Widening of the presacral space (differential)
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- updated 28 Nov 2022:
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Widening of the presacral space is one of the diagnostic indicators of diseases involving pelvic pathology and rectal involvement. It is ideally measured on barium studies at the level of S3/4 disc level on lateral radiographs and the normal value of the presacral space is <15 mm in adults.
There are a large number of potential causes of widening of the presacral space, including:
- presacral masses
- metastases
- chordomas
- rectal carcinoma
- giant cell tumour of bone 3
- neurofibromas 3
- schwannomas 3
- osteosarcomas 3
- sacral chondrosarcomas 3
- presacral paragangliomas 3
- presacral haemangiomas 3
- solitary fibrous tumours 3
- extra-adrenal myelolipomas 3
- extramedullary haematopoiesis
- ulcerative colitis
- osteomyelitis of the sacrum
- presacral perineural cysts
- anterior presacral perineural cysts
- dermoid cyst
- rectal duplication anomalies
- gonococcal proctitis 2
-<p><strong>Widening of the presacral space</strong> is one of the diagnostic indicators of diseases involving pelvic pathology and rectal involvement. It is ideally measured on barium studies at the level of S3/4 disc level on lateral radiographs and the normal value of the <a href="/articles/presacral-space">presacral space</a> is <15 mm in adults.</p><p>There are a large number of potential causes of widening of the presacral space, including:</p><ul>-<li>presacral masses<ul>-<li>metastases</li>-<li><a href="/articles/chordomas">chordomas</a></li>-<li><a href="/articles/rectal-cancer">rectal carcinoma</a></li>-<li>-<a href="/articles/giant-cell-tumour-of-bone">giant cell tumour of bone</a> <sup>3</sup>-</li>-<li>-<a title="Plexiform neurofibromas" href="/articles/plexiform-neurofibroma">neurofibromas</a> <sup>3</sup>-</li>-<li>-<a href="/articles/schwannoma">schwannomas</a> <sup>3</sup>-</li>-<li>-<a href="/articles/osteosarcomas">osteosarcomas</a> <sup>3</sup>-</li>-<li>sacral <a href="/articles/chondrosarcoma">chondrosarcomas</a> <sup>3</sup>-</li>-<li>presacral <a href="/articles/paragangliomas">paragangliomas</a> <sup>3</sup>-</li>-<li>presacral <a href="/articles/haemangioma">haemangiomas</a> <sup>3</sup>-</li>-<li>-<a href="/articles/solitary-fibrous-tumour">solitary fibrous tumours</a> <sup>3</sup>-</li>-<li>-<a title="Extra-adrenal myelolipoma" href="/articles/extra-adrenal-myelolipoma">extra-adrenal myelolipomas</a> <sup>3 </sup>-</li>-<li><a href="/articles/extramedullary-haematopoiesis">extramedullary haematopoiesis</a></li>-</ul>-</li>-<li><a href="/articles/ulcerative-colitis">ulcerative colitis</a></li>-<li>-<a href="/articles/osteomyelitis">osteomyelitis</a> of the <a href="/articles/sacrum">sacrum</a>-</li>-<li>presacral <a href="/articles/tarlov-cyst">perineural cysts</a>-</li>-<li>anterior presacral perineural cysts</li>-<li><a href="/articles/mature-cystic-ovarian-teratoma-1">dermoid cyst</a></li>-<li><a href="/articles/retrorectal-developmental-cysts">rectal duplication anomalies</a></li>-<li>-<a href="/articles/gonococcal-proctitis">gonococcal proctitis</a> <sup>2</sup>-</li>- +<p><strong>Widening of the presacral space</strong> is one of the diagnostic indicators of diseases involving pelvic pathology and rectal involvement. It is ideally measured on barium studies at the level of S3/4 disc level on lateral radiographs and the normal value of the <a href="/articles/presacral-space">presacral space</a> is <15 mm in adults.</p><p>There are a large number of potential causes of widening of the presacral space, including:</p><ul>
- +<li>presacral masses<ul>
- +<li>metastases</li>
- +<li><a href="/articles/chordomas">chordomas</a></li>
- +<li><a href="/articles/rectal-cancer">rectal carcinoma</a></li>
- +<li>
- +<a href="/articles/giant-cell-tumour-of-bone">giant cell tumour of bone</a> <sup>3</sup>
- +</li>
- +<li>
- +<a title="Plexiform neurofibromas" href="/articles/plexiform-neurofibroma">neurofibromas</a> <sup>3</sup>
- +</li>
- +<li>
- +<a href="/articles/schwannoma">schwannomas</a> <sup>3</sup>
- +</li>
- +<li>
- +<a href="/articles/osteosarcomas">osteosarcomas</a> <sup>3</sup>
- +</li>
- +<li>sacral <a href="/articles/chondrosarcoma">chondrosarcomas</a> <sup>3</sup>
- +</li>
- +<li>presacral <a href="/articles/paragangliomas">paragangliomas</a> <sup>3</sup>
- +</li>
- +<li>presacral <a href="/articles/haemangioma">haemangiomas</a> <sup>3</sup>
- +</li>
- +<li>
- +<a href="/articles/solitary-fibrous-tumour">solitary fibrous tumours</a> <sup>3</sup>
- +</li>
- +<li>
- +<a title="Extra-adrenal myelolipoma" href="/articles/extra-adrenal-myelolipoma">extra-adrenal myelolipomas</a> <sup>3 </sup>
- +</li>
- +<li><a href="/articles/extramedullary-haematopoiesis">extramedullary haematopoiesis</a></li>
- +</ul>
- +</li>
- +<li><a href="/articles/ulcerative-colitis">ulcerative colitis</a></li>
- +<li>
- +<a href="/articles/osteomyelitis">osteomyelitis</a> of the <a href="/articles/sacrum">sacrum</a>
- +</li>
- +<li>presacral <a href="/articles/tarlov-cyst">perineural cysts</a>
- +</li>
- +<li>anterior presacral perineural cysts</li>
- +<li><a href="/articles/mature-cystic-ovarian-teratoma-1">dermoid cyst</a></li>
- +<li><a href="/articles/retrorectal-developmental-cysts">rectal duplication anomalies</a></li>
- +<li>
- +<a href="/articles/gonococcal-proctitis">gonococcal proctitis</a> <sup>2</sup>
- +</li>
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Case2: Presacral solitary fibrous tumor
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