Posts tagged ‘fluid’

May 21, 2014

MRI Case Study: “Thoracic Cord Syrinx” or “Some new vocab words for today”

SAG t2 8Here is an example of an MRI of the thoracic spine. The image on the left is taken as if the body were being sliced from head to toe (sagittal image) and the image below is as if the body were being sliced across the middle like a loaf of bread (axial image).

 

The image to the left shows the vertebral bodies as blocks and the spinous processes back behind the spinal canal as obliquely oriented blades. The spinal canal on both contains the spinal cord which is mostly black surrounded by the normal cerebrospinal fluid which is white. The thoracic cord normally has a little bit of a bulge as it ends in the upper lumbar spine, seen on the sagittal image towards the bottom.

 

This patient presented for evaluation of mid-back pain. On the left side sagittal image, the cord has an area of white running through it centrally from top to bottom. This is seen as the central spot of white within the normally dark cord on the axial image. The signal of this area matches the signal of the cerebrospinal fluid surrounding the cord.

 

This area of white is one example of cord pathology that might be picked up on an MRI. This is known as a syrinx (or syringohydromyelia – how’s that for a long name!) and is an abnormal buildup of fluid in the central canal of the cord. Over time, this fluid buildup can enlarge and start to affect the nerves running through the cord, sometimes resulting in symptoms like muscle weakness.

 

Remember, most patients with back pain will find their symptoms resolve within 4 weeks. If symptoms do not improve or are accompanied by other changes like muscle weakness, evaluation by your doctor is warranted.

 

 

Diagnostic Imaging Centers blogs on regularly about women’s health atwww.mammographykc.com and general radiology atwww.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!AX t2

April 17, 2014

Shoulder Pain: When You Can’t Shrug It Off

Shoulder joint by National Institute Of Arthritis And Musculoskeletal And Skin Diseases (NIAMS) via Wikipedia Copright Public DomainThe shoulder is a complex joint of mythical strength (at least if your name is Atlas and you’re carrying the weight of the world on it).

 

From baseball pitching to carrying little kids to lifting overhead, the shoulder gets quite the workout. It’s important to take care of this joint – especially if it’s been injured. One of the most common injuries is to the rotator cuff tendons.

 

There are four tendons surrounding the shoulder to provide stability and assist in the normal range of motion. Pain and limited range of motion are often the first indicators that something could be wrong with those tendons. They can be inflamed, torn partially or torn full-thickness.

 

After an initial evaluation with your primary healthcare professional, you may be sent for imaging. Typically, this area can be evaluated with MRI or an  ultrasound. Some shoulder injuries are difficult to see without some fluid in the joint – this is when an MR arthrogram might be performed. MR arthrograms can evaluate partial tendon tears and provides an excellent evaluation of the labrum or cartilage lining the joint. Labral injuries may be seen in patients who have had a dislocation of their shoulder joint as well as in athletes.

 

Some of the rotator cuff tendons sit underneath the acromioclavicular joint – the smaller part of the joint on top of the shoulder. Changes in the acromioclavicular joint, either differences in the shape of the acromion or degenerative arthritis, may predispose you to problems with the rotator cuff tendons or may lead to chronic tendon irritation or tears.

 

The shoulder is a complex joint, and vital to many daily functions we don’t even think about, such as brushing your hair or lifting your groceries. So if you have an injury, pain or develop difficulty in moving your shoulder, don’t hesitate to see your doctor.

 

And remember – prevention is the best medicine! Stronger shoulders are less likely to incur injury, and strengthening the rotator cuff can be achieved. Here’s a Real Simple way to improve your shoulder health.

(Photo credit: Shoulder joint by National Institute Of Arthritis And Musculoskeletal And Skin Diseases (NIAMS) via Wikipedia Copright Public Domain)

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

March 13, 2014

Self-Exams for Men (and Women)

Operation Truck Nuts - Successful by The359 via Flickr Copyright Creative Commons Attribution-ShareAlike 2.0 Generic (CC BY-SA 2.0) Cropped

Operation Truck Nuts – Successful by The359 via Flickr Copyright Creative Commons Attribution-ShareAlike 2.0 Generic (CC BY-SA 2.0) Cropped

Okay, we’re slightly nerdy.

Aside from being fans of thought-gems on TED.com you may have noticed on our other blog, MammographyKC.com that we’re also fans of Lifehacker. We can’t help it – there are thought-gems there too. Recently, they did a report on Three Self Exams Everyone Should Perform. Because early detection saves lives, and we as radiologists have the capacity to assist in early detection, we are great fans of self-exams.

But there’s so much to learn!

Self-exams put the power in your hands. You are the first line of defense when it comes to taking care of yourself, from eating right to exercise to noticing unusual changes in your body. But you have to pay attention! This is why we loved the article so much – it encourages you to pay attention.

We’ve written about breast self-exams on our MammographyKC blog (here) so today we’d like to use the Lifehacker article as a jumping-off point to talk about men’s health and the scrotal self-exam.

Men’s health is something we care about too.

The Lifehacker article gives good tips on how a man can perform his own scrotal self-exam. Knowing how to do it and what to look for are step one!

Testicular cancer is a leading cancer type in young men – and if found early, most testicular cancers respond well to treatment. Scrotal self-exam after puberty is one of the ways of finding scrotal changes that may be a sign of this cancer. Testicular cancer will often present as a firm or hard persistent lump in the testes.

If you find a scrotal lump on self-exam, step one is to get in to see you doctor. He will perform a careful physical exam and may also evaluate blood work. Depending on the results of those tests, you may be referred to a radiologist for a scrotal ultrasound.

Earlier on this blog, Dr. Sid Crawley talked about scrotal ultrasound and what to expect. It’s a non-invasive and relatively quick procedure. Besides masses or lumps what other symptoms may prompt a request for a  scrotal ultrasound? Pain, feeling of heaviness/fullness, infertility and scrotal trauma are also reasons men may be referred for scrotal ultrasound. Remember any persistent scrotal changes should not be ignored!

What can we see on scrotal ultrasound?

Scrotal ultrasound examines the scrotum and contents including the two testicles, spermatic cords, and each epididymis. The exam evaluates for the presence or absence of masses within or outside the testes, infection, trauma, fluid accumulation (hydroceles) and testicular torsion (an abnormal twisting of the testes which causes blood circulation to be impeded and can lead to permanent damage or loss of the testes). The sonographic evaluation will help guide your clinician to the appropriate course of treatment.

Just as we talk about in the breast, all lumps are not cancers. Many benign cysts and other benign masses may feel like a lump or knot. The beauty of scrotal ultrasound is being able to examine right where you are having symptoms, and answering the question of what is this lump!

A quick word about scrotal trauma – many times, trauma to the scrotum prompts a first scrotal self-exam. If you feel a lump do not assume the lump must be from the trauma – one of the most common scenarios for finding testicular cancer is the patient who first feels a lump after an episode of trauma.

Take a breath.

Most often, the scrotal ultrasound will reveal benign, treatable conditions. A monthly scrotal self-exam is an excellent means of keeping aware of your body and finding changes early. So breathe easy and take care of yourself with a simple monthly self-exam.