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Case of the Week 125: Courtesy of Matilde Bianchi, DC, Switzerland

Case of the Week 125: Courtesy of Matilde Bianchi, DC, Switzerland. 19 year old female with recurrent low back pain. What are the abnormal imaging findings? What is the Diagnosis or DDX?. Coronal MR Myelogram. Sagittal T2. Sagittal T1. Axial upper lumbar slice. Axial L4-5 level.

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Case of the Week 125: Courtesy of Matilde Bianchi, DC, Switzerland

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  1. Case of the Week 125: Courtesy of Matilde Bianchi, DC, Switzerland 19 year old female with recurrent low back pain.

  2. What are the abnormal imaging findings? What is the Diagnosis or DDX? Coronal MR Myelogram Sagittal T2 Sagittal T1 Axial upper lumbar slice Axial L4-5 level Axial L5-S1 level

  3. Abnormal Imaging Findings: There are obviously posterior disc herniations at both the L4-5 and L5-S1 levels with effacement of the thecal sac at these levels. The myelographic image nicely shows the compression of the CSF at both levels. A large, round, cystic lesion is present adjacent to the anterior aspect of the right kidney. DX or DDX: Posterior disc herniations (prolapse) L4-5-S1. DDX Liver cyst vs Kidney cyst. Additional slices are needed to localize the abnormality. Answers

  4. Liver and Kidney Cysts • Liver cysts are often seen on MRI taken for other reasons. They may be congenital, due to previous trauma or from parasitic infestation. Often they are asymptomatic. • Kidney cysts are also often found on MRI and are usually congenital in origin.

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