Board Review 2 – Case 9

Neuroradiology board review. This lecture is geared towards the ABR core exam for residents, but it would be useful for review for the ABR certifying exam or certificate of added qualification (CAQ) exam for neuroradiology.

More description and the answer (spoiler!) are seen below the video.

This case shows narrowing of the thecal sac in the lower lumbar spine due to a cystic lesion that is in the dorsal epidural space just to the left of the midline. There is minimal surrounding abnormal enhancement.

The diagnosis is: synovial cyst

Synovial cysts, along with bursal cysts from the spinous processes, are cystic lesions which can cause canal narrowing. These can be treated with minimally invasive rupture versus surgical resection.