a common condition characterised by bony proliferation at sites of tendinous and ligamentous insertion of the spine affecting elderly individuals. On imaging, it is typically characterised by the flowing ...
Article

Disc extrusion

Disc extrusion is a type of intervertebral disc herniation and is distinguished from a disc protrusion in that it: in at least one plane, has a broader dome (B) than a neck (A)and/or extends above or below the disc level (into the suprapedicular or infrapedicular zone) Disc extrusions are ass...
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Disc sequestration

Sequestrated disc, also referred to as a free disc fragment, corresponds to extruded disc material that has no continuity with the parent disc and is displaced away from the site of extrusion. By definition, it corresponds to a subtype of disc extrusion. The term "migrated" disc refers only to ...
Article

Dorsal dermal sinus

Dorsal dermal sinus (DDS) is an epithelium-lined tract from the skin to the spinal cord, cauda equina, or arachnoid. Pathology Dorsal dermal sinus is caused by incomplete separation of the superficial ectoderm from the neural ectoderm, resulting in a focal segmental adhesion. Later during emb...
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Dorsal epidural disc migration

Dorsal epidural disc migration represents, as the name suggests, migration of disc material, usually a sequestrated disc fragment, into the dorsal (posterior) epidural space, posterior to the theca. This is a rare occurrence, often not suspected preoperatively and is almost invariably encountere...
Article

Dorsal thoracic arachnoid web

Dorsal thoracic arachnoid web is a cause of focal thoracic cord distortion with resulting neurological dysfunction.  Clinical presentation Due to the limited number of reported cases the incidence of this condition may well be under-recognised. The cases reported have a variety of signs and sy...
Article

Epidural angiolipoma

Epidural angiolipomas are rare benign tumours composed of mature adipocytes and abnormal vessels.  Epidemiology Epidural angiolipomas are more frequently encountered in women, and typically in middle age (40-50 years of age) 1.  Clinical presentation In keeping with the slow growth of these ...
Article

Extrapulmonary tuberculosis

Extrapulmonary tuberculosis (TB) refers to the haematogenous spread of Mycobacterium tuberculosis. Pathology Extrapulmonary tubercuosis can occur as a primary form of the disease, i.e. direct infection of an extrapulmonary organ without the presence of primary pulmonary tuberculosis or it can ...
Article

Fibrocartilaginous embolism

Fibrocartilaginous embolism (also known as nucleus pulposus embolism) is a rare cause of spinal cord ischaemia due to embolisation of nucleus pulposus material from intervertebral disc in a retrograde direction to a spinal artery or vein. Fibrocartilaginous embolism is a diagnosis of suspicion....
Article

Fluorosis

Skeletal fluorosis is a chronic metabolic bone disease caused by ingestion of large amounts of fluoride through either water or food in geographic areas where high levels of fluoride occur naturally. Radiographic features Plain film/CT Described features include: increased bone density: oste...
Article

Ganglioneuroma

Ganglioneuromas are fully differentiated neuronal tumours that do not contain immature elements and potentially occur anywhere along the peripheral autonomic ganglion sites.  On imaging, usually, they present as well-defined solid masses and can be quite large at presentation. Generally, they a...
Article

Intervertebral osteochondrosis

Intervertebral osteochondrosis represents the pathologic degenerative process involving the intervertebral disc and the respective vertebral body endplates (not necessarily symptomatic). It is believed to be different and a further stage of spondylosis deformans, which is a consequence of normal...
Article

Intradural disc herniation

Intradural disc herniations (IDH) occur when disc material related to an intervertebral disc hernia penetrate the spinal dura and lies in an intradural extramedullary location. Epidemiology IDH correspond to a rare presentation of a common pathology, comprising ~0.28% of all disc herniations 2...
Article

Intradural extramedullary metastases

Intradural extramedullary metastases are rare and only account for approximately 5% of spinal metastases. Please refer on leptomeningeal metastases (brain) to a general discussion focused on the brain's subarachnoid space involvement. Epidemiology The age at presentation depends on tumour typ...
Article

Intramedullary spinal metastasis

Intramedullary spinal metastases are rare, occurring in ~1% of autopsied cancer patients, and are less common than leptomeningeal metastases. Intramedullary lesions may result from: growth along the Virchow-Robin spaces haematogenous dissemination direct extension from leptomeninges Epidemi...
Article

Kümmell disease

Kümmell disease is an eponymous name for avascular necrosis and collapse of a vertebral body. Pathology Kümmell disease represents delayed (usually two weeks) vertebral body collapse due to ischaemia and non-union of the anterior vertebral body wedge fractures after major trauma. Risk factors...
Article

Limbus vertebra

Limbus vertebra is a well-corticated osseous density, usually of the anterosuperior vertebral body corner, that occurs secondary to herniation of the nucleus pulposus through the the vertebral body endplate beneath the ring apophysis (see ossification of the vertebrae). These are closely related...
Article

Lipoma of the filum terminale

Fatty filum terminale, also known as lipoma of the filum terminale or filar lipoma, is a relatively common finding on imaging of the lumbar spine, and in most cases is an incidental finding of no clinical concern. However, in some patients it may be associated with signs and symptoms of tethered...
Article

