The recumbent image (15A) shows posterior disc protrusions at C5/6 and C6/7. Also, note the adequate CSF space anterior to the spinal cord The upright-flexion image (15C) shows draping of the spinal cord over the posteriorly protruding discs. Clinically this patient exhibited L’Hermitte’s sign in the upright-flexion position.
“This MRI unit is important in that it enables the medical imaging specialist to uncover significant occult disease that is not apparent on the recumbent MRI studies” J. Randy Jinkins, MD, FACR, FEC Clinical Case Overview A 37-year-old male with bilateral pain and tingling in hands exacerbated upon flexion of the cervical spine. Case Study The images shown below were
Clinical Case Overview A 57-year old woman presented with pain of one year’s duration following failed back surgery performed in 2001*. The patient continued to experience persistent low back-pain, accompanied by sensations of coldness and numbness in both thighs and legs. The patient often required mechanical support to stabilize her walking. During the year following surgery, the patient sought help
The axial standing-extension gradient echo image (right) demonstrates a focal posterior disc herniation at the C4/5 level not visible on the recumbent scan. Note the associated spinal cord compression on the standing-extension scan.
The recumbent scan for this patient with right-sided radiculopathy following partial discectomy is shown on the left. The upright scan (right) shows a disc herniation at L5/S1.
The recumbent scan (9A) demonstrates no evidence of bladder or uterine prolapse and shows the levator sling is parallel to [and partially obscured by] the pubococygeal line. Note the decent of the bladder and uterus relative to the pubococygeal line which occurs with standing (9B) and is accentuated in the standing-straining view (9C). Note the levator sling (arrow) is oblique
Anterolisthesis at L4/5 is noted in the recumbent view (4A). The standing flexion scan (4C) shows an interspinous ligamentous rupture at the L4/5 level (arrow).
Sagittal images of the lumbosacral (6A) and thoracic (6B) spines in the upright-seated position shows compression of two thoracic vertebral bodies. This was ultimately found to be due to osteoporosis. The patient suffered from sufficiently marked kyphosis to render recumbent imaging impossible by either computed tomography or MRI.
Clinical Case Overview A 40-year old lady had been suffering for years from neck pain. A prior recumbent MRI had shown a C 5-6 disc degeneration with a posterior bulge and a moderate segmental kyphosis. Despite repeated attempts with conservative treatment, the patient’s symptoms worsened and were marked by the onset of transient paresthesias, transit loss of muscle tone in
Clinical Case Overview Following a violent body check, a professional ice hockey player experienced a sudden total quadriparesis that paralyzed him during play for a full minute. The upright flexion and extension images showed two centromedullary cord contusions where only one was visible on the neutral upright scan. The two contusions accounted for the quadriparesis that caused his sudden transient