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MRI of cervical spine injuries complicating ankylosing spondylitis
Objective The objective was to study characteristic MRI findings in cervical spine fractures complicating ankylosing spondylitis (AS). Technical issues related to MRI are also addressed. Materials and methods A review of 6,774 consecutive cervical spine multidetector CT (MDCT) scans obtained during...
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Published in: | Skeletal radiology 2008-09, Vol.37 (9), p.813-819 |
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description | Objective
The objective was to study characteristic MRI findings in cervical spine fractures complicating ankylosing spondylitis (AS). Technical issues related to MRI are also addressed.
Materials and methods
A review of 6,774 consecutive cervical spine multidetector CT (MDCT) scans obtained during 6.2 years revealed 33 ankylosed spines studied for suspected acute cervical spine injury complicating AS. Of these, 20 patients also underwent MRI.
Results
On MRI, of these 20 patients, 19 had a total of 29 cervical and upper thoracic spine fractures. Of 20 transverse fractures traversing both anterior and posterior columns, 7 were transdiskal and exhibited less bone marrow edema than did those traversing vertebral bodies. One Jefferson’s, 1 atlas posterior arch (Jefferson’s on MDCT), 2 odontoid process, and 5 non-contiguous spinous process fractures were detectable. MRI showed 2 fractures that were undetected by MDCT, and conversely, MDCT detected 6 fractures not seen on MRI; 16 patients had spinal cord findings ranging from impingement and contusion to complete transection.
Conclusion
Magnetic resonance imaging can visualize unstable fractures of the cervical and upper thoracic spine. Paravertebral hemorrhages and any ligamentous injuries should alert radiologists to seek transverse fractures. Multiple fractures are common and often complicated by spinal cord injuries. Diagnostic images can be obtained with a flexible multipurpose coil if the use of standard spine array coil is impossible due to a rigid collar or excessive kyphosis. |
doi_str_mv | 10.1007/s00256-008-0484-x |
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The objective was to study characteristic MRI findings in cervical spine fractures complicating ankylosing spondylitis (AS). Technical issues related to MRI are also addressed.
Materials and methods
A review of 6,774 consecutive cervical spine multidetector CT (MDCT) scans obtained during 6.2 years revealed 33 ankylosed spines studied for suspected acute cervical spine injury complicating AS. Of these, 20 patients also underwent MRI.
Results
On MRI, of these 20 patients, 19 had a total of 29 cervical and upper thoracic spine fractures. Of 20 transverse fractures traversing both anterior and posterior columns, 7 were transdiskal and exhibited less bone marrow edema than did those traversing vertebral bodies. One Jefferson’s, 1 atlas posterior arch (Jefferson’s on MDCT), 2 odontoid process, and 5 non-contiguous spinous process fractures were detectable. MRI showed 2 fractures that were undetected by MDCT, and conversely, MDCT detected 6 fractures not seen on MRI; 16 patients had spinal cord findings ranging from impingement and contusion to complete transection.
Conclusion
Magnetic resonance imaging can visualize unstable fractures of the cervical and upper thoracic spine. Paravertebral hemorrhages and any ligamentous injuries should alert radiologists to seek transverse fractures. Multiple fractures are common and often complicated by spinal cord injuries. Diagnostic images can be obtained with a flexible multipurpose coil if the use of standard spine array coil is impossible due to a rigid collar or excessive kyphosis.</description><identifier>ISSN: 0364-2348</identifier><identifier>EISSN: 1432-2161</identifier><identifier>DOI: 10.1007/s00256-008-0484-x</identifier><identifier>PMID: 18421455</identifier><identifier>CODEN: SKRADI</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Cervical Vertebrae - diagnostic imaging ; Cervical Vertebrae - injuries ; Diseases of the osteoarticular system ; Diseases of the spine ; Female ; Humans ; Imaging ; Inflammatory joint diseases ; Investigative techniques, diagnostic techniques (general aspects) ; Magnetic Resonance Imaging - methods ; Male ; Medical sciences ; Medicine & Public Health ; Middle Aged ; Nuclear Medicine ; Orthopedics ; Osteoarticular system. Muscles ; Pathology ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Radiology ; Scientific Article ; Spinal Injuries - diagnosis ; Spinal Injuries - diagnostic imaging ; Spinal Injuries - etiology ; Spondylitis, Ankylosing - complications ; Spondylitis, Ankylosing - diagnostic imaging ; Tomography, X-Ray Computed</subject><ispartof>Skeletal radiology, 2008-09, Vol.37 (9), p.813-819</ispartof><rights>ISS 2008</rights><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-4df0fcd54cacef761638cc6e6da73695210b2c9a44004701b8315dcb1d336f403</citedby><cites>FETCH-LOGICAL-c399t-4df0fcd54cacef761638cc6e6da73695210b2c9a44004701b8315dcb1d336f403</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20558035$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18421455$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Koivikko, Mika P.</creatorcontrib><creatorcontrib>Koskinen, Seppo K.</creatorcontrib><title>MRI of cervical spine injuries complicating ankylosing spondylitis</title><title>Skeletal radiology</title><addtitle>Skeletal Radiol</addtitle><addtitle>Skeletal Radiol</addtitle><description>Objective
The objective was to study characteristic MRI findings in cervical spine fractures complicating ankylosing spondylitis (AS). Technical issues related to MRI are also addressed.
