Complaint : 36Y,
Male c/o
backache & pain in the lower limbs - one year
FINDINGS:
MRI :
Posterio-lateral
extradural round cystic mass communicating with facet joint on Left side
at L3/L4 level & causing mass effect on thecal sac.
DIAGNOSIS:
Lt.L3/L4 Synovial facet cyst.
Differential Diagnosis :
Extruded disc fragment
-
Not contiguous facet joint
-
Usually anterior epidural
-
Posterolateral uncommon
-
Not as hyperintense on T2 WI
Ganglion cyst
-
Likely from ligamentum flavum
-
Difficult to distinguish by imaging
-
Different pathologically
-
Contains myxoid material
-
Lined by fibrous connective tissue capsule
Nerve sheath tumor
-
Intradural extramedullary most common
-
“Dumbbell” lesion less common
-
Intense post – contrast – enhancement
Septic facet arthritis
Asymmetric ligamentum flavum hypertrophy
REFERENCE : Jeffrey S. Ross, Diagnostic Imaging,
Spine 1st edition, 2004.
SUBMITTED
BY: DR. M.ADINARAYANA RAO. MD.
DR. D. PRASAD REDDY. DMRD.
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