21 postoperative lumbar region of spine on magnetic

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This document discusses magnetic resonance imaging findings of the lumbar spine after surgery. It includes 3 figures showing examples of: 1) a herniated disk where contrast enhancement helps differentiate the central herniation from surrounding scar tissue; 2) epidural scar appearing as diffuse enhancement in the epidural space; and 3) arachnoiditis seen as irregular contrast collection in the thecal sac along with thickened nerve roots and block, with inhomogeneous enhancement within the thecal sac contents.

21Postoperative Lumbar
Region of Spine on Magnetic
Resonance Imaging

CLINICAL IMAGAGING
AN ATLAS OF DIFFERENTIAL DAIGNOSIS
EISENBERG
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL

• Fig SP 21-1 Herniated disk. (A) Sagittal T1-weighted
precontrast image shows a very ill-defined anterior
epidural soft-tissue mass at the L4-L5 level (arrow),
with slight mass effect on the anterior thecal sac.
Differentiation of scar from disk is not possible. (B)
Repeat scan after intravenous injection of contrast
material clearly defines the central nonenhancing
herniation surrounded by enhancing scar tissue.

• Fig SP 21-2 Epidural scar. (A) Sagittal T1-weighted
precontrast image shows a large amount of abnormal
tissue within the epidural space at the L4-L5 through
L5-S1 levels. (B) Repeat scan after intravenous injection
of contrast material demonstrates diffuse and intense
enhancement throughout the epidural tissue,
consistent with scar.18

• Fig SP 21-3 Arachnoiditis. (A) Lateral view of a lumbar myelogram
shows irregular collection of contrast within the most distally filled
aspect of the thecal sac, thickened nerve roots, and a block at L3-
L4. Sagittal precontrast (B) and postcontrast (C) T1-weighted images
were performed. After contrast infusion, there is inhomogeneous,
amorphous enhancement of the contents of the thecal sac. Note
also the marked enhancement of the postoperative scar posterior
to the thecal sac at the site of previous laminectomy and
enhancement of the epidural venous plexus or postoperative scar
(or both) posterior to the L3 and L4 vertebral bodies.19

21 postoperative lumbar region of spine on magnetic

This document discusses and provides images of various neoplastic lesions of the vertebrae that can be seen on magnetic resonance imaging. It includes summaries and images of common lesions such as hemangioma, osteoblastoma, aneurysmal bone cyst, giant cell tumor, sacral teratoma, Langerhans cell histiocytosis, chordoma, lymphoma, and metastases. The images demonstrate how MRI can help identify these lesions and delineate their relationship to nearby structures like the spinal cord and vertebral bones.

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Dr. Muhammad Bin Zulfiqar

This document discusses and provides images of various non-neoplastic lesions of the vertebral bodies that can be seen on magnetic resonance imaging (MRI). It describes types of degenerative disk disease, Schmorl's nodes, compression fractures, infections, changes seen after radiation therapy, and Paget's disease. For each condition, it provides an example MRI image and brief description of the imaging findings.

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George Sapkas

1) This document describes the medical history of a patient born in 1927 who was treated for breast cancer and neck pain from cervical metastasis of breast cancer. 2) In 2005, the patient underwent decompression and stabilization surgery for neck pain and subsequent chemotherapy and radiotherapy, which resulted in negative findings. 3) In 2010, the patient presented with left hip pain and was found to have metastatic breast cancer in the left hip bone, which was treated with hip hemi-arthroplasty.

18 spinal cord tumors on magnetic resonance imaging

Dr. Muhammad Bin Zulfiqar

This document discusses spinal cord tumors as seen on magnetic resonance imaging (MRI). It provides 10 figures showing examples of different types of spinal cord tumors visualized on MRI, including ependymoma, astrocytoma, hemangioblastoma, metastasis, meningioma, neurofibroma, metastatic seeding, lipoma, epidermoid, and bony metastasis with an associated epidural soft tissue component. The tumors are described and their appearance on non-contrast and post-contrast T1-weighted and T2-weighted MRI images is shown.

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22 demyelinating and inflammatory disease of the spinal

Dr. Muhammad Bin Zulfiqar

This document discusses demyelinating and inflammatory diseases of the spinal cord that can be seen on magnetic resonance imaging (MRI). It provides 8 figures showing examples of various conditions, including multiple sclerosis, transverse myelitis, inflammatory myelitis, AIDS-related myelopathy, postradiation myelitis, intramedullary sarcoidosis, and pial sarcoidosis. The figures demonstrate how these conditions appear on MRI with abnormalities such as focal lesions, diffuse swelling and signal changes, and enhancement with contrast.

