|Patient: 52 year old female|
Low back pain with radiating left leg pain.
SYNOVIAL CYST PROJECTING FROM THE MEDIAL JOINT MARGIN OF THE LEFT L3-L4 ZYGAPOPHYSEAL JOINT. THE SYNOVIAL CYST CREATES NEURAL COMPRESSION UPON THE LEFT-SIDED NERVE ROOTS WITHIN THE CAUDA EQUINA AND APPROXIMATELY 40% CENTRAL STENOSIS.
INTERVERTEBRAL OSTEOCHONDROSIS WITH MILD LOSS OF DISC HEIGHT L3-L4 DEMONSTRATING A CONCENTRIC 12 MM ANNULAR TEAR AT THE 4-5 O’CLOCK POSITION.
|Discussion: · Cystic extensions from the zygapophyseal articulations with variable content, including synovial fluid with proteinaceous or mucinous fluid, hemorrhage or air.|
· Present on MR as well-defined epidural soft tissue masses with juxta-articular location and are usually seen in conjuction with obvious degenerative change of the adjoining joint.
· Central MR signal intensity varies, depending on cyst contents; non-contrast enhanced studies show high, intermediate or low T2 signal and low to intermediate T1 signal.
· Hypointensity of the outer rim on T2 images is attributed to a fibrous capsule that may have further reduced signal with hemosiderin or calcium deposition.
· Inflammatory changes are suggested as a rationale for rim enhancement with contrast-enhanced MR; typically no central enhancement.
· Differential considerations include migrated disc fragment and neurogenic cysts/tumors, but combination of location and MR signal features are usually sufficient for identification.
REFERRING PHYSICIAN: AGNES KISS, DC
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Case Number: 10056848Last Updated: 09-05-2007 The reader is fully responsible for confirming the accuracy of this content.
The reader is fully responsible for confirming the accuracy of this content.