Table Of ContentJeffrey S. Ross, MD
euroradiology
Barrow Neurological Institute
SI.Joseph's Hospital
Phoenix, AZ
Kevin R. Moore, MD
Pedialric euroradiologisl
Primary hildren's Medical Center
Adjunct Associate Professor of Radiology
University of Utah School of Medicine
Salt LakeCity, UT
Lubdha M. Shah, MD
Assistant Professor of Radiology
Division of 'euroradiology
University of Utah School of Medicine
Salt LakeCity, UT
Bryson Borg, MD
Chief of Neuroradiology
David Grant Medical Center
Travis Air Force Base,CA
Julia Crim, MD
Chief of Musculoskeletal Radiology
Professor of Radiology
University of Ulah School of Medicine
Salt Lake ity, UT
iii
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.-11III1''''
AMIRSYS'"
Names you know. Content you trust.'"
Second Edition
©2010 Amirsys, Inc.
Compilation ©2010 Amirsys Publishing, Inc.
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ISBN: 978-1-931884-87-7
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Library of Congress Cataloging-in-Publication Data
Diagnostic imaging. Spine /Jeffrey S.Ross ... let al.]. --2nd ed.
p.; em.
Spine
Includes bibliographical references and index.
ISBN978-1-931884-87-7 (alk. paper)
I. Spinenlmaging. I.Ross,Jeffrey S.Oeffrey Stuart) II.Title: Spine.
IDNLM: 1. Spinal Diseasesndiagnosis. 2. Magnetic Resonance Imaging. 3.
Spine--anatomy &: histology. WE 725J
RD768.D535 2010
616.7'30754ndc22
2010036792
With love toPeg, Whitney, Tyler,and Jamie - my earthly foundation
Wisdom issupreme; thereforeget wisdom.
Though it cost all you have, get understanding.
Proverbs4:7 (NIV)
JRS
Welcome to the second edition of Diagnostic Imaging: Spine. Why a new edition? Sixyears isan eternity given the
rapid pace of change in medicine.
This edition has 40 new diagnoses and almost 4000 images (both in print and eBook). Thousands of images are
new for this edition, and many beautiful new illustrations are included to emphasize key aspects of the diagnoses. The
format retains the ease of use of the first edition, with individual diagnoses meant to stand by themselves, but with
a tight integration within the sections. Akey facts box starts each diagnosis, giving prompt access to the basics. The
bulk of the text remains in a concise outline format, allowing for a dense amount of information but also the ability
to scan rapidly to the area of interest. Prose text isnow used for the introductory sections, which cover broad topics
ranging from embryology to tumor spread. Also new in this edition are tables, allowing side by side placement of
important data and measurements.
Iam deeply indebted to my co-authors and the staff at Amirsys for all the hard work that went into this book.
Idon't have enough adjectives to describe the work ethic of my collaborators, but a few are "brilliant," "diligent,"
IIconscientious," and ({thorough."
Suggestions or comments on what you see or read? Email [email protected]. We take your input
very seriously, and you will get a prompt reply.
We hope you find this reference immensely useful on a daily basis in your practice.
Jeffrey S.Ross, MD
Neuroradiology
Barrow Neurological Institute
St.Joseph's Hospital
Phoenix, AZ
Text Editing
Arthur G. Gelsinger, MA
Katherine Riser, MA
Dave L.Chance, MA
Matthew R.Connelly, MA
Image Editing
jeffrey j. Marmorstone
Medical Editing
Lea Alhilali, MD
Saeed Fakhran, MD
Illustrations
james A. Cooper, MD
Lane R. Bennion, MS
Richard Coombs, MS
Laura C. Sesto, MA
AMIRSYS8
Names YOLIknow. Content YOlitrust.®
vii
Simple Coccygeal Dimple 1-1-72
PART I
Kevin II.Moore, MD
Dermoid Cysts 1-1-76
Congenital and Genetic Disorders
Kevin R.Moore, MD
Epidermoid Cysts 1-1-80
SECTION 1 Kevin /I. Moore, MD
Congenital Anomalies of the Caudal Cell Mess
Tethered Spinal Cord 1-1-84
Normal Anatomical Variations Kevin R.Moore, A1D
Caudal RegressionSyndrome 1-1-88