Materials and methods
A review of 6,774 consecutive cervical spine multidetector CT (MDCT) scans obtained during 6.2 years revealed 33 ankylosed spines studied for suspected acute cervical spine injury complicating AS. Of these, 20 patients also underwent MRI.
Results
On MRI, of these 20 patients, 19 had a total of 29 cervical and upper thoracic spine fractures. Of 20 transverse fractures traversing both anterior and posterior columns, 7 were transdiskal and exhibited less bone marrow edema than did those traversing vertebral bodies. One Jefferson’s, 1 atlas posterior arch (Jefferson’s on MDCT), 2 odontoid process, and 5 non-contiguous spinous process fractures were detectable. MRI showed 2 fractures that were undetected by MDCT, and conversely, MDCT detected 6 fractures not seen on MRI; 16 patients had spinal cord findings ranging from impingement and contusion to complete transection.
Conclusion
Magnetic resonance imaging can visualize unstable fractures of the cervical and upper thoracic spine. Paravertebral hemorrhages and any ligamentous injuries should alert radiologists to seek transverse fractures. Multiple fractures are common and often complicated by spinal cord injuries. Diagnostic images can be obtained with a flexible multipurpose coil if the use of standard spine array coil is impossible due to a rigid collar or excessive kyphosis.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Cervical Vertebrae - diagnostic imaging</subject><subject>Cervical Vertebrae - injuries</subject><subject>Diseases of the osteoarticular system</subject><subject>Diseases of the spine</subject><subject>Female</subject><subject>Humans</subject><subject>Imaging</subject><subject>Inflammatory joint diseases</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Nuclear Medicine</subject><subject>Orthopedics</subject><subject>Osteoarticular system. Muscles</subject><subject>Pathology</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Radiology</subject><subject>Scientific Article</subject><subject>Spinal Injuries - diagnosis</subject><subject>Spinal Injuries - diagnostic imaging</subject><subject>Spinal Injuries - etiology</subject><subject>Spondylitis, Ankylosing - complications</subject><subject>Spondylitis, Ankylosing - diagnostic imaging</subject><subject>Tomography, X-Ray Computed</subject><issn>0364-2348</issn><issn>1432-2161</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><recordid>eNp1kE1r3DAQhkVpaLZpf0AvxRTSm5MZfVk-JiFtAimB0p6FVpaDtl7Z0axD9t9Xyy4JFHqagXlm5uVh7BPCGQI05wTAla4BTA3SyPr5DVugFLzmqPEtW4DQsuZCmmP2nmgFgE2j9Dt2jEZylEot2OWPn7fV2Fc-5Kfo3VDRFFOoYlrNOQaq_LiehjLYxPRQufRnO4y0a2kaU7cd4ibSB3bUu4HCx0M9Yb-_Xf-6uqnv7r_fXl3c1V607aaWXQ-975T0zoe-0aiF8V4H3blG6FZxhCX3rZMSQDaASyNQdX6JnRC6lyBO2Nf93SmPj3OgjV1H8mEYXArjTFa3ouECeQG__AOuxjmnks1yMCiNkqJAuId8Holy6O2U49rlrUWwO7t2b9cWu3Zn1z6Xnc-Hw_NyHbrXjYPOApweAEdFZp9d8pFeOA5KGRA7ju85KqP0EPJrwv9__wt8cJGq</recordid><startdate>20080901</startdate><enddate>20080901</enddate><creator>Koivikko, Mika P.</creator><creator>Koskinen, Seppo K.</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20080901</creationdate><title>MRI of cervical spine injuries complicating ankylosing spondylitis</title><author>Koivikko, Mika P. ; Koskinen, Seppo K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-4df0fcd54cacef761638cc6e6da73695210b2c9a44004701b8315dcb1d336f403</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Cervical Vertebrae - diagnostic imaging</topic><topic>Cervical Vertebrae - injuries</topic><topic>Diseases of the osteoarticular system</topic><topic>Diseases of the spine</topic><topic>Female</topic><topic>Humans</topic><topic>Imaging</topic><topic>Inflammatory joint diseases</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Nuclear Medicine</topic><topic>Orthopedics</topic><topic>Osteoarticular system. Muscles</topic><topic>Pathology</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Radiology</topic><topic>Scientific Article</topic><topic>Spinal Injuries - diagnosis</topic><topic>Spinal Injuries - diagnostic imaging</topic><topic>Spinal Injuries - etiology</topic><topic>Spondylitis, Ankylosing - complications</topic><topic>Spondylitis, Ankylosing - diagnostic imaging</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koivikko, Mika P.