Spine DDx Flashcards
1
Q
Spinal Ependymoma vs Spinal Astrocytoma:
A
Ependymoma:
- Child or adult (“E - Elderly).
- More central in location.
- Bone remodelling common.
- 3 - 4 segments long.
- Low T1 signal
- Haemosiderin Cap sign on T2.
- Surrounding cord oedema.
- Well defined homogenous enhancement
- Associated cysts common
- Syrinx more common
- Haemorrhage more common
- cervical > thoracic.
Astrocytoma:
- Child ( “C containing Child”)
- more eccentric, with fusiform expansion of cord.
- Cervical > thoracic.
- Short segment < 4 segments.
- Bone remodelling less common
- Low T1 signal
- Ill defined heterogenous enhancement
- Syrinx less common
- Haemorrhage less common
2
Q
Adult Sacral Mass:
A
Lytic osseous Mets Sacral stress Fracture Occult intra sacral meningocele Chordoma Lymphoma Giant cell tumour Multiple Myeloma Chondrosarcoma
3
Q
Paediatric sacrococcygeal Mass:
A
Sacrococcygeal teratoma Presacral abscess Chordoma Neuroblastic tumour Plexiform neurofibroma Lymphoma Chondrosarcoma Ewings.
4
Q
Solitary flattened vertebral body:
A
Osteoporosis Lytic osseous Mets Plasmacytoma MM Steroids LCH Giant cell tumour Ewing Sarcoma Leukaemia Lymphoma Pyogenic OM
5
Q
Multiple flattened Vertebral Fractures:
A
Trauma Osteoporosis Lytic osseous Mets MM Leukaemia Lymphoma Sickle cell disease Osteogenesis Imperfecta
6
Q
Aggressive bony lesion:
A
Lytic osseous Mets Blastic osseous mets lymphoma MM Pyogenic Infection Granulomatous OM LCH Haemodialysis Spondyloarthropathy Neurogenic arthropathy Ewings in child
7
Q
Diffuse Vertebral body T1 Hypointense Signal
A
Hyperplastic Marrow Blastic osseous Mets MM Lymphoma Leukaemia HIV Sickle Cell Renal Osteodystrophy Myelofibrosis Osteopetrosis Fibrous dysplasia
8
Q
Ventral / lateral paraspinal Mass:
A
Lymphadenopathy - Lymphoma - Mets Vertebral body Met Aortic Aneurysm Paraspinal abscess Retroperitoneal haemorrhage Lateral meningocele Neurogenic tumour: - schwannoma - Neuroblastoma - ganglmioneuroma Extramedullary haematopoiesis.
9
Q
Extra dural lesion with solid enhancement
A
Peridural fibrosis Osseous Mets Neurofibroma Schwannoma Lymphoma Plasmacytoma Ewings LCH
10
Q
Intra dural intra medullary lesion with solid enhancement:
A
Tumour like conditions:
- Spinal cord ependymoma
- Spinal cord astrocytoma
- Haemangioblastoma
- Mets: assess bones, and leptomenigneal enhancement.
Demyelinating:
- MS
- ADEM
- Neuromyelitis optica
Cavernous malformation.
11
Q
Intra dural extra medullary lesion with solid enhancement:
A
schwannoma Meningioma Neurofibroma Myxopapillary ependymoma. CSF Mets.
12
Q
INtra dural extra medullary lesion with ring / peripheral enhancement:
A
Arachnoid cyst Schwannoma cystic Meningioma cystic Neurenteric cyst Meningitis Cysticercosis
13
Q
Intra dural extra medullary lesion T1 hyperintense
A
Metal artifact Filum terminale fibrolipoma Lipoma Subdural haematoma SAH Lipomyelomeningocele Dermoid / epidermoid.
14
Q
Intra dural extra medullary lesion T2 hyperintense T1 isointense:
A
Schwannoma Neurofibroma Epidermoid CSF Mets Myxofibrillary ependymoma Cysticercosis.
15
Q
Vertebral body scalloping:
A
POSTERIOR: "SALMON" S: spinal cord tumour: astrocytoma, ependymoma, schwannoma. A: Achondroplasia, acromegaly. L: Loeys Dietz M: Marfans, Mucopolysaccharidoses O: Osteogenesis Imperfecta N: NF1 --> lateral menigocele.
ANTERIOR: Retroperitoneal lymphadenopathy: - Leukaemia - Lymphoma - TB. Abdominal aortic aneursym Down syndrome.
