Clinics in diagnostic imaging (161)

Abstract

A 53-year-old man presented with acute weakness of all four limbs (more on the right side) after an assault, during which he fell on his right side. He reported no urinary problems, but had not had any bowel movement for the past fi ve days.On examination, the patient had bilateral hypoaesthesia from the C5 to T1 level. Muscle strength in both upper limbs was decreased, with the right side affected more than the left. Muscle strength was also markedly reduced (1/5) in the right lower limb but full (5/5) in the left lower limb. Refl exes were graded 3+ in both upper limbs and the right lower limb, and 2+ in the left lower limb. Babinski refl ex was negative. Abdominal examination was signifi cant for a palpable, distended bladder and urinary catheterisation yielded 1,100 mL of urine. Sphincter tone was normal.A cervical spine radiograph ( Fig. 1) was initially obtained, followed by magnetic resonance (MR) imaging (Fig. 2) and computed tomography (CT) (Fig 3). What do the images show? What is the status of the cervical spinal cord?

A case of cervical OPLL and DISH mimicking stroke

“…Table 1 highlights the cases with OPLL that showed an acute presentation and a rapid progression. [8,5,7] In the present report, following trivial trauma, our patient presented with an acute left hemiparesis and anterior cord compression from C2 to C7 attributed to OPLL (i.e., once the brain MR ruled out a stroke).…”

“…No improvement; ventilator dependent Mizuno et al [5] 1999 63-year-old male Quadriplegia following a neck injury OPLL C2-C7 Medical treatment Fatal sepsis due to UTI 4 yrs later Tan et al [7] 2015 53-year-old male Acute quadriparesis following an assault…”

Compressive Cervical Myelopathy in X-Linked Hypophosphataemic Rickets

“…MRI is generally superior to CT in detecting soft tissue abnormalities, such as concurrent disc protrusions and resultant spinal cord compression (as in this case). 4 Radiographic predictors for the development of myelopathy in patients with OPLL include >60% spinal canal stenosis; large range of motion of the cervical spine; and lateral deviatedtype OPLL. 5 It is important to consider compressive myelopathy in patients with XLHR.…”