Lipomyelocele

Lipomyelocele is one of the most common closed spinal dysraphism. It is seen in thoracolumbar region and usually presents as a fatty subcutaneous mass. It is twice as common as lipomyelomeningocele. Clinical presentation Affected individuals are usually asymptomatic at birth, but many (~ 50%)...
Article

Lymphoma of the spinal cord

Lymphoma of the spinal cord is an uncommon manifestation of lymphoma. Although lymphoma more commonly involves the vertebral body (vertebral body tumours) or epidural compartment, intramedullary lymphoma may rarely occur.   Apparent intramedullary spinal cord lymphoma may often, in fact, repres...
Article

Modic type endplate changes

Modic type endplate changes represent a classification for vertebral body end-plate MRI signal, first described in 1988 1. It is widely recognised by radiologists and clinicians and is a useful shorthand for reporting MRIs of the spine. Recently Modic type I has received renewed attention due t...
Article

Myelomeningocoele

Myelomeningocoele, also known as spina bifida cystica, is a complex congenital spinal anomaly that results in spinal cord malformation (myelodysplasia).  Epidemiology It is one of the commonest congenital CNS anomalies and thought to occur in approximately 1:500 of live births 5. There may be ...
Article

Neurenteric cyst

Neurenteric cysts are a rare type of foregut duplication cyst, accounting for ~1% of all spinal cord tumours. They are usually classified as spinal or intracranial, and are associated with vertebral or CNS abnormalities respectively.  Pathology Neurenteric cysts result from incomplete resorpti...
Article

Ochronosis

Ochronosis, or alkaptonuria, is a rare multisystem autosomal recessive metabolic disorder. On imaging, the most particular presentation is on the spine, with osteoporotic bones and dense disc calcifications.  Terminology The term ochronosis usually refers to the bluish black discoloration of ...
Article

Olisthesis

Olisthesis, also known as the etymologically less correct listhesis, means slipping or sliding. Types It can be: anterolisthesis spondylolisthesis spondylolisthesis grading retrolisthesis
Article

Ossification of the ligamentum flavum

Ossification of the ligamentum flavum (OLF) is a phenomenon where there is formation of ossific-calcific components in the ligamentum flavum. It is recognised causes of myelopathy (especially in the thoracic and to a lesser degree the cervical region). Epidemiology The condition as a whole is ...
Article

Ossification of the posterior longitudinal ligament

Ossification of the posterior longitudinal ligament (OPLL) is typically an entity seen in patients of Asian descent, although it is seen in all ethnic groups. It is characterised by, as the name suggests, ossification of the posterior longitudinal ligament. Epidemiology There is a recognised g...
Article

Osteoporotic spinal compression fracture

Osteoporotic spinal compression fractures occur as a result of injury, commonly fall onto the buttock or pressure from normal activities, to the weakened vertebrae due to osteoporosis. Epidemiology They have a reported incidence of 1.2 per 1000 person-years after 85 years of age in the United ...
Article

Pneumorrhachis

Pneumorrhachis (PR) refers to a rare phenomenon characterized by the presence of air within the spinal canal (either intra- or extradural). Clinical presentation Patients can often be asymptomatic 3. Pathology Aetiology PR can result from a number of causes: trauma (traumatic pneumorrhachi...
Article

Pott disease

Pott disease, also known as tuberculous spondylitis, refers to vertebral body and intervertebral disc involvement with tuberculosis (TB). The spine is the most frequent location of musculoskeletal TB, and commonly related symptoms are back pain and lower limb weakness/paraplegia. Epidemiology ...
Article

Radiation induced MRI signal changes in bone

Radiation induced MRI signal changes in bone are the earliest detectable changes in bone. They increase with increase in the radiation dose. Pathology 1st week: decreased marrow cellularity with oedema and haemorrhage 2nd week: increased marrow cellularity due to influx from unirradiated area...
Article

Romanus lesion

The Romanus lesion represents an early finding in inflammatory spondyloarthropathies, such as ankylosing spondylitis and enteropathic arthritis, and appears as irregularity and erosion involving the anterior and posterior edges of the vertebral endplates 1. Healing response to these inflammatory...
Article

Sacral dimple

Sacral dimples are a clinical and radiological feature that is associated with occult spinal dysraphism (e.g. tethered cord syndrome) but are more frequently a non-significant isolated finding. Epidemiology Common in healthy children (~5%) 1. Pathology Simple sacral dimples have the followin...
Article

Sacral insufficiency fractures

Sacral insufficiency fractures are stress fractures, which are the result of normal stresses on abnormal bone, most frequently seen in the setting of osteoporosis. They fall under the broader group of pelvic insufficiency fractures. Clinical presentation They are usually seen in elderly female...
Article

Spina bifida

Spina bifida is a type of neural tube defect/spinal dysraphism which can occur to varying degrees of severity. It is often considered the most common congenital CNS malformation. Epidemiology The estimated incidence is at 1:1000-2000 live births 2. Clinical presentation A constellation of fe...
Article

