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L5-S1 disk herniation with sequestered disk material in the spinal canal, compressing the cauda equina and causing myelopathic symptoms

Sutcliffe JBS - MedPix

View Article: MedPix Image - MedPix Case

Affiliation: Brooke Army Medical Center

ABSTRACT

Diagnosis: L5-S1 disk herniation with sequestered disk material in the spinal canal, compressing the cauda equina and causing myelopathic symptoms

History: Patient heard his lower back "pop" during exercise. Within a few hours, he developed decreased sensation in his groin and urinary incontinence.

Findings: Image 1 is a sagittal T2 weighted MRI of the lumbar spine demonstrating a low signal structure compressing the cauda equina posterior to the superior sacrum Image 2 is an axial T-2 weighted image at the level upper sacrum demonstrating the low signal structure in the axial plane Image 3 is the same axial image with arrows pointing out the pertinent finding Image 4 is a magnified view of the sagittal image with arrows Image 5 demonstrates the utility of the cross-referencing function of a PACS.

Ddx: L5-S1 Disk extrusion/sequestered disk with compression of cauda equina Other extradural spinal lesions, much less likely in light of patient's history: Spinal canal meningioma Spinal canal schwannoma Spinal canal neurofibroma Chordoma Dural or extradural metastatic disease (e.g. lymphoma) Spinal AVM Osteochondroma

Dxhow: The MRI morphology and signal characteristics of the lesion and the patient's history of hearing his back "pop" during exercise followed by the acute onset of perineal hypesthesia and urinary incontinence, essentially excludes all other diagnostic possibilities

Exam: Decreased perineal sensation.

No MeSH data available.


Arrows identify the low signal structure in the sagittal plane
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MPX2514_synpic19030: Arrows identify the low signal structure in the sagittal plane


L5-S1 disk herniation with sequestered disk material in the spinal canal, compressing the cauda equina and causing myelopathic symptoms

Sutcliffe JBS - MedPix

Arrows identify the low signal structure in the sagittal plane
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2514&req=5

MPX2514_synpic19030: Arrows identify the low signal structure in the sagittal plane

View Article: MedPix Image - MedPix Case

Affiliation: Brooke Army Medical Center

ABSTRACT

Diagnosis: L5-S1 disk herniation with sequestered disk material in the spinal canal, compressing the cauda equina and causing myelopathic symptoms

History: Patient heard his lower back "pop" during exercise. Within a few hours, he developed decreased sensation in his groin and urinary incontinence.

Findings: Image 1 is a sagittal T2 weighted MRI of the lumbar spine demonstrating a low signal structure compressing the cauda equina posterior to the superior sacrum Image 2 is an axial T-2 weighted image at the level upper sacrum demonstrating the low signal structure in the axial plane Image 3 is the same axial image with arrows pointing out the pertinent finding Image 4 is a magnified view of the sagittal image with arrows Image 5 demonstrates the utility of the cross-referencing function of a PACS.

Ddx: L5-S1 Disk extrusion/sequestered disk with compression of cauda equina Other extradural spinal lesions, much less likely in light of patient's history: Spinal canal meningioma Spinal canal schwannoma Spinal canal neurofibroma Chordoma Dural or extradural metastatic disease (e.g. lymphoma) Spinal AVM Osteochondroma

Dxhow: The MRI morphology and signal characteristics of the lesion and the patient's history of hearing his back "pop" during exercise followed by the acute onset of perineal hypesthesia and urinary incontinence, essentially excludes all other diagnostic possibilities

Exam: Decreased perineal sensation.

No MeSH data available.