</creatorcontrib><creatorcontrib>Koskinen, Seppo K.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Biological Sciences</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest advanced technologies & aerospace journals</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Skeletal radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koivikko, Mika P.</au><au>Koskinen, Seppo K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>MRI of cervical spine injuries complicating ankylosing spondylitis</atitle><jtitle>Skeletal radiology</jtitle><stitle>Skeletal Radiol</stitle><addtitle>Skeletal Radiol</addtitle><date>2008-09-01</date><risdate>2008</risdate><volume>37</volume><issue>9</issue><spage>813</spage><epage>819</epage><pages>813-819</pages><issn>0364-2348</issn><eissn>1432-2161</eissn><coden>SKRADI</coden><abstract>Objective
The objective was to study characteristic MRI findings in cervical spine fractures complicating ankylosing spondylitis (AS). Technical issues related to MRI are also addressed.
Materials and methods
A review of 6,774 consecutive cervical spine multidetector CT (MDCT) scans obtained during 6.2 years revealed 33 ankylosed spines studied for suspected acute cervical spine injury complicating AS. Of these, 20 patients also underwent MRI.
Results
On MRI, of these 20 patients, 19 had a total of 29 cervical and upper thoracic spine fractures. Of 20 transverse fractures traversing both anterior and posterior columns, 7 were transdiskal and exhibited less bone marrow edema than did those traversing vertebral bodies. One Jefferson’s, 1 atlas posterior arch (Jefferson’s on MDCT), 2 odontoid process, and 5 non-contiguous spinous process fractures were detectable. MRI showed 2 fractures that were undetected by MDCT, and conversely, MDCT detected 6 fractures not seen on MRI; 16 patients had spinal cord findings ranging from impingement and contusion to complete transection.
Conclusion
Magnetic resonance imaging can visualize unstable fractures of the cervical and upper thoracic spine. Paravertebral hemorrhages and any ligamentous injuries should alert radiologists to seek transverse fractures. Multiple fractures are common and often complicated by spinal cord injuries. Diagnostic images can be obtained with a flexible multipurpose coil if the use of standard spine array coil is impossible due to a rigid collar or excessive kyphosis.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>18421455</pmid><doi>10.1007/s00256-008-0484-x</doi><tpages>7</tpages></addata></record> |
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subjects | Adult Aged Aged, 80 and over Biological and medical sciences Cervical Vertebrae - diagnostic imaging Cervical Vertebrae - injuries Diseases of the osteoarticular system Diseases of the spine Female Humans Imaging Inflammatory joint diseases Investigative techniques, diagnostic techniques (general aspects) Magnetic Resonance Imaging - methods Male Medical sciences Medicine & Public Health Middle Aged Nuclear Medicine Orthopedics Osteoarticular system. Muscles Pathology Radiodiagnosis. Nmr imagery. Nmr spectrometry Radiology Scientific Article Spinal Injuries - diagnosis Spinal Injuries - diagnostic imaging Spinal Injuries - etiology Spondylitis, Ankylosing - complications Spondylitis, Ankylosing - diagnostic imaging Tomography, X-Ray Computed |
title | MRI of cervical spine injuries complicating ankylosing spondylitis |
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