Objective: To determine the prevalence of incidental findings on magnetic resonance imaging (MRI) scans of the cervical, thoracic and lumbar spine in a paediatric population. Materials and Methods: We evaluated 190 spinal MRI examinations of patients aged ≤ 18 years of age. The study included only patients for whom complete medical records were available and who underwent complete MRI examination of the cervical, thoracic or lumbar spine, including whole-spine sagittal T2-weighted sequences. Imaging findings not related to the symptom or indication for MRI were considered incidental findings. Results: Of the 190 MRI examinations evaluated, 110 were in women and 80 were in men. The mean age of the study population was 12.46 ± 3.68 years. The main clinical indications for MRI in the sample were lumbago, scoliosis, dorsalgia and cervicalgia. Incidental findings were detected in the cervical, thoracic and lumbar spine in 40 (21.05%), 26 (13.83%) and 43 (22.63%) of the patients, respectively. The most common were (in the cervical spine) reversal/correction of the normal curvature; (in the thoracic spine) intravertebral disc herniation (Schmorl’s node) and disc dehydration; and (in the lumbar spine) disc protrusion (12 cases), Schmorl’s node (5 cases) and spondylolysis (4 cases). Conclusion: Incidental findings on MRI of the spine are less common in the paediatric population than in the adult population. Nevertheless, careful clinical evaluation of paediatric patients with complaints of axial and radiating pain is necessary in order to determine the correlation between symptoms and imaging findings.
0100-3984 © Colégio Brasileiro de Radiologia e Diagnóstico por ImagemWhich is your diagnosis? • Qual o seu diagnóstico? A female, Caucasian, 76-year-old patient reported the onset, approximately three weeks ago, of an intense, diffuse lumbar pain, irradiating over the lower limbs up to the knees. The pain did not decrease with rest and presented only a mild improvement with analgesic and non-hormonal anti-inflammatory drugs. The patient reported a previous history of rectal neoplasm treated with surgery and radiotherapy six months ago. At clinical examination, the patient presented pain at palpation and movement of the lumbar region, negative Lasègue's sign, with no motor or sensitivity deficit. Plain radiography (unshown), computed tomography ( Figure 1
OBJETIVO: analisar os resultados clínicos, radiológico e possíveis complicações de pacientes submetidos à cifoplastia no tratamento das fraturas por osteoporose dolorosas que não respondem ao tratamento conservador. MÉTODOS: foram avaliados 24 pacientes com fraturas osteoporóticas tratados através da cifoplastia. Destes, 19 (76%) eram do sexo feminino e 5 (24%) do masculino. A média de idade foi de 71,3 anos. A média de seguimento foi de 19 meses, variando de 3 a 29 meses. Os pacientes foram avaliados em relação à dor por meio da escala visual analógica (EVA) no pré-operatório e no último dia de seguimento. Também foi realizada uma análise radiográfica na qual se comparou o ganho de altura do muro anterior (A), terço médio do corpo vertebral (M), muro posterior (P) e ganho de cifose local (C). RESULTADOS: foram analisados 24 pacientes com 34 fraturas. Destes, 15 (62,5%) apresentavam fratura única e 9 (37,5%) apresentavam fraturas múltiplas. Dessas fraturas, 20 (58,8%) eram na coluna torácica e 14 (42,2%) lombares. A média do EVA no pré-operatório era de 9,3, passando para 3,2 no último seguimento (melhora de 6,1 pontos). O ganho médio de altura do corpo vertebral foi de 0,73 mm na porção anterior, 1,3 mm na porção média e 0,5 mm na porção posterior. A melhora da cifose foi, em média, de 1,32º - de 11,06º no pré para 12,4º no pós-operatório. Em relação a complicações, houve um caso de extravasamento do cimento para o espaço discal superior, assintomático e um caso de fratura do nível adjacente tratado com nova cifoplastia. CONCLUSÃO: a cifoplastia se mostrou uma técnica cirúrgica segura e efetiva para o tratamento da dor. Não foi observado ganho significativo da altura vertebral e da cifose vertebral.
Objective: To compare the interobserver reliability of measurements of psoas morphology and lumbar lordosis in different positions and to standardize the performance of magnetic resonance imaging in the prone and lateral positions. Methods: This is a cross-sectional study carried out with asymptomatic volunteers of both sexes, aged over 18 years, with no known pathological changes in the lumbar region. Magnetic resonance imaging of the lumbar spine was performed in the supine, right lateral decubitus and prone positions, obtaining images in T2-weighted sequences in the sagittal and axial planes. The distances were measured from the psoas to the vertebral plateau and from the psoas to the lumbar plexus. The exams were assessed by two independent, blinded orthopedists. Results: There was excellent agreement between the measurements of vertebral size (ICC=0.92), low agreement for plexus distance (ICC=0.63) and high agreement for the anterior margin (ICC=0.84). Conclusion: There was good reproducibility of 2 of the 3 measures proposed, suggesting that the technique in the lateral and prone positions is capable of generating quality images. Level of Evidence 3B; Prospective.
Engenharia de produção. 2. Segurança do trabalho. 3.Sustentabilidade. I. Título. CDD 658.5 Elaborado por Maurício Amormino Júnior -CRB6/2422 O conteúdo dos artigos e seus dados em sua forma, correção e confiabilidade são de responsabilidade exclusiva dos autores. 2018 Permitido o download da obra e o compartilhamento desde que sejam atribuídos créditos aos autores, mas sem a possibilidade de alterá-la de nenhuma forma ou utilizá-la para fins comerciais. www.atenaeditora.com.br
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