scholarly journals Association of History Taking and Accuracy of the Interpretation of Cervical and Lumbar Magnetic Resonance Imaging

2020 ◽  
Vol 8 (B) ◽  
pp. 676-682
Author(s):  
Mohammad Hossein Daghighi ◽  
Mohammad Asghari Jafarabadi ◽  
Mitra Shoja Sefat
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Neck Pain ◽  
Clinical History ◽  
Diagnostic Methods ◽  
Imaging Method ◽  
Resonance Imaging ◽  
Disk Herniation ◽  
Canal Stenosis ◽  
History Of

BACKGROUND: Disk herniation leading to radiculopathy is one of the most important causes of neck and back pain, requiring specific diagnostic tests. Magnetic resonance imaging (MRI) is one of these diagnostic methods. Interpreting the findings of this imaging method by an experienced skilled person is very important. AIM: The purpose of this study was to investigate the role of history on the accuracy of the lumbar or cervical MRI reports in patients with back and neck pain referring to the radiology department. METHODS: This study was performed on patients with complaints of lumbar or neck pain that MRI had been performed for them. At first, the MRI was studied by the residents of the 2nd and 3rd years and then a radiologist as a routine, respectively. From 4 to 6 months later, patients’ clinical history was presented to the same students and professors and MRI was re-reported. Statistical differences were evaluated and analyzed using SPSS software version 20. RESULTS: Out of 150 patients with mean age of 42.56 ± 10.65, 87 patients (58%) were female and 63 (42%) were male. Most of the patients were between the ages of 40 and 50 years (34.66%). The most common clinical symptom of patients was waist and neck pain followed by sensory disturbances of the extremities. The most pathologic changes found was disk bulging in 28.8% of patients (68 cases). In terms of lumbar canal stenosis, the most cases were in the L4-L5 levels of the moderate type. The most reported cases of cervical stenosis have been mild. Disk herniation and DOCP were two main factors causing canal stenosis in the study patients. Statistical difference in the MRI reports performed by the residents on most of the variables was statistically significant before and after knowing the clinical history of the patient (p < 0.05). However, this difference was less noted in the reports of the radiologists. CONCLUSION: The results of this study showed that knowing the history of patients in interpreting the results of MRI in patients with vertebral disk hernia is misleading and will lead to many false positive and negative results, especially for radiology residents. It is recommended that the residents and radiologists consider the MRI films before focusing on the biographies and clinical features of the patient, to prevent the occurrence of bias and to increase the accuracy of the reports.

scholarly journals Redundant nerve roots of the cauda equina: review of the literature

2012 ◽  
Vol 45 (3) ◽  
pp. 155-159 ◽  
Author(s):  
Marcello Henrique Nogueira-Barbosa ◽  
Leonor Garbin Savarese ◽  
Carlos Fernando Pereira da Silva Herrero ◽  
Helton Luiz Aparecido Defino
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cauda Equina ◽  
Imaging Method ◽  
Resonance Imaging ◽  
Nerve Roots ◽  
Canal Stenosis ◽  
Close Relationship ◽  
The Moment ◽  
Lumbar Spinal

In imaging diagnosis, redundant nerve roots of the cauda equina are characterized by the presence of elongated, enlarged and tortuous nerve roots in close relationship with a high-grade lumbar spinal canal stenosis. This is not an independent entity, but it is believed to be a consequence of the chronic compression at the level of the lumbar canal stenosis and thus may be part of the natural history of lumbar spinal stenosis. The present paper is aimed at reviewing the histopathological, electrophysiological and imaging findings, particularly at magnetic resonance imaging, as well as the clinical meaning of this entity. As the current assessment of canal stenosis and root compression is preferably performed by means of magnetic resonance imaging, this is the imaging method by which the condition is identified. The recognition of redundant nerve roots at magnetic resonance imaging is important, particularly to avoid misdiagnosing other conditions such as intradural arteriovenous malformations. The literature approaching the clinical relevance of the presence of redundant nerve roots is controversial. There are articles suggesting that the pathological changes of the nerve roots are irreversible at the moment of diagnosis and therefore neurological symptoms are less likely to improve with surgical decompression, but such concept is not a consensus.