Normal Anatomy 1-1-2
Kevin R.Moore, MD
JeffreyS. Ross,M0
Segmental Spinal Dysgenesis 1-1-92
Measurement Techniques 1-1-8
Kevin R.Moore, MD
JeffreyS. Ross,MD
Normal Variant 1-1-14 Terminal Myelocystocele 1-1-96
Kevin II.Moore, MD
Kevin II.Moore, MD
Anterior Sacral Meningocele 1-1-100
MR Artifacts 1-1-18
Kevin R.Moore, MD
Kevin R.Moore, MD
Occult Intrasacral Meningocele 1-1-104
Craniovertebral Junction Variants 1-1-24
Kevin/l. Moore, MD
Kevin R.Moore, MD
Sacrococcygeal Teratoma 1-]-108
Conjoined Nerve Roots 1-1-28
Kevin R.Moore, MD
Kevin R.Moore, MD
Limbus Vertebra 1-1-32 Anomalies of Notochord
Kevin R.Moore, MD and Vertebral Formation
Filum Terminale Fibrolipoma 1-1-36
Craniovertebral Junction Embryology 1-1-112
Kevin R.Moore, MD
Kevin /I.Moore, MD
Bone Island 1-1-38
Klippel-Feil Spectrum 1-]-116
Kevin R.Moore, MIJ
Kevin R.Moore, MD
Ventriculus Terminalis 1-1-40
Failure of Vertebral Formation 1-]-120
Kevin R.Moore, MIJ
Key;', R. Moore, MD
Abnormalities of Neurulation
Vertebral Segmentation Failure 1-]-]24
Embryology Overview 1-1-44 Kevin /I.Moore, MD
Kevin R.Moore, MD Diastematomyelia 1-1-128
Chiari 2 1-1-52 Kevin II. Moore, MD
Kevin II.Moore, MD Partial Vertebral Duplication 1-]-132
Myelomeningocele 1-1-56 Kevin II.Moore, MD
Kevin R.Moore, MD Incomplete Fusion, Posterior Element 1-]-134
Lipomyelomeningocele 1-1-60 Kevin R.Moore, MD
Kevin R.Moore, MD Neurenteric Cyst 1-1-136
Lipoma 1-1-64 Kevin II.Moore, MD
Kevin R.Moore, MD
Developmental Abnormalities
Dorsal Dermal Sinus 1-1-68
OsOdontoideum 1-1-140
Kevin R.Moore, MD
Kevin/I. Moore, MD
VIU
Chiari I 1-1-144 Flat Back Syndrome
Kevin R. Moore, MD Lubdha M. 5/1Il11, MD
Lateral Meningocele 1-1-148
PART II
Kevin R. Moore, MD
Dorsal Spinal Meningocele 1-1-152
Kev;" I? Moore, MD Trauma
Dural Dysplasia 1-1-156
Kev;n R. Moore, MD
SECTION 1
Genetic Disorders
Vertebral Column, Discs,
Neurofibromatosis Type 1 1-1-160
and Paraspinal Muscle
Kevhl R. Moore, MD
Neurofibromatosis Type 2 1-1-164
Fracture Classification 11-1-2
Jeffrey 5. /loss, M0
Je((rey 5.Ross, M/J
Achondroplasia 1-1-170
Atlantooccipital Dislocation 11-1-8
Bryson Borg, MD
}/ll;a Crim, MD
Mucopol ysaccha ridoses 1-1-174
Ligamentous Injury 11-1-12
Bryson Borg, M0
Bryson Borg, MD
Sickle Cell Disease 1-1-178
Bryson Borg, M0 Occipital Condyle Fracture 11-1-16
Osteogenesis Imperfecta 1-1-182 Bryson Borg, M/J
Kevin R. Moore, M/J Jefferson CI Fracture 11-1-20
Tuberous Sclerosis 1-1-186 Bryson Borg, M0
Jeffrey 5. Ross, M/J Atlantoaxial Rotatory Fixation 11-1-24
Osteopetrosis 1-1-190 Je(frey 5. Ross, M/J
Kellin R. Moore, MO Odontoid C2 Fracture 11-1-30
Gaucher Disease 1-1-192 Bryson Borg, M/J
Kev;n R. Moore, MD
Burst C2 Fracture 11-1-34
Ochronosis 1-1-194
Bryson Borg, M/J
Kev;n /I. Moore, MD
Hangman's C2 Fracture 11-1-38
Con nective Tissue Disorders 1-1-196
Bryson BOlg,MD
Kevin R. Moore, MO
Cervical Hyperflexion Injury 11-1-42
Spondyloepiphyseal Dysplasia 1-1-200
Bryson Borg, M0
Kevin R.Moore, MO
Thanatophoric Dwarfism 1-1-204 Cervical Hyperextension Injury 11-1-44
Kevin R. Moore, MD Bryson Borg, M0
Cervical Hyperflexion-Rotation Injury 11-1-46
SECTION 2 Bryson Borg, M/J
Scoliosis Cervical Burst Fracture 11-1-48
Bryson BOlg,M/J
Scoliosis 1-2-2 Cervical Hyperextension-Rotation Injury 11-1-50
Julia Crim, MV !lrY.<liII!lorg, M/J
Neuromuscular Scoliosis 1-2-6 Cervical Lateral Flexion Injury 11-1-52
Julia Cr;m, MD Bryson Borg, M/J
Congenital Scoliosis and Kyphosis 1-2-8 Cervical Posterior Column Injury 11-1-54
Jul;a Crim, M/J Bryson Borg, M0
Idiopathic Scoliosis 1-2-12 Traumatic Disc Herniation 11-1-56
Illlia Crim, MD Bryson Borg, M0
Degenerative Scoliosis 1-2-14 Thoracic and Lumbar Burst Fracture 11-1-58
Jeffrey 5.Ross, M/J Julia Crim, MO
Idiopathic Kyphosis 1-2-18 Facet-Lamina Thoracolumbar Fracture 11-1-62
Julia Cr;m, MD Br)'son Borg, M0
IX
