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Pain Imaging pp 135-158 | Cite as

Imaging of Spine Pain

  • Rosario Francesco Balzano
  • Giuseppe Guglielmi
Chapter

Abstract

Spinal pain is a common disabling condition, that may often involve healthy individuals as well, for which many people seek medical attention in their lifetime; most of the times, it is an occasional condition which tends to limit itself, but in some cases, radiological investigations may be indicated to reach a certain diagnosis. Spinal pain (cervical, thoracic, and lumbar) can afflict both young and adult people, being an important cause of disability, in particular for working population. Several risk factors have been identified such as physical, occupational, and environmental ones, but also daily habits may be triggering for pain onset and maintenance. Many treatment options have been proposed for the management of spinal pain, i.e., analgesic medications, manipulative treatments, percutaneous interventional procedures, and surgical approaches as well. In this chapter they will be discussing several conditions which may be indicated as the main causes of pain; among these, degenerative disease is surely one of the most important sources of pain.

Keywords

Spine Pain Metabolic Inflammatory Neoplasms Imaging 

Supplementary material

Video 8.1a

Right lateral disc herniation on transversal T2-wi (a). On transversal images it can be noticed the annual disc tear where it takes origin. (MOV 3784 kb)

Video 8.1b

Sagittal fat sat T2-wi (b). On transversal images it can be noticed the annual disc tear where it takes origin. (MOV 2150 kb)

Video 8.1c

Sagittal T1-wi (c) craniallymigrated. On transversal images it can be noticed the annual disc tear where it takes origin. (MOV 2417 kb)

Video 8.2a

Spinal stenosis. MRI examination on transversal T2-wi (a) shows multilevel degenerative zygoapophyseal joint changes, ligamentum flavum hypetrophy, and disc herniation. Pseudoanterolysthesis of L5 on S1 and anterior L5 collapse are also noticed. (MOV 1913 kb)

Video 8.2b

Spinal stenosis. Sagittal T1-wi (b) shows multilevel degenerative zygoapophyseal joint changes, ligamentum flavum hypetrophy, and disc herniation. Pseudoanterolysthesis of L5 on S1 and anterior L5 collapse are also noticed. (MOV 1389 kb)

Video 8.2c

Spinal stenosis. T2-wi (c) shows multilevel degenerative zygoapophyseal joint changes, ligamentum flavum hypetrophy, and disc herniation. Pseudoanterolysthesis of L5 on S1 and anterior L5 collapse are also noticed. (MOV 1411 kb)

Video 8.3a

MRI features of Modic changes. Transversal T2-wi (a). Type I modification represents bone edema and appears hyperintense on T2-wi, better evaluated using FS, as in L4 anterosuperiorior aspect. Type II modification appears hyperintense on both T1-w and T2-wi as a consequence of fat infiltration (as in the superior L5 endplate). (MOV 4148 kb)

Video 8.3b

MRI features of Modic changes. Sagittal fat sat T2-wi (b). Type I modification represents bone edema and appears hyperintense on T2-wi, better evaluated using FS, as in L4 anterosuperiorior aspect. Type II modification appears hyperintense on both T1-w and T2-wi as a consequence of fat infiltration (as in the superior L5 endplate). (MOV 1818 kb)

Video 8.3c

MRI features of Modic changes. T1-wi (c). Type I modification represents bone edema and appears hyperintense on T2-wi, better evaluated using FS, as in L4 anterosuperiorior aspect. Type II modification appears hyperintense on both T1-w and T2-wi as a consequence of fat infiltration (as in the superior L5 endplate). (MOV 1597 kb)

Video 8.3d

MRI features of Modic changes. T2-wi (d). Type I modification represents bone edema and appears hyperintense on T2-wi, better evaluated using FS, as in L4 anterosuperiorior aspect. Type II modification appears hyperintense on both T1-w and T2-wi as a consequence of fat infiltration (as in the superior L5 endplate). (MOV 1922 kb)

Video 8.4a

Grade I anterolisthesis of L4 on L5, which is caused by bilateral L4 pars interarticularis lysis, as well documented on CT transversal images (a, bone filter). (MOV 2248 kb)

Video 8.4b

Grade I anterolisthesis of L4 on L5, which is caused by bilateral L4 pars interarticularis lysis, as well documented on CT transversal images (b, soft tissue filter). (MOV 2311 kb)

Video 8.4c

Grade I anterolisthesis of L4 on L5, as documented in the MRI exam (c, transversal T1-wi). (MOV 392 kb)

Video 8.4d

Grade I anterolisthesis of L4 on L5, on MPR reconstructions (d, coronal bone filter). (MOV 589 kb)

