Abnormal MRI of the Lumbar Spine without Back Pain

2016 ◽  
Author(s):  
Christoph I. Lee
Keyword(s):  
Magnetic Resonance Imaging ◽  
Back Pain ◽  
Lumbar Spine ◽  
Incidental Findings ◽  
Clinical Implications ◽  
Resonance Imaging ◽  
Clinical Context ◽  
Additional Information ◽  
Study Methodology ◽  
Magnetic Resonance Imaging Mri

This chapter, found in the back pain section of the book, provides a succinct synopsis of a key study examining incidental findings on magnetic resonance imaging (MRI) of the lumbar spine in patients without back pain. This summary outlines the study methodology and design, major results, limitations and criticisms, related studies and additional information, and clinical implications. The study showed that many people without back pain have disk bulges or protrusions on imaging of the lumbar spine, but that these findings are frequently coincidental and should not necessarily lead to further tests or interventions. In addition to outlining the most salient features of the study, a clinical vignette and imaging example are included in order to provide relevant clinical context.

Follow-Up MRI for Sciatica

2016 ◽  
Author(s):  
Christoph I. Lee
Keyword(s):  
Magnetic Resonance Imaging ◽  
Back Pain ◽  
Clinical Implications ◽  
Resonance Imaging ◽  
Disk Herniation ◽  
Clinical Context ◽  
Additional Information ◽  
Study Methodology ◽  
Magnetic Resonance Imaging Mri

This chapter, found in the back pain section of the book, provides a succinct synopsis of a key study examining the use of follow-up magnetic resonance imaging (MRI) for patients with sciatica. This summary outlines the study methodology and design, major results, limitations and criticisms, related studies and additional information, and clinical implications. Researchers concluded that the presence of disk herniation on MRI at 1-year follow-up after treatment for sciatica does not help distinguish between favorable and unfavorable clinical outcomes. In addition to outlining the most salient features of the study, a clinical vignette and imaging example are included in order to provide relevant clinical context.

Imaging Selection and Endovascular Treatment for Ischemic Stroke

2016 ◽  
Author(s):  
Christoph I. Lee
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Ischemic Stroke ◽  
Endovascular Treatment ◽  
Standard Care ◽  
Clinical Implications ◽  
Resonance Imaging ◽  
Clinical Context ◽  
Additional Information ◽  
Study Methodology

This chapter, found in the headache section of the book, provides a succinct synopsis of a key study examining the imaging selection and endovascular treatment for ischemic stroke. This summary outlines the study methodology and design, major results, limitations and criticisms, related studies and additional information, and clinical implications. Researchers found that a favorable penumbral pattern by computed tomography or magnetic resonance imaging does not help identify patients who would benefit from endovascular therapy for acute stroke, and that embolectomy is not superior to standard care with regard to clinical and imaging outcomes for acute ischemic stroke. In addition to outlining the most salient features of the study, a clinical vignette and imaging example are included in order to provide relevant clinical context.

Incidental Meniscal Findings on Knee MRI

2016 ◽  
Author(s):  
Christoph I. Lee
Keyword(s):  
Incidental Findings ◽  
The Elderly ◽  
Clinical Implications ◽  
Resonance Imaging ◽  
Clinical Context ◽  
Additional Information ◽  
High Prevalence ◽  
Study Methodology ◽  
Meniscal Damage ◽  
Knee Magnetic Resonance Imaging

This chapter, found in the bone, joint, and extremity pain section of the book, provides a succinct synopsis of a key study examining the frequency of incidental findings on knee magnetic resonance imaging. This summary outlines the study methodology and design, major results, limitations and criticisms, related studies and additional information, and clinical implications. Incidental meniscal damage on MRI was shown to be common in the general population, especially among the elderly, and is not necessarily attributable to patients’ knee symptoms. Authors advise those interpreting MRI reports and planning interventions that there is a high prevalence of incidental tears even among those without knee symptoms. In addition to outlining the most salient features of the study, a clinical vignette and imaging example are included in order to provide relevant clinical context.

Magnetic Resonance Imaging for Low Back Pain

2016 ◽  
Author(s):  
Michael E. Hochman
Keyword(s):  
Magnetic Resonance Imaging ◽  
Low Back Pain ◽  
Back Pain ◽  
Magnetic Resonance ◽  
Functional Outcomes ◽  
Low Back ◽  
Resonance Imaging ◽  
Additional Information ◽  
Study Methodology ◽  
Magnetic Resonance Imaging Mri

This chapter, found in the back pain section of the book, provides a succinct synopsis of a key study examining the use of magnetic resonance imaging (MRI) for low back pain. This summary outlines the study methodology and design, major results, limitations and criticisms, related studies and additional information, and clinical implications. Researchers concluded that although spinal MRIs (compared with plain radiographs) are reassuring for patients with low back pain, they do not lead to improved functional outcomes; also, spinal MRIs detect anatomical abnormalities that would otherwise go undiscovered, possibly leading to spinal surgeries of uncertain value. In addition to outlining the most salient features of the study, a clinical vignette and imaging example are included in order to provide relevant clinical context.

