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Fatty filum terminale

Case contributed by J. Ray Ballinger
Diagnosis certain

Presentation

Radicular pain.

Patient Data

Age: 35 years
Gender: Male
mri

A linear area of increased signal is seen on the sagittal image in the filum terminale on the proton density image. On the axial image, a focus of increased signal is seen in the cross-section of the filum. On the T2-weighted image, a chemical shift artifact is seen along the borders of the filum with a black crescent along the right side of the filum, and a bright crescent along the left.

Case Discussion

A fatty filum terminale is found in a small percentage (<1%) of normal patients. This finding as well as fibrolipomas of the filum are occasionally associated with tethered cords and a low lying conus medullaris.

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