Become a Pro Member for full access to this course and more.

View Plans   Log In
Expand ("E")   Collapse

Age: 67

Sex: Male

Indication: Fever, back pain

Save ("V")

Case #11


Findings

  • T6-T8 vertebral body fractures with 25% anterior height loss at T6, 70% anterior height loss at T7, and 50% anterior height loss at T8 with associated kyphosis. 2-3 mm bony retropulsion at each of these level, most pronounced at T7
  • Fluid-filled fracture cleft just inferior to the T8 superior endplate with patchy areas of T2/STIR signal hyperintensity and enhancement in the T6-T8 vertebral bodies
  • Minimal STIR signal hyperintensity in the intervertebral discs at T6-T7 and T7-T8
  • T1-T4 superior endplate fractures, each with less than 25% height loss, without corresponding T2/STIR signal hyperintensity or enhancement
  • Enhancing epidural soft tissue ventrally from T6-T8 without discrete peripherally enhancing collection, which contributes to moderate to advanced spinal canal stenosis at the level of T7
  • Bilateral T6-T7 and T7-T8 facet joint effusions
  • Moderate to advanced bilateral neural foraminal stenosis at T6-T7 and T7-T8
  • No abnormal cord signal
  • Extensive paraspinal soft tissue enhancement from T5-T8 with bilateral peripherally enhancing collections, measuring up to 1.5 x 2 x 4 cm on the left and 1 x 3 x 3 cm on the right at the level of T6-T7
  • Moderate-sized left pleural effusion


Diagnosis

  • Tuberculous spondylitis

Sample Report

Findings concerning for discitis/osteomyelitis at T6-T7 and T7-T8 with ventral epidural phlegmon and bilateral paraspinal abscesses. Paraspinal abscesses measure up to 1.5 x 2 x 4 cm on the left and 1 x 3 x 3 cm on the right at the level of T6-T7. The relative disc sparing and large paraspinal infectious components raise concern for tuberculosis as a potential etiology.

Associated acute/subacute pathologic fractures of the T6-T8 vertebral bodies with 25% anterior height loss at T6, 70% anterior height loss at T7, and 50% anterior height loss at T8 and associated kyphosis. 2-3 mm bony retropulsion at each of these level, most pronounced at T7, which in combination with epidural phlegmon results in moderate to advanced spinal canal stenosis at the level of C7. No abnormal cord signal.

Sterility-indeterminate bilateral T6-T7 and T7-T8 facet joint effusions.

Remote appearing T1-T4 superior endplate fractures, each with less than 25% height loss and no bony retropulsion.

Moderate-sized left pleural effusion.


Discussion

Become a Pro Member to unlock the discussion.

View Plans   Log In





📣 Feedback?

⌨️  Keyboard Shortcuts ("K")

Call Preparation

Prepare for call efficiently with interactive cases, sample reports, and annotated images.

1,400+ cases  91.25 CME

Call Simulator

   Neuro CT

250 cases

  Neuro MRI

146 cases

   Peds Radiographs

372 cases

   MSK Radiographs

281 cases

   Chest CT

84 cases

   Chest Radiographs

97 cases

   KUB

43 cases

   Body CT

127 cases

   Ultrasound

75 cases

Call Simulator

• Shuffle cases from our courses to simulate the mix of a call shift.
• Submit your own report before reviewing the case write-up.

Neuro Fellowship

Develop deeper knowledge of neuro topics with clinical pearls, differentials, and in-depth discussions.

118 cases  11.8 CME

   Brain Tumors

105 cases

   Neurodegenerative

13 cases

Call Preparation

   Neuro CT

250 cases

   Neuro MRI

146 cases

   Peds Radiographs

372 cases

   MSK Radiographs

281 cases

   Ultrasound

75 cases

   Chest CT

84 cases

   Chest Radiographs

97 cases

   Body CT

127 cases

   KUB

43 cases

Neuro Fellowship

   Brain Tumors

105 cases

   Neurodegenerative

13 cases

Call Simulator

• Shuffle cases from our courses.
• Submit your own report.