Vertebroplasty for Osteoporotic Spinal Fractures

2016 ◽  
Author(s):  
Christoph I. Lee
Keyword(s):  
Quality Of Life ◽  
Back Pain ◽  
Spinal Fractures ◽  
Clinical Implications ◽  
Clinical Context ◽  
Similar Symptom ◽  
Additional Information ◽  
Study Methodology ◽  
Osteoporotic Spinal Fractures

This chapter, found in the back pain section of the book, provides a succinct synopsis of a key study examining the use of vertebroplasty for osteoporotic spinal fractures. This summary outlines the study methodology and design, major results, limitations and criticisms, related studies and additional information, and clinical implications. For patients with pain from fractures of less than 1 year duration, vertebroplasty brings similar symptom and quality of life improvements as a simulated vertebroplasty. In addition to outlining the most salient features of the study, a clinical vignette and imaging example are included in order to provide relevant clinical context.

Cervical Spine Imaging in Alert and Stable Trauma Patients

2016 ◽  
Author(s):  
Christoph I. Lee
Keyword(s):  
Emergency Department ◽  
Back Pain ◽  
Cervical Spine ◽  
Clinical Implications ◽  
Trauma Patients ◽  
Clinical Context ◽  
Appropriate Use ◽  
Additional Information ◽  
Spine Imaging ◽  
Study Methodology

This chapter, found in the back pain section of the book, provides a succinct synopsis of a key study validating the Canadian C-spine rule for imaging the cervical spine in alert and stable trauma patients. This summary outlines the study methodology and design, major results, limitations and criticisms, related studies and additional information, and clinical implications. The study shows that the Canadian C-Spine Rule may be able to identify a large group of alert and stable adult trauma patients for whom cervical spine imaging is unnecessary. It may also help to standardize the appropriate use of cervical spine imaging in the emergency department. In addition to outlining the most salient features of the study, a clinical vignette and imaging example are included in order to provide relevant clinical context.

scholarly journals Incorporation of Whole Spine Screening in Magnetic Resonance Imaging Protocols for Low Back Pain: A Valuable Addition

2017 ◽  
Vol 11 (5) ◽  
pp. 700-705 ◽  
Author(s):  
Akhilesh Rao ◽  
Atul Mishra ◽  
Yayati Pimpalwar ◽  
Ravinder Sahdev ◽  
Neha Yadu
Keyword(s):  
Magnetic Resonance Imaging ◽  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Magnetic Resonance ◽  
Incidental Findings ◽  
Lumbosacral Spine ◽  
Low Back ◽  
Resonance Imaging ◽  
Whole Spine

<sec><title>Study Design</title><p>A retrospective review of lumbar magnetic resonance imaging (MRI) studies conducted at the Department of Radiodiagnosis &amp; Imaging of a Tertiary Care Armed Forces Hospital between May 2014 and May 2016.</p></sec><sec><title>Purpose</title><p>To assess the advantages of incorporating sagittal screening of the whole spine in protocols for conventional lumbar spine MRI for patients presenting with low back pain.</p></sec><sec><title>Overview of Literature</title><p>Advances in MRI have resulted in faster examinations, particularly for patients with low back pain. The additional detection of incidental abnormalities on MRI helps to improve patient outcomes by providing a swifter definitive diagnosis. Because low back pain is extremely common, any change to the diagnostic and treatment approach has a significant impact on health care resources.</p></sec><sec><title>Methods</title><p>We documented all additional incidental findings detected on sagittal screenings of the spine that were of clinical significance and would otherwise have been undiagnosed.</p></sec><sec><title>Results</title><p>A total of 1,837 patients who met our inclusion criteria underwent MRI of the lumbar spine. The mean age of the study population was 45.7 years; 66.8% were men and 33.2% women. Approximately 26.7% of the patients were diagnosed with incidental findings. These included determining the level of indeterminate vertebrae, incidental findings of space-occupying lesions of the cervicothoracic spine, myelomalacic changes, and compression fractures at cervicothoracic levels.</p></sec><sec><title>Conclusions</title><p>We propose that T2-weighted sagittal screening of the whole spine be included as a routine sequence when imaging the lumbosacral spine for suspected degenerative pathology of the intervertebral discs.</p></sec>

Whole spine localizers of magnetic resonance imaging detect unexpected vertebral fractures

