Demographics:
40 years old, Male
Indication:
Gait imbalance, history of leukemia status post radiati...
Gait imbalance, history of leukemia status post radiation therapy
Findings
- Extensive abnormal T2/STIR hyperintensity in the dorsal columns extending throughout the thoracic spinal cord without cord expansion or atrophy
- Additional areas of signal abnormality in the lateral columns
- Diffuse T1 hyperintense marrow signal
- Small T6 superior endplate Schmorl's node
- Conus terminates at L1-L2, in normal position
Diagnosis
Subacute combined degeneration (SCD)
Sample Report
Extensive abnormal T2/STIR hyperintensity in the dorsal columns and also involving the lateral columns extending throughout the thoracic spinal cord, which is primarily concerning for subacute combined degeneration, though methotrexate-induced myelopathy can have a similar appearance. Recommend correlation with serum B12 values.
Diffuse T1 hyperintense marrow signal, which may represent sequela of prior radiation therapy.
Discussion