Spina bifida occulta

Spina bifida occulta is the mildest form of spina bifida and is a type of neural tube defect that affects the spinal cord. Epidemiology Spinda bifida occulta is the commonest form of spina bifida, and is estimated to affect between 10-20% of the population in most western countries. Clinical ...
Article

Spinal astrocytoma

Spinal astrocytomas are the second most common spinal cord tumour overall, representing 40% of intramedullary tumours 3. They account for 60% of paediatric intramedullary tumours, making them the most common spinal cord tumour in children 6. This article specifically relates to spinal astrocyto...
Article

Spinal cord cavernous malformation

Spinal cord cavernous malformations, also known as spinal cavernomas, are vascular malformations that occur within the spinal cord. This article specifically relates to spinal cord cavernomas. For a discussion of cerebral cavernomas and a general discussion of the pathology refer to the main ar...
Article

Spinal ependymoma

Spinal ependymomas are the most common spinal cord tumour overall, seen both in adult and paediatric population.  This article specifically relates to spinal cord ependymomas. For a discussion of intracranial ependymomas and for a general discussion of the pathology refer to the main article: e...
Article

Spinal epidural abscess

Spinal epidural abscess represents infection of the epidural space, located between the spinal dura mater and the vertebral periosteum. It can present with rapidly deteriorating neurological function due to compression. Imaging is best performed with MRI and emergency surgery is often required. ...
Article

Spinal epidural haematoma

Spinal epidural haematomas (spinal EDH) are a rare spinal pathology can result in serious morbidity with delayed or non-treatment. They are typically considered a surgical emergency.  Clinical presentation The patient's symptoms and signs will depend on the location of the EDH, and degree of s...
Article

Spinal meningeal cyst

Spinal meningeal cysts are diverticulae of the arachnoid or dura mater or of the nerve root sheath. They are uncommon, usually asymptomatic and typically found incidentally at MRI (that has been performed for another reason).  Clinical presenation They cysts are usually asymptomatic, but if th...
Article

Spinal meningioma

Meningiomas arising from the coverings of the spinal cord represent a minority of all meningiomas (approximately 12% 5) but are the second most common intradural extramedullary spinal tumour representing 25% of all such tumours 2. Despite usually being small, due to the confines of the spinal ca...
Article

Spinal myxopapillary ependymoma

Spinal myxopapillary ependymomas are a variant type of spinal ependymoma that occur almost exclusively in the conus medullaris and filum terminale. They represent 13% of all spinal ependymomas, and are by far the most common tumours of the conus medullaris and filum terminale.   Epidemiology T...
Article

Spondylolisthesis

Spondylolisthesis is a term denoting anterolisthesis of a vertebra relative to the segment below, typically due to spondylolysis (pars interarticularis defects). This term is often used to denote anterolisthesis from any cause (e.g. degenerative spondylosis).  Pathology Location Spondylolisth...
Article

Spondylolysis

Spondylolysis is a defect in the pars interarticularis of the neural arch, the portion of the neural arch that connects the superior and inferior articular facets. It is commonly known as pars interarticularis defect or more simply as pars defect.  Epidemiology Spondylolysis is present in ~5% ...
Article

Tarlov cyst

Tarlov cysts, also called perineural cysts, are CSF filled dilatations of the nerve root sheath at the dorsal root ganglion (posterior nerve root sheath). These are type II spinal meningeal cysts that are, by definition, extradural but contain neural tissue. Epidemiology They occur in ~5% of t...
Article

Terminal myelocystocele

Terminal myelocystoceles are an uncommon form of spinal dysraphism representing marked dilatation of the central canal of the spinal cord, herniating posteriorly through a dorsal spinal defect. The result is a skin-covered mass in the lower lumbar region, consisting of an ependyma-lined sac.  E...
Article

Transverse myelitis

Acute transverse myelitis (ATM) is an inflammatory condition affecting both halves of the spinal cord and associated with rapidly progressive motor, sensory, and autonomic dysfunction. It is mostly imaged with MRI, which generally shows a long segment (3-4 segments or more) of T2 increased sign...
Article

Ventral cord herniation

Ventral cord herniation, also known by a variety of other terms such as spontaneous thoracic cord herniation or idiopathic spinal cord herniation, is a rare cause of focal myelopathy due to herniation of the thoracic cord through a dural defect.  Post surgical cord herniation can occur at any l...
Article

Vertebral haemangioma

Vertebral haemangiomas are the most common benign vertebral neoplasms. They are usually asymptomatic and incidentally detected due to their characteristic features on imaging for other reasons. Please refer on the article on primary intraosseous haemangioma for a general discussion in this enti...
Article

Vertebral metastases

Vertebral metastases represent the secondary involvement of the vertebral spine by haematogenously-disseminated metastatic cells. They must be included in any differential diagnosis of a bone lesion in a patient older 40 years. This article will focus only on the metastasis involving the bony s...
Article

Vertebral pneumatocyst

Vertebral pneumatocysts refer to the presence of air filled cavity within the vertebrae, more prevalent on the cervical spine. Intraosseous pneumatocysts are more common adjacent to the sacroiliac joint while it is rare in the vertebral column. Other causes of vertebral air e.g. Kummel disease, ...

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