2018 ◽  
Vol 60 (6) ◽  
pp. 742-748 ◽  
Author(s):  
Malwina Kaniewska ◽  
Johannes Maria de Beus ◽  
Frank Ahlhelm ◽  
Alexander Mameghani ◽  
Karim Eid ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Lumbar Spine ◽  
Magnetic Resonance ◽  
Thoracic Spine ◽  
Vertebral Fractures ◽  
Resonance Imaging ◽  
Fracture Detection ◽  
Additional Information ◽  
Magnetic Resonance Imaging Mri ◽  
Whole Spine

Background Whole spine localizers (WS-loc) of magnetic resonance imaging (MRI) are performed for enumeration of the vertebrae but they can be also used for the evaluation of the spine. Purpose To assess the accuracy of fracture detection using WS-locs of MRI and compare the findings with standard high-resolution short tau inversion recovery (STIR) sequences, and to determine whether the review of WS-locs is useful and if additional information can be gained by assessing the thoracic spine section of the WS-locs. Material and Methods A total of 298 magnetic resonance (MR) examinations of the lumbar spine with WS-locs were evaluated. Two independent readers reviewed the images. In case of fracture detection, further characterization of the fracture was performed. To assess inter-reader agreement, unweighted Cohen’s kappa with 95% confidence intervals (CI) and Phi coefficients were calculated. Results The study sample included 187 female and 111 male patients (age range = 65–94 years; median age = 75.0 years). The WS-locs detected 42 fractures of the lumbar spine and 36 of the thoracic spine. Inter-reader agreement for fracture detection in the lumbar and thoracic spine was strong (K = 0.87, 95% CI = 0.78–0.95, Phi = 0.87, and K = 0.88, 95% CI = 0.79–0.96, Phi = 0.88, respectively). Conclusion WS-locs from MR examinations of the lumbar spine provide a good diagnostic tool for the detection and evaluation of unsuspected vertebral fractures. WS-locs show strong inter-reader agreement for fracture detection in the thoracic and lumbar spine.

scholarly journals THU0492 MAGNETIC RESONANCE IMAGING OF THE SACROILIAC JOINTS IN PATIENTS WITH HYPERMOBILITY: A RETROSPECTIVE COHORT STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 482.4-483
Author(s):  
A. Jones ◽  
C. Ciurtin ◽  
H. Kazkaz ◽  
M. Hall-Craggs
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Back Pain ◽  
Lumbar Spine ◽  
Magnetic Resonance ◽  
Bone Marrow Oedema ◽  
Resonance Imaging ◽  
Sacroiliac Joints ◽  
Fatty Change ◽  
Subchondral Sclerosis

Background:The incidence of inflammatory and structural lesions on magnetic resonance imaging of sacroiliac joints (MRI SIJs) in patients with hypermobility related disorders has not been fully investigated. Hypermobile patients are more susceptible to pelvic instability and biomechanical stress of the SIJs, leading to MRI SIJ changes similar to those occurring in spondyloarthritis (SpA). Patients with hypermobility and suspected SpA pose a unique challenge owing to the high prevalence of back pain in the hypermobility cohort and the absence of spinal restriction on clinical examination.Objectives:In this study, we aim to investigate the incidence of MRI SIJ lesions in patients with hypermobility.Methods:We performed a retrospective study of all patients with a confirmed diagnosis of hypermobility related disorders (including hypermobility syndrome, hypermobility spectrum disorders and Ehlers-Danlos Syndromes) referred for an MRI lumbar spine and SIJ between 2011 and 2019 to investigate long-standing back pain. MRIs were examined by a musculoskeletal (MSK) radiologist with more than 25 years of experience, who was blinded to the clinical outcome of the patients. MRI SIJs were assessed for the presence of bone marrow oedema, subchondral sclerosis, erosion, fatty change, enthesitis, ankylosis, joint fluid and capsulitis.Results:51 patients with confirmed hypermobility related disorders were referred for MRI SIJ and lumbar spine between 2011 and 2019. 3 patients demonstrated clinical features in keeping with a diagnosis of SpA and were excluded from the study. 15/48 (31.3%) of patients with hypermobility and back pain (but no clinical picture of SpA) were found to have inflammatory and/or structural lesions on MRI SIJ. The most frequent lesions were small foci of bone marrow oedema (16.6%) followed by subchondral sclerosis (12.5%) and fatty change (10.4%). The incidence of erosions was 4.2%.Conclusion:There is a relatively high incidence of inflammatory and structural lesions on MRI SIJ of patients with hypermobility. The presence of hypermobility should be taken into consideration when interpreting MRI changes in patients with suspected SpA. Further research into long-term outcomes of MRI SIJs in patients with hypermobility and back pain is required to establish the clinical significance of these findings.Disclosure of Interests: :Alexis Jones: None declared, Coziana Ciurtin Grant/research support from: Pfizer, Consultant of: Roche, Modern Biosciences, Hanadi Kazkaz: None declared, Margaret Hall-Craggs: None declared

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