MRI: Collapsed Vertebral Bodies

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MRI: Collapsed Vertebral Bodies

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  4. 5. COLLAPSED VERTEBRAL BODIES <ul><li>Metastases & myeloma </li></ul><ul><li>Infections </li></ul><ul><li>Osteoporosis & osteomalacia </li></ul><ul><li>Trauma </li></ul><ul><li>Eosinophilic granuloma </li></ul>
  5. 6. LYSIS WITHIN A VERTEBRA <ul><li>Metastases – primary tumors of lung, breast, kidneys </li></ul><ul><li>Multiple myeloma / Plasmacytoma </li></ul><ul><li>Malignant lymphoma </li></ul>DENSE VERTEBRA <ul><li>Metastases – primary tumors of prostate, breast. </li></ul><ul><li>Malignant lymphoma </li></ul><ul><li>Paget’s disease </li></ul><ul><li>Hemangioma </li></ul>
  6. 7. POTT’S DISEASE (TB SPINE) <ul><li>Spine is MC site of bone & joint TB. </li></ul><ul><li>Types of vertebral TB </li></ul><ul><li>A) paradiscal B) Central C) Anterior D) posterior </li></ul><ul><li>Radiological examination: </li></ul><ul><li>Reduction of disc space </li></ul><ul><li>Destruction of vertebral body- contiguous margins, wedging, angular kyphotic deform. </li></ul><ul><li>Evidence of cold abscess. </li></ul><ul><li>Psoas, retropharyngeal abscess. </li></ul><ul><li>Widening mediastinum. </li></ul>
  7. 8. VERTEBRAL METASTASES <ul><li>Bone destruction & replacement of marrow signal by tumor on MRI </li></ul><ul><li>Disc space is normal </li></ul><ul><li>Classification of vertebral lesions : </li></ul><ul><li>Grade1: partial or total vertebral invasion without bony deformity </li></ul><ul><li>Grade2: hypo intense in T1 & hyperintnse in T2-wieghted sequences </li></ul><ul><li>Grade3 : impaction fracture of vertebral body </li></ul><ul><li>Grade4: due to involvement of vertebral body and articular processes, there is </li></ul><ul><li>displacement # most often complicates by neurological compromise </li></ul><ul><li>Thoracolumbar# classification </li></ul><ul><li>Anterior column : wedging with pain in upright position no neurological sign </li></ul><ul><li>Middle column: little instability/pain, an intact posterior long lig rep a barrier that turns ext to for. Post column: pain instability, severe neurological compromise </li></ul><ul><li>Tomita’s classification 8 grades of increasing severity </li></ul>
  8. 11. <ul><li>Thank you </li></ul><ul><li>References : </li></ul><ul><li>Harrisons INT medicine </li></ul><ul><li>Abeloff oncology </li></ul><ul><li>Peter Armstrong's diagnostic imaging </li></ul>
  9. 12. <ul><li>Vertebral osteomyelitis </li></ul><ul><li>Vertebral osteomyelitis (also termed spinal osteomyelitis, spondylodiskitis, septic diskitis, or disk-space infection) may be acute (i.e., evolving over a period of a few days or weeks) or sub-acute or chronic (i.e., lasting for weeks or months before antimicrobial therapy is initiated). </li></ul><ul><li>Vertebral osteomyelitis most often results from hematogenous seeding , direct inoculation at the time of spinal surgery, or contiguous spread from an infection in the adjacent soft tissue. </li></ul><ul><li>Staphylococcus aureus is the most common. </li></ul><ul><li>Most patients with hematogenous pyogenic vertebral osteomyelitis have underlying medical diseases — especially diabetes, coronary heart disease, immunosuppressive disorders, cancer, or renal failure requiring hemodialysis — or use intravenous drugs </li></ul><ul><li>Vertebral osteomyelitis can be complicated by direct seeding in different compartments, resulting in paravertebral, epidural, or psoas abscesses </li></ul>

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