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Case Challenge: Spine MRI Cases


Spine MRI Case Challenge Pre-Course Activities
2 topics

18b - Answer: A patient with back pain and right-sided sciatica

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

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Watch Dr. David Yousem review similar cases on spondylolysis


Case Report

HISTORY: Back pain. Right-sided sciatica

MRI REPORT

TECHNIQUE: 
Sagittal T1 weighted, sagittal T2 weighted, sagittal STIR, axial T1 weighted, and axial T2 weighted scans were performed through the lumbar spine.
 
FINDINGS: 
The conus medullaris has normal signal intensity and terminates at an appropriate level.
 
The alignment of the vertebral bodies and the signal intensity of the vertebral bodies show normal alignment of the vertebral bodies in signal intensity of the vertebral bodies.

Axial scans through the lumbar spine are normal. The patient shows bilateral healed pars defects at the L5 level without anterolisthesis, canal compromise, or foraminal stenosis.

Mild sacroiliac joint degenerative changes present.

IMPRESSIONS:

  1. Bilateral healed pars defects without canal stenosis or spondylolisthesis.
  2. Sacroiliac joint degenerative changes, right greater than left.

CT REPORT

EXAMINATION: CT lumbar spine without contrast.  
 
INDICATION: 24-year-old female with L5-S1 spondylolisthesis and back pain.  
 
TECHNIQUE:  
Contiguous axial CT images of the lumbar spine without intravenous  
contrast material.  
 
COMPARISON:  
None available.  
 
FINDINGS:   
1 mm anterolisthesis L5 over S1. Otherwise normal alignment of the lumbar  
vertebral bodies. Spondylolysis bilaterally at L5. No evidence of acute  
fracture. Intervertebral disc heights are preserved.  
 
T12-L1: No significant spinal canal or neural foraminal narrowing.  
L1-2: No significant spinal canal or neural foraminal narrowing.  
L2-3: No significant spinal canal or neural foraminal narrowing.  
L3-4: No significant spinal canal or neural foraminal narrowing.  
L4-5: No significant spinal canal or neural foraminal narrowing.  
L5-S1: No significant spinal canal or neural foraminal narrowing.  
 
Urinary bladder is distended.  
 
IMPRESSIONS:   

  1. No acute abnormality in the lumbar spine.  
  2. Spondylolysis bilaterally at L5. Minimal (1 mm, grade I)  
    anterolisthesis L5 over S1. 

 

LESSON 5, TOPIC 9

Case Challenge: Spine MRI Cases

Case Challenge

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