CME

• Earn up to 91 CME.
• Claim your CME to receive a certificate.

Call Simulator

• Shuffle cases from our courses to simulate the mix of a call shift.
• Submit your own report before reviewing the case write-up.

CME

• Earn up to 91 CME by completing cases in our radiology courses.
• Claim your CME to receive a certificate.

On Call

Quick references created specifically to help while on call.

  Peds Normals by Age

Reference database of normal imaging from birth to age 16

   Incidental Findings

Summary of consensus guidelines for managing incidental CT findings

   Media Index

Index of select illustrations & videos from our courses

  Neuro CT Mimics

Visual reference for common mimics of pathology on CT

On Call

  Peds Normals by Age

Reference database of normal imaging from birth to age 16

   Incidental Findings

Summary of consensus guidelines for managing incidental CT findings

   Media Index

Index of select illustrations & videos from our courses

  Neuro CT Mimics

Visual reference for common mimics of pathology on CT

Anatomy

Labelled radiographs and CT/MRI series teaching anatomy with a level of detail appropriate for medical students and junior residents.

   Pelvis

Pelvic MRI anatomy

   Chest

Chest radiograph & CT anatomy

   Body

Abdominal CT anatomy

   Cardiac

Cardiac CT anatomy

   Brain

Brain & calvarial anatomy on CT/MRI

   Cranial Nerves

Cranial nerves on MRI

   Shoulder

Shoulder MRI anatomy

   Knee

Knee MRI anatomy

   Temporal Bone

Resident/fellow-level anatomy

Anatomy

   Pelvis

Pelvic MRI anatomy

   Chest

Chest radiograph & CT anatomy

   Body

Abdominal CT anatomy

   Cardiac

Cardiac CT anatomy

   Brain

Brain & calvarial anatomy on CT/MRI

   Cranial Nerves

Cranial nerves on MRI

   Shoulder

Shoulder MRI anatomy

   Knee

Knee MRI anatomy

   Temporal Bone

Resident/fellow-level anatomy

Neuro Courses

Includes our call preparation neuro courses (Neuro CT and Neuro MRI) and our neuro fellowship courses.

   Neuro CT

250 cases

  Neuro MRI

146 cases

   Brain Tumors

105 cases

   Neurodegenerative

13 cases

   Congenital Hearing Loss

Coming soon

Neuro Courses

   Neuro CT

250 cases

   Neuro MRI

146 cases

   Brain Tumors

105 cases

   Neurodegenerative

13 cases

  Congenital Hearing Loss

Coming soon

CME

• Claim your CME to receive a certificate.

Call Simulator

• Shuffle cases from our courses to simulate the mix of a call shift.
• Submit your own report before reviewing the case write-up.

CME

• Earn up to 91 CME by completing cases in our radiology courses.
• Claim your CME to receive a certificate.

   Neuro CT

250 cases

   Neuro MRI

146 cases

   Peds Radiographs

372 cases

   MSK Radiographs

281 cases

   Ultrasound

75 cases

   Chest CT

84 cases

   Chest Radiographs

97 cases

   Body CT

127 cases

   KUB

43 cases

Call Simulator

• Shuffle cases from our courses to simulate the mix of a call shift.
• Submit your own report before reviewing the case write-up.

CME

• Earn up to 91 CME by completing cases in our radiology courses.
• Claim your CME to receive a certificate.

⌨️ Keyboard Shortcuts

View shortcuts

Zoom/Pan

  Full screen

  Window/Level

  Expand/collapse

  Scroll

  Save the case

  Close case/tab

Previous Slice (PC)

Next Slice (PC)

SHIFT Previous Slice (MAC)

 SHIFT Next Slice (MAC)

 Toggle presets

 Previous series (if multiple)

 Next series (if multiple)

  Previous case (⌘ ◄ on a mac)

  Next case (⌘ ► on a mac)

Toggle dark mode