36 DAVID SUTTON PICTURES PERIOSTEAL REACTION BONE AND JOINT INFECTIONS: SARCOID

Dr. Muhammad Bin Zulfiqar

This document contains 40 figures showing various bone and soft tissue abnormalities. The figures demonstrate a variety of pathological conditions through radiographs, CT, MRI, bone scans and other imaging modalities. Examples include fibrous cortical defects, non-ossifying fibromas, desmoplastic fibromas, fibrosarcomas, giant cell tumors, aneurysmal bone cysts, haemangiomas, neurofibromas and other conditions. Each figure is labeled and captioned to identify the specific anatomical location and imaging findings of the abnormality shown.

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Dr. Muhammad Bin Zulfiqar

The document discusses various soft tissue pathologies that can be identified on MRI imaging. It includes 25 figures showing examples of soft tissue masses, infections, hematomas, tendon injuries and other conditions. Captions provide details on the pathology shown and MRI features that aid diagnosis, such as signal characteristics and enhancement patterns. The figures demonstrate how MRI can differentiate between benign and malignant soft tissue lesions.

8 localized widening of the interpedicular distance

Dr. Muhammad Bin Zulfiqar

The document discusses two spinal conditions: meningomyelocele and diastematomyelia. Meningomyelocele is characterized by a markedly increased distance between the pedicles of the lumbar vertebrae and a large soft tissue mass posterior to the spine, with absent posterior elements in the lower lumbar and sacral regions. Diastematomyelia features a pathognomonic ossified septum lying in the midline of the neural canal.

44 DAVID SUTTON PICTURES SKELETAL TRAUMA REGIONAL

Dr. Muhammad Bin Zulfiqar

The document contains 44 figures showing various types of fractures visible on CT scans, MRI, and x-rays. It shows fractures of the skull, face, spine, pelvis and long bones including: extradural hematomas, depressed skull fractures, facial fractures, spinal fractures such as compression fractures and Jefferson fractures, as well as pelvic fractures. The images provide examples of the appearance of different fractures seen on various imaging modalities.

Presentation1, radiological imaging of lateral hindfoot impingement.

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This document discusses radiological imaging of lateral hindfoot impingement. It provides illustrations and images showing normal hindfoot anatomy as well as examples of talocalcaneal impingement, subfibular impingement, and combined impingement. MRI and CT images demonstrate bone marrow edema, cystic changes, sclerosis, and soft tissue swelling associated with impingement between the talus, calcaneus, and fibula. Measurements of hindfoot valgus angle are also shown on imaging to evaluate impingement and alignment. Case studies with patients presenting lateral ankle pain further demonstrate imaging findings of extra-articular hindfoot impingement.

Presentation1, artifact and pitfalls of the knee, hip and ankle joints.

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The document summarizes common artifacts and pitfalls seen on MRI of the knee, hip, and ankle joints that can be mistaken for pathology but are actually normal anatomical variants or imaging findings. Some examples provided include meniscofemoral ligaments in the knee that can mimic meniscal tears, transverse ligaments that can appear to disrupt the meniscus, and popliteal tendon sheaths that can resemble lesions. For the hip, examples given are synovial pits, os acetabuli, the transverse acetabular ligament, perilabral recesses, and intraosseous contrast tracks in the acetabulum. Proper identification requires knowledge of anatomy and correlation across imaging planes.

13 atlantoaxial subluxation

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Atlantoaxial subluxation is a condition where the first and second vertebrae in the neck (C1 and C2) are abnormally separated or misaligned. Flexion x-rays can help diagnose this condition by showing increased separation between the anterior arch of the atlas (C1) and the odontoid process of the axis (C2) when the neck is flexed, compared to a normal relationship seen on a routine lateral x-ray. This separation seen on flexion x-rays indicates atlantoaxial subluxation.

Presentation1.pptx, radiological imaging of bursae.

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This document discusses various bursae in the body, including those around the shoulder, knee, and other joints. It provides details on the anatomy and locations of bursae and describes imaging findings of normal and pathological bursae. Key points include: - Bursae are fluid-filled sacs that reduce friction between tissues like tendons and bones. They can communicate with joints or be separate. - Common shoulder bursae include the subacromial-subdeltoid bursa and subcoracoid bursa. MRI is useful for identifying bursal inflammation or fluid from rotator cuff tears. - Around the knee, the superficial and deep infrapatellar burs

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This document discusses the grading and imaging of rotator cuff tears. It provides grading scales for rotator cuff tears seen on MRI from grade 0 (normal) to grade III (defined tear). Several coronal and sagittal MRI images show examples of partial thickness and full thickness tears of the supraspinatus, infraspinatus, and subscapularis tendons. Fatty degeneration of the rotator cuff muscles is also demonstrated in association with large, retracted tears.

Presentation1.pptx. shoulder joint.

