Musculoskeletal ImagingSyringomyelia
a slowly progressive disorder of the spinal cord, characterized by cavitary lesions in the central segments. Usually the
cervical region is affected. Among the causes are developmental defect,
tumour,
trauma,
infarction and
haemorrhage. Idiopathic cases are also known. Patients have neurological deficits with segmental muscle weakness and atrophy and sensory loss.
Posttraumatic syringomyelia can occur decades after the initial injury in patients who have sustained spinal trauma. Myelography shows arachnoiditis and adhesions at the level of injury; focal alterations in the size of the spinal cord may also be present. CT scanning is relatively insensitive in this disorder. At present, MR imaging is the imaging method of choice for detection of posttraumatic syringomyelia. With MR imaging, the cystic cavity in posttraumatic syringomyelia shows signal intensity characteristics similar to those of cerebrospinal fluid on all sequences (Fig.1). A homogeneous intramedullary process is observed to be sharply demarcated from the spinal cord, with a prolonged T1 and T2 time. Frequently the cysts expand the spinal cord.
A significant number of patients with syringomyelia develop neuropathic osteoarthropathy. The changes in syringomyelia are common in the joints of the upper extremity, especially the glenohumeral joint, elbow, and joints of the wrist and fingers. In the lower extremity, the knee, ankle and hip are affected with approximately equal frequency. Also, see syringomyelia.
DR/RB
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Sagittal T2-weighted MR image of the cervical spine demonstrates an oval area of low signal intensity within the spinal cord posterior to the C5 vertebral body.
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Syringomyelia, Fig.1 | |