Video 8.4e

Grade I anterolisthesis of L4 on L5, on MPR reconstructions (e, coronal soft tissue filter). (MOV 1605 kb)

Video 8.4f

Grade I anterolisthesis of L4 on L5, as documented in the MRI exam (f, coronal T2-wi). (MOV 482 kb)

Video 8.4g

Grade I anterolisthesis of L4 on L5, on MPR reconstructions (g, sagittal bone filter). (MOV 1013 kb)

Video 8.4h

Grade I anterolisthesis of L4 on L5, as documented in the MRI exam (h, sagittal fat sat T2-wi). (MOV 389 kb)

Video 8.4i

Grade I anterolisthesis of L4 on L5, as documented in the MRI exam (i, sagittal T1-wi). (MOV 224 kb)

Video 8.4j

Grade I anterolisthesis of L4 on L5, as documented in the MRI exam (j, sagittal T2-wi). (MOV 335 kb)

Video 8.5a

Pyogenic Spondylodiscitis. The infectous process appear as hypointense on T1-wi (a, sagittal). (WMV 1447 kb)

Video 8.5b

Pyogenic Spondylodiscitis. Hyperintense on T2-wi (b). (WMV 1486 kb)

Video 8.5c

Pyogenic Spondylodiscitis. The infectous process appear as hypointense on T1-wi (c, transversal). (WMV 2119 kb)

Video 8.5d

Pyogenic Spondylodiscitis. Intense CE is noticed on fat sat T1-wi after iv Gd contrast agent (d, sagittal). (WMV 1580 kb)

Video 8.5e

Pyogenic Spondylodiscitis. Intense CE is noticed on fat sat T1-wi after iv Gd contrast agent (e, transversal). (WMV 2369 kb)

Video 8.5f

Spine lung metastasis involving L4 vertebral body, which is fractured, eith intracanalar spread. Lesion appear hypointense on T1-wi (a; due to normal bone marrow sostitution). Other lesions are present at L1, L3, S1 and S3. (MOV 130 kb)

Video 8.6a

Spine lung metastasis involving L4 vertebral body, which is fractured, eith intracanalar spread. Lesion appear hypointense on T1-wi (b; due to normal bone marrow sostitution). Other lesions are present at L1, L3, S1 and S3. (MOV 244 kb)

Video 8.6b

Spine lung metastasis involving L4 vertebral body, which is fractured, eith intracanalar spread. Lesion appear hypointense on T1-wi (b; due to normal bone marrow sostitution). Other lesions are present at L1, L3, S1 and S3. (MOV 244 kb)

Video 8.6c

Spine lung metastasis involving L4 vertebral body, which is fractured, eith intracanalar spread. Disomogeneous on T2-wi (c). Other lesions are present at L1, L3, S1 and S3. (MOV 219 kb)

Video 8.6d

Spine lung metastasis involving L4 vertebral body, which is fractured, eith intracanalar spread. Disomogeneous on T2-wi (d). Other lesions are present at L1, L3, S1 and S3. (MOV 178 kb)

Video 8.7a

Multiple myeloma; diffuse vertebral spine involvement. T1-wi show typical "salt and pepper" appearance, better than T2-wi (a). T12 patological collapse is also present. (MOV 681 kb)

Video 8.7b

Multiple myeloma; diffuse vertebral spine involvement. T1-wi show typical "salt and pepper" appearance, better than T2-wi (b). T12 patological collapse is also present. (MOV 275 kb)

Video 8.7c

Multiple myeloma; diffuse vertebral spine involvement. T1-wi (c) show typical "salt and pepper" appearance, better than T2-wi. T12 patological collapse is also present. (MOV 396 kb)

Video 8.7d

Multiple myeloma; diffuse vertebral spine involvement. T1-wi show typical "salt and pepper" appearance, better than T2-wi (d). T12 patological collapse is also present. (MOV 189 kb)

Video 8.7e

Multiple myeloma; diffuse vertebral spine involvement. T1-wi (e) show typical "salt and pepper" appearance, better than T2-wi. T12 patological collapse is also present. (MOV 235 kb)

Video 8.7f

Multiple myeloma; diffuse vertebral spine involvement. T1-wi show typical "salt and pepper" appearance, better than T2-wi (f). T12 patological collapse is also present. (MOV 334 kb)

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Rosario Francesco Balzano
    • 1
  • Giuseppe Guglielmi
    • 1
    • 2
  1. 1.Department of RadiologyUniversity of FoggiaFoggiaItaly
  2. 2.Department of RadiologyScientific Institute “Casa Sollievo della Sofferenza” HospitalFoggiaItaly

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