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This document provides an overview of MRI protocols and findings for evaluating the shoulder. It describes ten common clinical scenarios where MRI may be useful. It then details the anatomy visualized with MRI and various pathologies that can be identified, including rotator cuff tears, labral tears, bursitis, capsulitis, and ligament injuries. A variety of tear patterns, classifications, and lesions involving the labrum and biceps are presented. In summary, the document serves as a guide for interpreting shoulder MRI studies and identifying relevant musculoskeletal abnormalities.

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Presentation1, radiological film reading of knee joint.

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This document provides a radiological report and overview of knee pathology related to the meniscus and anterior cruciate ligament (ACL). It describes various grades of meniscal degeneration and discusses features of common meniscal tears including horizontal, longitudinal, radial, and bucket-handle tears. Anatomical variants like discoid meniscus are also reviewed. Expected MRI appearances of different tear patterns and signs like the double PCL sign for bucket-handle tears are presented. Healing responses and partial ACL tears are additionally summarized. The report contains multi-planar knee MRI images illustrating normal anatomy and various pathological conditions.

45 solid pelvic masses

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This document discusses solid pelvic masses that can be identified on ultrasound imaging. It includes 11 figures showing ultrasound images of various masses in the pelvic region including uterine fibroids, calcified fibroids, leiomyosarcoma, endometrial carcinoma, cervical carcinoma, dysgerminoma, endodermal sinus tumor, Krukenberg's tumor, and trophoblastic disease. The images demonstrate the appearance of these masses and allow for differential diagnosis of solid pelvic masses on ultrasound.

Presentation1 radiological imaging of tarsal tunnel syndrome.

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- Tarsal tunnel syndrome refers to entrapment of the posterior tibial nerve as it passes through the tarsal tunnel in the ankle. Common symptoms include pain, numbness and tingling in the foot. - Causes of tarsal tunnel syndrome include ganglion cysts, bone deformities, varicose veins, space-occupying lesions, and muscle or structural abnormalities that compress the nerve. - Radiological imaging techniques like ultrasound and MRI can identify potential compressive elements, assess nerve damage, and help determine appropriate treatment which may be conservative therapy or surgery.

43 cystic appearing pelvic masses

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This document contains 10 figures showing ultrasound images of various cystic pelvic masses. Figure 43-1 shows multiple follicular cysts within the ovary. Figure 43-2 demonstrates a paraovarian cyst superior to the vagina. Figure 43-3 depicts a corpus luteum cyst in the left ovary. The remaining figures show images of a theca lutein cyst, polycystic ovary disease, tubo-ovarian abscess, serous cystadenoma, endometrioma, hydrocolpos, and hematometrocolpos. All of the figures provide ultrasound examples of different types of cystic pelvic masses that can be seen on imaging.

Presentation1, radiological imaging of morel lavallee lesion.

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Morel-Lavallée lesions are closed degloving injuries that result from shearing forces separating the skin and subcutaneous tissues from the underlying fascia during trauma. This creates a potential space that fills with blood, lymph, and fat. Morel-Lavallée lesions are most commonly seen near bony protuberances like the greater trochanter. MRI and ultrasound are useful for evaluating these lesions, which can vary in appearance from serous fluid collections to hematomas based on the acuity and inflammatory response. The Mellado-Bencardino classification system categorizes lesions based on their shape, signal characteristics, and enhancement pattern.

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The document provides information about normal and abnormal bile duct anatomy and pathology as seen on various medical imaging modalities like CT, MRI, MRCP, and ultrasound. It includes images and descriptions of normal bile ducts, gallbladder anatomy, choledochal cysts, Caroli's disease, gallstones, sclerosing cholangitis, biliary hamartomas, cholangiocarcinoma, and hilar cholangiocarcinoma. Complications from gallstones like pancreatitis and suppurative cholangitis are also discussed.

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29 orbital masses not involving the optic nerve

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This document discusses and provides images of various orbital masses that do not involve the optic nerve. It describes cavernous hemangioma, retinoblastoma, melanoma, orbital varix, orbital pseudotumor, orbital subperiosteal abscess, mucocele, meningioma, adenoid cystic carcinoma, hematogenous metastasis, lacrimal gland tumor, dermoid cyst, and lymphoma. For each condition, it highlights imaging findings on CT and MRI scans that are characteristic of the mass.

10 hypothalamic lesions on magnetic resonance imaging

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This document contains 16 figures showing magnetic resonance images of various hypothalamic lesions. The images depict lesions including gliomas, germinomas, primary CNS lymphomas, hamartomas, Langerhans cell histiocytosis, metastases, hemangioblastomas, choristomas, craniopharyngiomas, dermoid cysts, Rathke's cleft cysts, colloid cysts, encephalitis, sarcoidosis, ectopic posterior pituitary glands, and Wernicke's encephalopathy. Each image is labeled and captioned, identifying key features of the lesions.

