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Case Challenge: Spine MRI Cases


Spine MRI Case Challenge Pre-Course Activities
2 topics

12b: Answer - High-speed motor vehicle collision (MVC) Trauma

David Yousem MBA, MD
David M Yousem, MBA, MD
Professor of Radiology, Vice Chairman and Associate Dean
Includes DICOM files

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Case Report

HISTORY: Trauma, MVC at 35 miles per hour.

TECHNIQUE: Axial CT scan images were performed through the cervical spine without administration of intravenous contrast.

FINDINGS:

CT CERVICAL SPINE:
Craniocervical junction is intact.
Alar ligament calcification.
There is no acute fracture or traumatic listhesis.
Vertebral bodies are normal in height. The intervertebral disk spaces are well preserved.
The facet joint alignment is anatomic bilaterally.
Posterior vertebral body alignment is preserved.
There is straightening of normal cervical lordosis, which may positional or related to muscle spasm.
Prevertebral soft tissues are unremarkable.  There is no paraspinal hematoma.
Advanced degenerative changes of the cervical spine with diffuse anterior longitudinal ligament calcification and bridging osteophytes, compatible with diffuse idiopathic skeletal hyperostosis.
Additionally, there is calcification and thickening of the posterior longitudinal ligament, compatible with OPLL.
Crescentic radiodensity posterior to the tip of the C7 spinous process compatible with chronic deformity.

C2-C3: No significant spinal canal or neural foraminal stenosis.

C3-C4: No significant spinal canal or neural foraminal stenosis.  

C4-C5: Mild bilateral neural foraminal narrowing secondary to posterior osteophytes and posterior longitudinal ligament calcifications.

C5-C6: Mild bilateral neural foraminal narrowing secondary to posterior osteophytes and posterior longitudinal ligament calcifications.

C6-C7: Mild left neural foraminal narrowing secondary to posterior osteophytes and posterior longitudinal ligament calcifications.

C7-T1: No significant spinal canal or neural foraminal stenosis.

IMPRESSION:
1.   Diffuse calcification of the anterior longitudinal ligament, which may
be compatible with diffuse idiopathic skeletal hyperostosis.
2.  Ossification of the posterior longitudinal ligament. 

LESSON 4, TOPIC 6

Case Challenge: Spine MRI Cases

Case Challenge

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