Case 148

Abstract

HomeRadiologyVol. 251, No. 1 PreviousNext Diagnosis PleaseFree AccessCase 148Nanda Venkatanarasimha, Richard W. ParrishNanda Venkatanarasimha, Richard W. ParrishAuthor Affiliations1From the Department of Neuroradiology, Derriford Hospital, Derriford Road, Level 6, Plymouth PL6 8DH, England. Received March 3, 2008; revision requested April 9; final revision received April 19; accepted April 23; final version accepted May 13.Address correspondence to N.V. (e-mail: [email protected]).Nanda VenkatanarasimhaRichard W. ParrishPublished Online:Apr 1 2009https://doi.org/10.1148/radiol.2511080364MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked InEmail HISTORYA 61-year-old man presented to the emergency department with sudden onset of inability to walk, worsening of long-standing back pain, and bilateral lower limb weakness. There were no bowel or bladder problems. He had an 18-month history of progressive back and bilateral lower limb pain and difficulty walking. (He required rest after walking 100 yards.) He did not have a history of peripheral vascular disease. Relevant medical history included diet-controlled diabetes mellitus and chronic obstructive pulmonary disease, for which he had received high-dose inhaled steroids for 4 years prior to admission. He had received oral steroids occasionally but for no more than a few days at a time. Neurologic examination revealed spastic paraparesis and decreased sensation below the T9 vertebra. Magnetic resonance (MR) imaging of the thoracolumbar spine was performed (,Figs 1,, ,2,).Submit the most likely diagnosis to http://rsna.org/dxplease (use only for submission of diagnosis). Select the case from the Active Case List for which you are submitting a diagnosis. Only one case, one name, and one diagnosis per e-mail submission. Multiple diagnoses and multiple submissions will not be considered. Deadline: Midnight U.S. Central Time, June 10, 2009. Answer will appear in the August issue. Authors wishing to submit cases for Diagnosis Please should first write to the Editor to obtain approval for the case and further information.Figure 1a: Fast spin-echo sagittal (a) T1-weighted (repetition time msec/echo time msec, 400/10.5; 4-mm section thickness) and (b) T2-weighted (3500/120, 4-mm section thickness) MR images of the thoracic spine.Figure 1a:Download as PowerPointOpen in Image Viewer Figure 1b: Fast spin-echo sagittal (a) T1-weighted (repetition time msec/echo time msec, 400/10.5; 4-mm section thickness) and (b) T2-weighted (3500/120, 4-mm section thickness) MR images of the thoracic spine.Figure 1b:Download as PowerPointOpen in Image Viewer Figure 2a: Fast spin-echo axial (a) T1-weighted (400/11, 4.5-mm section thickness) MR image at the T7 vertebral body level and (b) T2-weighted (4478/120, 4-mm section thickness) MR image at the T6-T7 dorsal intervertebral disk level.Figure 2a:Download as PowerPointOpen in Image Viewer Figure 2b: Fast spin-echo axial (a) T1-weighted (400/11, 4.5-mm section thickness) MR image at the T7 vertebral body level and (b) T2-weighted (4478/120, 4-mm section thickness) MR image at the T6-T7 dorsal intervertebral disk level.Figure 2b:Download as PowerPointOpen in Image Viewer Authors stated no financial relationship to disclose.Article HistoryPublished in print: 2009 FiguresReferencesRelatedDetailsRecommended Articles Nontraumatic Spinal Cord Compression: MRI Primer for Emergency Department RadiologistsRadioGraphics2019Volume: 39Issue: 6pp. 1862-1880Injuries to the Rigid Spine: What the Spine Surgeon Wants to KnowRadioGraphics2019Volume: 39Issue: 2pp. 449-466CT Myelography: Clinical Indications and Imaging FindingsRadioGraphics2020Volume: 40Issue: 2pp. 470-484Case 234: Neuropathic SpondyloarthropathyRadiology2016Volume: 281Issue: 1pp. 314-319Multimodality Imaging Evaluation of Fetal Spine Anomalies with Postnatal CorrelationRadioGraphics2021Volume: 41Issue: 7pp. 2176-2192See More RSNA Education Exhibits Acuity and Etiology of Vertebral Compression Fractures on Plain RadiographyDigital Posters2018The Fault of Being Laid Back? Intraspinal Fat Containing LesionsDigital Posters2018The Whole Spine Yards: A Review of Pediatric Spine TraumaDigital Posters2019 RSNA Case Collection Diffuse idiopathic skeletal hyperostosis RSNA Case Collection2020Spinal canal cement leakRSNA Case Collection2021Pediatric Idiopathic Intervertebral Disc CalcificationRSNA Case Collection2020 Vol. 251, No. 1 Metrics Downloaded 287 times Altmetric Score