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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.


PACS (picture archiving and communication system) allows the radiologist to cross-reference sagittal and axial images to a specific level or specific point. The white line on the sagittal image indicates the specific level and angle of the accompanying axial image. The line through the axial image defines the transverse location of the sagittal image.  This is a convenient feature which helps the radiologist to  quickly and accurately correlate axial and sagittal findings.
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MPX2514_synpic19031: PACS (picture archiving and communication system) allows the radiologist to cross-reference sagittal and axial images to a specific level or specific point. The white line on the sagittal image indicates the specific level and angle of the accompanying axial image. The line through the axial image defines the transverse location of the sagittal image. This is a convenient feature which helps the radiologist to quickly and accurately correlate axial and sagittal findings.


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

Sutcliffe JBS - MedPix

PACS (picture archiving and communication system) allows the radiologist to cross-reference sagittal and axial images to a specific level or specific point. The white line on the sagittal image indicates the specific level and angle of the accompanying axial image. The line through the axial image defines the transverse location of the sagittal image.  This is a convenient feature which helps the radiologist to  quickly and accurately correlate axial and sagittal findings.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

MPX2514_synpic19031: PACS (picture archiving and communication system) allows the radiologist to cross-reference sagittal and axial images to a specific level or specific point. The white line on the sagittal image indicates the specific level and angle of the accompanying axial image. The line through the axial image defines the transverse location of the sagittal image. This is a convenient feature which helps the radiologist to quickly and accurately correlate axial and sagittal findings.

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.