scholarly journals Diagnosis and Spontaneous Resolution of an Epidural Hematoma in a Patient Presenting after Cervical Epidural Steroid Injection

2018 ◽  
pp. 213-219
Author(s):  
Ivan Urits
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Neck Pain ◽  
Epidural Hematoma ◽  
Steroid Injection ◽  
Spontaneous Resolution ◽  
Resonance Imaging ◽  
Radiographic Findings ◽  
History Of ◽  
Epidural Steroid

While not a cure for the underlying spinal pathology, cervical epidural steroid injections (CESI) are an important minimally invasive treatment for neck pain with radiculopathy. Although CESIs are considered safe, cervical epidural hematoma (CEH) is a major complication and has previously been reported. Patients, who develop CEH, present with acute neck pain and upper extremity radiculopathy. A prolonged time to treatment may lead to worsened neurological outcome. Diagnostic magnetic resonance imaging and surgical decompression is the mainstay of treatment. This report presents a patient with a history of chronic neck pain and repeat cervical injections, who presented with increased neck pain and upper extremity weakness after undergoing a CESI. Initial radiographic findings were complicated and inconclusive of a definitive epidural hematoma. With conservative management, the patient showed signs of clinical improvement and ultimately had spontaneous resolution of his CEH. Though CEH are frequently rapidly progressing and most often surgically decompressed, some acutely presenting cases may be approached conservatively. Though MRI is an important diagnostic tool for CEH, interpretation of radiographic findings, following a recent CESI, may be challenging due to distortion of the epidural space anatomy. Patients with a history of multiple cervical epidural injections may have an increased risk for the development of CEH. Key words: Cervical epidural steroid injection, cervical epidural hematoma, spontaneous resolution, conservative management, magnetic resonance imaging, complication

Сauses of Dizziness in Patients with Suspected Stroke

2018 ◽  
Vol 7 (3) ◽  
pp. 217-221
Author(s):  
E. V. Shevchenko ◽  
G. R. Ramazanov ◽  
S. S. Petrikov
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Demyelinating Disease ◽  
Heart Rhythm ◽  
Diagnostic Methods ◽  
Deficiency Anemia ◽  
Resonance Imaging ◽  
Peripheral Vestibulopathy ◽  
Suspected Stroke ◽  
The Brain

Background Acute dizziness may be the only symptom of stroke. Prevalence of this disease among patients with isolated dizziness differs significantly and depends on study design, inclusion criteria and diagnostic methods. In available investigations, we did not find any prospective studies where magnetic resonance imaging, positional maneuvers, and Halmagyi-Curthoys test had been used to clarify a pattern of diseases with isolated acute dizziness and suspected stroke.Aim of study To clarify the pattern of the causes of dizziness in patients with suspected acute stroke.Material and methods We examined 160 patients admitted to N.V. Sklifosovsky Research Institute for Emergency Medicine with suspected stroke and single or underlying complaint of dizziness. All patients were examined with assessment of neurological status, Dix-Hollpike and Pagnini-McClure maneuvers, HalmagyiCurthoys test, triplex scans of brachiocephalic arteries, transthoracic echocardiography, computed tomography (CT) and magnetic resonance imaging (MRI) of the brain with magnetic field strength 1.5 T. MRI of the brain was performed in patients without evidence of stroke by CT and in patients with stroke of undetermined etiology according to the TOAST classification.Results In 16 patients (10%), the cause of dizziness was a disease of the brain: ischemic stroke (n=14 (88%)), hemorrhage (n=1 (6%)), transient ischemic attack (TIA) of posterior circulation (n=1 (6%)). In 70.6% patients (n=113), the dizziness was associated with peripheral vestibulopathy: benign paroxysmal positional vertigo (n=85 (75%)), vestibular neuritis (n=19 (17%)), Meniere’s disease (n=7 (6%)), labyrinthitis (n=2 (1,3%)). In 6.9% patients (n=11), the cause of dizziness was hypertensive encephalopathy, 1.9% of patients (n=3) had heart rhythm disturbance, 9.4% of patients (n=15) had psychogenic dizziness, 0.6% of patients (n=1) had demyelinating disease, and 0.6% of patients (n=1) had hemic hypoxia associated with iron deficiency anemia.Conclusion In 70.6% patients with acute dizziness, admitted to hospital with a suspected stroke, peripheral vestibulopathy was revealed. Only 10% of patients had a stroke as a cause of dizziness.

