Rk Rauniyar

Pott's Spine: Diagnostic Imaging Modalities and Technology Advancements.

Spinal tuberculosis (TB) or Potts spine is the commonest extrapulmonary manifestation of TB. It spreads through hematogenous route. Clinically, it presents with constitutional symptoms, back pain, tenderness, paraplegia or paraparesis, and kyphotic or scoliotic deformities. Potts spine accounts for 2% of all cases of TB, 15% of extrapulmonary, and 50% of skeletal TB. The paradiscal, central, anterior subligamentous, and neural arch are the common vertebral lesions. Thoracic vertebrae are commonly affected followed by lumbar and cervical vertebrae. Plain radiographs are usually the initial investigation in spinal TB. For a radiolucent lesion to be apparent on a plain radiograph there should be 30% of bone mineral loss. Computed tomographic scanning provides much better bony detail of irregular lytic lesions, sclerosis, disc collapse, and disruption of bone circumference than plain radiograph. Magnetic resonance imaging (MRI) is the best diagnostic modality for Potts spine and is more sensitive than other modalities. MRI frequently demonstrates disc collapse/destruction, cold abscess, vertebral wedging/collapse, marrow edema, and spinal deformities. Ultrasound and computed tomographic guided needle aspiration or biopsy is the technique for early histopathological diagnosis. Recently, the coexistence of human immunodeficiency virus infections and TB has been increased globally. In recent years, diffusion-weighted MRI (DW-MRI) and apparent diffusion coefficient values in combination with MRI are used to some extent in the diagnosis of spinal TB. We have reviewed related literature through internet. The terms searched on Google scholar and PubMed are TB, extrapulmonary TB, skeletal TB, spinal TB, Potts spine, Potts paraplegia, MRI, and computed tomography (CT).

Aneurysmal bone cyst of temporal bone.

Aneurysmal bone cysts (ABC) are benign neoplasms frequently occurring in the long tubular bones. It is very rare in temporal bone. We report a case of ABC of the left temporal bone in an 8-year-old Asian boy who presented clinically with swelling over the left temporal region for 5 months. CT and MRI features were suggestive of ABC. Surgical resection was performed and on follow-up the patient was doing well. CT and MRI are the imaging modalities for proper evaluation of ABC, aiding to diagnosis and helpful in treatment planning.

Primary Intrapelvic Hydatid Cyst Presenting with Urinary Retention

Although hydatid disease can affect any part of the body, hydatid cysts located at unusual sites may create diagnostic confusion. The primary involvement of the pelvic cavity is a very rare and patients usually present with pressure symptoms affecting the adjacent organs. Herein, we report a case of pelvic hydatid cyst describing the ultrasonography (USG) and computed tomography (CT) findings of disease.

Orbital Cysticercosis Presenting as Swelling in the Medial Canthus

The orbital involvement of the cysticercosis is a rare manifestation involving eyelids, extraocular muscles, orbit, conjunctiva, anterior chamber, uvea, retina, vitreous and optic nerve. All the extraocular muscles are involved in myocysticercosis. Ultrasonography and Computed tomography are the imaging modalities for evaluation of orbital cysticercosis. The patients can be treated with systemic steroids and albendazole; however surgical excision is the treatment of choice. Hereby, we report an unusual case of orbital myocysticercosis with involvement of medial rectus muscle and swelling in the region of left medial canthus.

Cranial Computed Tomographic Findings of Neurofibromatosis Type 2

Neurofibromatosis type 2 (NF-2) is a rare inherited autosomal dominant disorder, characterized by multiple neoplasms of the central and peripheral nervous system associated with ocular abnormalities. NF-2 is associated with tumors of Schwann cells and meninges. Intracranial schwannoma most frequently involve the vestibulocochlear nerve (eighth cranial nerve). Bilateral eighth cranial nerve schwannomas are the hallmark of NF-2 and diagnostic of this condition. Intracranial meningiomas are also common in this disorder and are often multiple.We report a case of bilateral vestibulocochlear schwannoma and a solitary meningioma in a 17-year-old female who presented with headache and bilateral hearing impairment for last three months. Based on the clinical and computed tomographic (CT) findings, the diagnosis of NF-2 was made.

Incidental Isolated Fibrolipoma of Filum Terminale in Adult

Fibrolipomas of the filum terminale are embryonic in origin and are seen on MR images as small areas of fatty tissue along the filum terminale. These lipomas may result from faulty retrogressive differentiation. Though the lesions are frequently asymptomatic, fibrolipomas are a known cause of cord tethering and the tight filum syndrome. We present a case of isolated fibrolipoma of the filum terminale in an adult male which was detected incidentally on MRI done for evaluation of disc herniation.