Intraspinal synovial cyst

Case contributed by Petralli Carlo Lucius E
Diagnosis almost certain

Presentation

Lower back pain

Patient Data

Age: 45 years
Gender: Male

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

mri

A synovial cyst is noted at L4-5 level, which causes lateral deformity of the thecal sac on the left. It displaces the nerve root S1 on the left.

Note the degenerative changes of the facet joint with fluid in the articular space.  

Case Discussion

Synovial cysts of the spine are combined with osteoarthritic disease of the facets. Normally they arise at the level L4-L5 or L5-S1 and may contribute to central canal stenosis.

On MR the cyst is isointense or slightly hyperintense with respect to CSF on T1-weighted images. On T2-weighted images the cyst is hyperintense.

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