Magnetic Resonance Imaging of Pseudo-impingement of Rotator Cuff with Strength Training

2019 ◽  
Vol 1 ◽  
pp. 2-6
Author(s):  
Asad Naqvi ◽  
Timothy Ariyanayagam ◽  
Mir Akber Ali ◽  
Akhila Rachakonda ◽  
Hema N. Choudur
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Strength Training ◽  
Radiology Department ◽  
Resonance Imaging ◽  
Subacromial Space ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Training Exercises

Objective: The objective of this study was to outline a novel unique concept of secondary impingement of the muscles, myotendons, and tendons of the rotator cuff from hypertrophy as a result of strength training exercises. Methods: In this retrospective observational study, 58 patients were referred for an magnetic resonance imaging (MRI) by the orthopedic surgeon to the radiology department over a period of 1½ years. All patients gave a history of strength training exercises and presented with clinical features of rotator cuff impingement. Results: We identified features of hypertrophy of rotator cuff muscles, myotendons, and tendons in 12 of these 58 patients. This was the only abnormality on MRI. The hypertrophy of rotator cuff muscles and tendon bulk completely filling the subacromial space to the point of overfilling and resulting in secondary compressive features. Conclusion: Rotator cuff impingement is a common phenomenon that can occur with various inlet and outlet pathological conditions. However, rotator cuff impingement may also result from muscle and tendon hypertrophy from strength training regimens. Hypertrophy of the rotator cuff can result in overfilling of the subacromial space, leading to secondary impingement, which we have termed as “pseudo-impingement.”

Computed Tomography and Magnetic Resonance Imaging-aided Diagnosis of Primary Essential Cutis Verticis Gyrata: A Case Report with 5-year Follow-up and Review of the Literature

2019 ◽  
Vol 15 (9) ◽  
pp. 906-910
Author(s):  
Hongzhang Zhu ◽  
Shi-Ting Feng ◽  
Xingqi Zhang ◽  
Zunfu Ke ◽  
Ruixi Zeng ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Three Dimensional ◽  
Stable Condition ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Cutis Verticis Gyrata ◽  
Essential Form ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

Background: Cutis Verticis Gyrata (CVG) is a rare skin disease caused by overgrowth of the scalp, presenting as cerebriform folds and wrinkles. CVG can be classified into two forms: primary (essential and non-essential) and secondary. The primary non-essential form is often associated with neurological and ophthalmological abnormalities, while the primary essential form occurs without associated comorbidities. Discussion: We report on a rare case of primary essential CVG with a 4-year history of normal-colored scalp skin mass in the parietal-occipital region without symptom in a 34-year-old male patient, retrospectively summarizing his pathological and Computer Tomography (CT) and magnetic resonance imaging (MRI) findings. The major clinical observations on the CT and MR sectional images include a thickened dermis and excessive growth of the scalp, forming the characteristic scalp folds. With the help of CT and MRI Three-dimensional (3D) reconstruction techniques, the characteristic skin changes could be displayed intuitively, providing more evidence for a diagnosis of CVG. At the 5-year followup, there were no obvious changes in the lesion. Conclusion: Based on our observations, we propose that not all patients with primary essential CVG need surgical intervention, and continuous clinical observation should be an appropriate therapy for those in stable condition.