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A brainstem lesion is shown on MRI involving most of the pons and medulla compressing the fourth ventricle, appearing hyperintense on T2-weighted imaging and encasing the basilar artery. A pontine mass is shown appearing hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging, consistent with metastasis. Central pontine myelinolysis is depicted with a hyperintense lesion in the central midpons on T1-weighted imaging and symmetric lesions in the cerebral peduncles on a more rostral scan.

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This document presents and describes 17 figures showing various hypodense supratentorial masses visible on computed tomography scans. The figures illustrate examples of cystic astrocytoma, glioblastoma multiforme, oligodendroglioma, metastasis, epidermoid, lipoma of the corpus callosum, acute and chronic cerebral infarcts, basal ganglia infarction, pyogenic abscess, echinococcal cyst, herpes simplex encephalitis, subdural hematoma, subdural empyema, and multiple sclerosis. Each figure includes a brief description of the imaging findings.

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This document discusses various malignant bone tumors and how they appear on magnetic resonance imaging (MRI). It includes MRI images of osteosarcoma, chondrosarcoma, Ewing's sarcoma, malignant fibrous histiocytoma, plasmacytoma, lymphoma, Paget's sarcoma, and bone metastasis. The images demonstrate features of these tumors such as their intraosseous and extraosseous extent, areas of calcification, bone destruction, and associated soft tissue masses.

15 cerebellopontine angle masses on magnetic resonance imaging

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This document discusses various masses that can occur in the cerebellopontine angle region as seen on magnetic resonance imaging. It provides 14 figures showing examples of different pathologies that can present in this area, such as acoustic neuromas, meningiomas, metastases, and aneurysms. Each figure includes one or more images of a lesion and provides a brief description and diagnosis. A variety of imaging characteristics are demonstrated, including signal intensity, enhancement patterns, and effects on surrounding structures.

43 DAVID SUTTON PICTURES SKELETAL TRAUMA : GENERAL CONSIDERATION

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The document contains 43 figures showing various bone fractures and bone-related injuries visible on x-rays and other imaging modalities like MRI and CT scans. The figures show a variety of fractures types including comminuted fractures, compression fractures, avulsion fractures, stress fractures and more. They involve many bones including the tibia, femur, radius, vertebrae and others. The imaging helps identify fracture patterns, bone displacement, and complications like non-union, malunion and avascular necrosis.

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This document discusses various types of periarticular calcification seen on clinical imaging: 1) Calcific tendinitis is seen as amorphous calcium deposits in the supraspinatus tendon on shoulder imaging. 2) Hyperparathyroidism can cause dense masses of tumoral calcification in joint capsules and soft tissues, as seen in the foot of a patient with renal osteodystrophy. 3) Scleroderma is associated with clumps of calcification around shoulder joints, along with reticulonodular lung patterns and surgical clips from treatment of Raynaud's phenomenon.

27 central nervous system changes in acquired immunodeficiency

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8 sellar and juxtasellar masses on magnetic resonance

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1. 21Postoperative Lumbar Region of Spine on Magnetic Resonance Imaging

2. CLINICAL IMAGAGING AN ATLAS OF DIFFERENTIAL DAIGNOSIS EISENBERG DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

3. • Fig SP 21-1 Herniated disk. (A) Sagittal T1-weighted precontrast image shows a very ill-defined anterior epidural soft-tissue mass at the L4-L5 level (arrow), with slight mass effect on the anterior thecal sac. Differentiation of scar from disk is not possible. (B) Repeat scan after intravenous injection of contrast material clearly defines the central nonenhancing herniation surrounded by enhancing scar tissue.

4. • Fig SP 21-2 Epidural scar. (A) Sagittal T1-weighted precontrast image shows a large amount of abnormal tissue within the epidural space at the L4-L5 through L5-S1 levels. (B) Repeat scan after intravenous injection of contrast material demonstrates diffuse and intense enhancement throughout the epidural tissue, consistent with scar.18

5. • Fig SP 21-3 Arachnoiditis. (A) Lateral view of a lumbar myelogram shows irregular collection of contrast within the most distally filled aspect of the thecal sac, thickened nerve roots, and a block at L3- L4. Sagittal precontrast (B) and postcontrast (C) T1-weighted images were performed. After contrast infusion, there is inhomogeneous, amorphous enhancement of the contents of the thecal sac. Note also the marked enhancement of the postoperative scar posterior to the thecal sac at the site of previous laminectomy and enhancement of the epidural venous plexus or postoperative scar (or both) posterior to the L3 and L4 vertebral bodies.19

21 postoperative lumbar region of spine on magnetic

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