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Case of the Week 133. Elderly male presents with Clinical signs of Myelopathy. What are the abnormal findings? What is the Diagnosis?. Answers. Abnormal Findings:

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case of the week 133

Case of the Week 133

Elderly male presents with Clinical signs of Myelopathy

answers
Answers
  • Abnormal Findings:
    • There is significant spinal stenosis at the levels of C3-C5 with compression of the cord. High signal intensity is present within the cord at these levels.
    • A band of low signal intensity is noted posterior to the vertebral bodies in this region, compressing the cord.
    • Thick, new bone formation is seen along the anterior body margins from C4 – C7 with sparing of the disc heights.
  • Diagnosis:
    • DISH with associated OPLL resulting in spinal stenosis and imaging (as well as clinical) signs of myelopathy.
slide4

Here are the plain radiographs of this same patient. In addition to the obvious DISH, the OPLL is noted posteriorly and a ‘nuchal bone’ is seen behind the SPs. Facet degeneration is particularly prominent at C4-5 on the right.