Answer for BIR CoW 30 Jun 2024
SUBLIGAMENTOUS DISC SEQUESTRATION
Findings
Evidence of well defined T2 hyperintense to the disc lesion noted in the anterior epidural space abutting the L4-L5 disc with supradiscal extension. The lesion is noted causing compression of the cauda equina. On contrast administration,peripheral enhancement is noted surrounding the lesion with no enhancement of the lesion. Diagnosis : Features suggestive of Subligamentous disc sequestration.
Discussion
Intervertebral disc herniation refers to displacement of the intervertebral disc outside its anatomical space.
Disc sequestration is defined as the migration of protruding disc fragments into the epidural space and complete separation from the parent disc. Referring to the PLL,Displaced disc material can be Subligamentous Extraligamentous Transligamentous Perforated When the distinction between the outer annulus and the PLL is unclear and a fragment is under such a blended structure(capsule)-it is called Subcapsular.
If the peridural membrane alone surrounds the displaced disc materiality is called Submembranous Extraligamentous vs subligamentous disc herniations
Criteria suggestive of Extraligamentous HIVD Spinal canal compromise more than half its dimension Internal signal difference in the HIVD ill defined Margin of the HIVD Disruption of the continuous low signal intensity line covering the HIVD The presence of an internal dark line in the HVID
References
Oh KJ, Lee JW, Yun BL, Kwon ST, Park KW, Yeom JS, Kang HS. Comparison of MR imaging findings between extraligamentous and subligamentous disk herniations in the lumbar spine. AJNR Am J Neuroradiol. 2013 Mar;34(3):683-7. doi: 10.3174/ajnr.A3258. Epub 2012 Sep 6. PMID: 22954743; PMCID: PMC7964892. Nomenclature and Classification of Lumbar Disc Pathology Recommendations of the Combined Task Forces of the North American Spine Society, American Society of Spine Radiology, and American Society of NeuroradiologyDavid F. Fardon, MD,* and Pierre C. Milette,
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
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We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!