Reporting a lumbar spine MRI - disc extrusion

[@queenpower9514]

If I knew about your program before knowing that I want to go into radiology. I would have worked very hard to obtain a spot in your residency program. Again, this is amazing!

[@LearnNeuroradiology]

I'm glad you enjoy the videos. Luckily, there are a lot of great residencies to learn radiology so you'll no doubt do great!

[@immane75]

Best teaching ever .

[@immane75]

Excellent , thank you very much.

[@dr.kushagramittal6060]

Where to measure the spinal canal diameter, at the midvertebral level or at the disk level (where the actual stenosis happens)?

[@LearnNeuroradiology]

I don't really recommend measuring the canal, but narrowing most commonly occurs at the disc level so that's where you should look at it.

[@makarand123]

Is sequestration happened in L4 L5 ? What recommanded in this case either surgery or conservatory treatment.

[@LearnNeuroradiology]

Well, it's an extrusion because it's still connected. If it becomes separated, then it is a sequestration. I'm pretty sure this patient had a microdiscetomy because they were pretty symptomatic. That is the most common treatment here in the US, although conservative management with physical therapy (and possibly steroid injection) would be a consideration too.

[@immane75]

Hi , it's been a lo,g time , hope you are fine ? Can you please do a video on your search pattern for cervical MRI and step bey step reporting ? You can't imagine the impact of your videos on my confidence , I can't thank you enough !!!!! Your residents are so lucky !!!!

[@LearnNeuroradiology]

I'm good, but have been very busy, making it hard to make new videos. I hope to start adding more in the next few months

[@immane75]

@@LearnNeuroradiology Thank you for the response , wish you the best.

[@salmaaslam1894]

amazing

[@LearnNeuroradiology]

Glad you think so!

[@UneSteakFrites]

Why describe a grade of the disc bulge at L3-L4 but not L2-L3? What is the difference between a small disc bulge and a mild disc bulge?

[@LearnNeuroradiology]

Unfortunately, you have hit on a key point in spine reporting. That is, despite trying as hard as we can, we don't do a very good job of maintaining consistency. Generally speaking, any comment like mild/small is probably a bulge with little narrowing. Any synonym probably means the same thing. There typically isn't much going on until you say moderate or severe/critical. There are a few papers out there which help with grading, but you will find a lot of variation, even among single individuals.

[@sudeepsinghawal7610]

Where can i get that MRI reporting template?

[@LearnNeuroradiology]

Send me an email to [e-mail]. I can send you the outline.

[@sudeepsinghawal7610]

@@LearnNeuroradiology Already sent sir, Please check

[@LearnNeuroradiology]

Hopefully the template I sent you is helpful! Thanks for watching!