scholarly journals Whiplash Injuries Can be Visible by Functional Magnetic Resonance Imaging

2006 ◽  
Vol 11 (3) ◽  
pp. 197-199 ◽  
Author(s):  
Bengt H Johansson
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Functional Magnetic Resonance Imaging ◽  
Medical Condition ◽  
Diagnostic Methods ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Eye Problems ◽  
Concentration Sensitivity ◽  
Whiplash Trauma

Whiplash trauma can result in injuries that are difficult to diagnose. Diagnosis is particularly difficult in injuries to the upper segments of the cervical spine (craniocervical joint [CCJ] complex). Studies indicate that injuries in that region may be responsible for the cervicoencephalic syndrome, as evidenced by headache, balance problems, vertigo, dizziness, eye problems, tinnitus, poor concentration, sensitivity to light and pronounced fatigue. Consequently, diagnosis of lesions in the CCJ region is important. Functional magnetic resonance imaging is a radiological technique that can visualize injuries of the ligaments and the joint capsules, and accompanying pathological movement patterns.Three severely injured patients that had been extensively examined without any findings of structural lesions were diagnosed by functional magnetic resonance imaging to have injuries in the CCJ region.These injuries were confirmed at surgery, and after surgical stabilization the medical condition was highly improved.It is important to draw attention to the urgent need to diagnose lesions and dysfunction in the CCJ complex and also improve diagnostic methods.

Solitary Paraganglioma of the Hypoglossal Nerve: Case Report

Neurosurgery ◽  
2011 ◽  
Vol 68 (4) ◽  
pp. E1170-E1174 ◽  
Author(s):  
Kazim Raza ◽  
Chandrasekaran Kaliaperumal ◽  
Michael Farrell ◽  
John A. O'Dwyer ◽  
Christopher Pidgeon
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Hypoglossal Nerve ◽  
Jugular Foramen ◽  
Low Grade ◽  
Resonance Imaging ◽  
Stereotactic Radiation ◽  
Hypoglossal Canal ◽  
Suboccipital Craniotomy ◽  
History Of

Abstract BACKGROUND AND IMPORTANCE: We report the case history of solitary hypoglossal paraganglioma in a 64-year-old woman. The surgical difficulties encountered in the removal of this challenging tumor are discussed and as a literature review provided. CLINICAL PRESENTATION: A 64-year-old woman presented with a short history of dysphonia, occasional dysphagia, tinnitus, altered taste, and unilateral left-sided tongue wasting. On examination, there was left lower motor hypoglossal paralysis. Imaging showed a discrete enhancing lobulated mass, measuring 2 × 2 cm, in the region of the hypoglossal nerve extending into the hypoglossal canal suggestive of hypoglossal paraganglioma. A left dorsolateral suboccipital craniotomy was performed with the patient in the sitting position. The hypoglossal nerve appeared to be enlarged, and the jugular foramen was normal. Complete surgical debulking of the tumor was not attempted because of its vascular nature. The nerve was decompressed, and neuropathology confirmed a low-grade paraganglioma arising from the hypoglossal nerve. The patient was scheduled to receive stereotactic radiation for further management. CONCLUSION: When a case of solitary hypoglossal paraganglioma is encountered in clinical practice, the aim of management should be mainly focused on achieving a diagnosis and preserving the hypoglossal nerve function. If there is evidence of vascularity in the lesion noted on magnetic resonance imaging, a preoperative angiogram should be obtained with a view for embolization. We decompressed the hypoglossal canal and achieved good improvement in the patient's symptoms. We recommend stereotactic radiosurgery for remnant and small hypoglossal tumors and regular follow-up with magnetic resonance imaging scans.

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