Abstract
ObjectiveTo describe expected imaging findings to assist the emergency room radiologist with recognising complications and pathology unique to the spinal cord injury (SCI) patient population to ensure rapid and accurate diagnosis.MethodsPictorial review.ResultsWe review several imaging findings common to persons with chronic SCI, emphasising imaging in the emergency setting and on CT.ConclusionSCI patients present a unique diagnostic challenge, as they may present with symptoms that are difficult to localise because of abnormal sensation and autonomic instability. Imaging plays an important role in the emergent setting, rapidly differentiating the most commonly encountered complications from less common, unanticipated complications. Radiologists need to be attuned to both the expected findings and potential complications, which may be unique to SCI patients, to ensure accurate diagnosis and treatment in the emergency setting.Main Messages• Medical complications after spinal cord injury are common and associated with significant morbidity.• Radiologists should be aware of complications unique to the SCI population to aid diagnosis.• Due to abnormal sensation, SCI patients often present with symptoms that are difficult to localise.• In the ED, imaging helps to rapidly differentiate common complications from less anticipated ones.
Highlights
For individuals surviving beyond 1 year post spinal cord injury (SCI), life expectancy is estimated at 90 % of that of the general population [2, 3]
To ensure rapid and accurate diagnosis, it is essential that the radiologist be familiar with expected imaging findings, recognise complications and pathology unique to the SCI patient population, and be knowledgeable of emergency conditions and potential pitfalls in diagnosing and treating SCI patients
An unusual contour, described as an hourglass configuration, can result from detrusor hyperactivity, or secondary to a malpositioned suprapubic catheter with excessive traction applied to the bladder dome, but this imaging feature is more apparent on cystography [9]
Summary
We review several imaging findings common to persons with chronic SCI, emphasising imaging in the emergency setting and on CT. Radiologists need to be attuned to both the expected findings and potential complications, which may be unique to SCI patients, to ensure accurate diagnosis and treatment in the emergency setting. For individuals surviving beyond 1 year post SCI, life expectancy is estimated at 90 % of that of the general population [2, 3] Despite these significant improvements in survival and life expectancy, medical complications after SCI are common and associated with significant morbidity. Spinal cord injured patients are frequently evaluated and imaged in the emergency room setting. To ensure rapid and accurate diagnosis, it is essential that the radiologist be familiar with expected imaging findings, recognise complications and pathology unique to the SCI patient population, and be knowledgeable of emergency conditions and potential pitfalls in diagnosing and treating SCI patients. We have included a table including practical ‘pearls and pitfalls’ for readers’ benefit (Table 1)
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