Vertebral and Paravertebral Diseases
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1 Department of Radiology University of California San Diego Vertebral and Paravertebral Diseases John R. Hesselink, M.D.
2 Vertebral / Paravertebral Disease (Extradural) Metastatic disease Primary bone tumors Bone marrow disease Paraspinal tumors Infection
3 History: 72 y/o man with esophageal CA Sag T1 Sag T2 T1-Gd-FS
4 Breast Metastases T1 FSE T2 FSE STIR
5 History: 28 y/o female with back pain & urinary incontinence 569
6 {Page 2}
7 {Page 3} Dx: Lymphoma
8 History: 64 y/o woman with back pain Dx: Diffuse Breast metastases 547
9 History: 62 y/o man with back pain Dx: Diffuse Prostate metastases 548
10 Vertebral Compression Benign vs. Malignant Marrow signal intensity Signal pattern on T1WIs Pedicles & posterior elements Paraspinal mass Enhancement features Diffusion properties
11 Breast Metastases T1 FSE T2 FSE STIR
12 History: 70 y/o woman with back pain 545
13 Dx: Renal cell CA {Page 2}
14 Traumatic Vertebral Fracture 3 Weeks Ago LE 1-2
15 Benign Vertebral Collapse LE 3-5
16 {Page 2}
17 Biopsy negative for tumor {Page 3}
18 Chronic Benign Vertebral Collapse
19 Chronic Vertebral Collapse with a Subacute Endplate Compression
20 Acute Vertebral Fracture T2 FSE T1 FSE STIR
21 Vertebral Body Fracture T2 FSE T1 FSE STIR
22 Spinal Metastases Post Radiation Therapy TD 40
23 History: 62 y/o man with spasms in the mid-back Dx: Vertebral Hemangioma 222
24 History: 55 y/o man with progressive leg weakness for 6 months
25 Dx: Vertebral hemangioma {Page 2}
26 Primary Bone Tumors Osteosarcoma Chondrosarcoma Osteoblastoma Aneurysmal bone cyst Giant cell tumor Osteoid osteoma Eosinophilic granuloma Vascular tumors
27 31 History: 55 y.o. man with leg weakness
28 Dx: Chondrosarcoma Leg weakness {Page 2}
29 Osteoblastoma Jerry Dwek, Rady Children s Hospital of San Diego
30 History: 11 month male
31 {Page 2} Marvin Nelson, Children s Hospital of Los Angeles Dx: Osteochondroma
32 Aneurysmal Bone Cyst Jerry Dwek, Rady Children s Hospital of San Diego
33 Mark Halsted & Elizabeth Ey, Cincinnati Children s Hospital Aneurysmal Bone Cyst
34 {Page 2}
35 Osteoid Osteoma Jerry Dwek, Rady Children s Hospital of San Diego
36 Langerhans Cell Histiocytosis Jerry Dwek, Rady Children s Hospital of San Diego
37 History: 67 y/o man with sacral pain with sitting & kneeling 766 VA7495
38 Dx: Sacral chordoma {Page 2}
39 History: 41 y.o. female with low back and buttock pain 67
40 {Page 2} Dx: Sacral metastasis - Breast carcinoma
41 Bone Marrow Disease Metastatic disease Tumors of blood cell origin Blood dyscrasias / anemias Radiation therapy
42 History: 65 y/o woman with back pain & progressive leg weakness & gait problem for 2 months 656
43 Dx: Plasmacytoma {Page 2}
44 History: 53 y/o woman with back pain & bilateral foot numbness 692
45 Dx: Plasmacytoma & Multiple myeloma {Page 2}
46 History: 32 y/o man with back pain Dx: Epidural lymphoma 557
47 Leukemia Sag T1 Sag T2 FS T1-FS post contrast Evelyne Fliszar, UC San Diego
48 History: 54 y/o woman with CLL & right foot numbess Sag T2 Sag T1 T1-FS post contrast
49 History: 54 y/o woman with chronic lymphocytic leukemia, anemia, & s/p bone marrow transplant Dx: Anemia of chronic disease 714
50 History: 35 y/o man with chronic leg ulcer for 4 months 517
51 Dx: Staph osteomyelitis {Page 2}
52 History: 40 y/o man with worsening back & abdominal pain for 3 weeks 653
53 Dx: TB spine {Page 2}
54 578 History: 50 y/o man with AIDS, hepatitis B & back pain
55 Dx: Staph osteomyelitis & psoas abscesses {Page 2}
56 History: 30 y/o man with neck pain 371
57 {Page 2} Dx: IVDA - Staph osteomyelitis
58 Cocci Osteomyelitis CC 1-2
59 {Page 2}
60 162 History: 23 y/o male IVDA who had an MVA following an overdose
61 {Page 2} Dx: Staph epidural abscess
62 History: 46 y/o woman developed left arm pain and difficulty swallowing 1 week post anterior cervical diskectomy & fusion 595
63 Dx: Retropharyngeal abscess {Page 2}
64 History: 40 y/o male with fever, back pain, and a T6 sensory level 423
65 Dx: Epidural abscess {Page 2}
66 422 History: 73 y/o female with a urinary tract infection and progressive lower extremity weakness and hyperreflexia
67 Dx: Epidural abscess {Page 2}
68 History: 68 y/o woman developed leg weakness following hip surgery 217
69 She also had an epidural catheter for pain control & was on coumadin for deep vein thrombosis {Page 2} Dx: Epidural Hemorrhage (Lab: INA = 3.0)
70 299 History: 16 y/o male with back pain since a fall 2 weeks ago
71 Back pain {Page 2} Dx: Subacute epidural hematoma
72 History: 43 y/o man with chronic progressive morning neck pain 386
73 Dx: OPLL {Page 2}
74 History: 37 y/o man with bilateral leg pain 166
75 {Page 2} Dx: Neurofibromatosis, Type 1
76 History: 69 y/o woman with back pain Dx: Abdominal aortic aneurysm 323
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