ABSTRACT
Tarlov cysts are perineural cysts and are usually found in sacral region. The dorsal nerve root is encased in this type of the cyst. These may or may not be with any of the symptomatology. The entity is infrequently found as an incidental finding. These are cerebrospinal fluid (CSF) filled sacs which are diagnosed on cross sectional imaging modalities especially in magnetic resonance imaging (MRI). Tarlov cysts can cause different type of myelopathies as per their location and size. Methods: We present a series of seven cases where these perineural cysts were found during the routine imaging of lumbosacral spine. All these patients had undergone Magnetic Resonance Imaging (MRI) of lumbosacral spine for backache or some other pelvic complaints. In one case Computerized Tomography (CT) Myelography also helped in diagnosis and related bone remodeling.MR myelography adds to the delineation of CSF wrapping around the spinal cord. Results: Three patients were found to be symptomatic and the intensity of complaints corresponded to the size and location of the cysts. In our three cases, the etiopathogenesis also corresponded to the underlying development of these entities. Four patients were asymptomatic as the size of these cysts were small and not contributing to the complaints of the patient. Conclusion: MRI is the best modality to diagnose these perineural cysts which are responsible for different types of myelopathies .T2WI sequences in non contrast MRI studies are the best in delineating the size, shape, outline and location of these cysts. This also further elaborates their extension to the surrounding regions.MR myelography is adjuvant to more morphological features of these cysts.
ABSTRACT
Hoffa’s fat pad is intracapsular and extra synovial structure present behind the patella and Infrapatellar tendon. This is delineated nicely in magnetic resonance imaging(MRI) by which it has become a modality of choice for its evaluation .The evaluation is by disruption of the outline of this region due to injury or other underlying pathologies .The indirect signs of this fat pad corresponds to the grading of associated trauma or underlying disease. Methods: We had conducted the MRI knee studies of fifty three patients which included both the genders from March 2018 to July 2018 .They all were having complaints of knee pain because of different aetiologies This cross sectional study included from 7-70 years of age group and patients were evaluated for the characteristics of Hoffa’s pad in MRI .The morphological characters of the region were studied and correlated in relation to the corresponding pathology. Results: There was excellent delineation and intensity relationship of HFP in various MRI sequences. The most vulnerable group to the changes was in 21- 30 years age group .The trivial trauma was the most common cause. The left knee was affected more than the right. Conclusion: Hoffa’s fat pad sign is an excellent indicator in various knee pathologies during MR evaluation. This also helps to know the involvement of the associated surrounding structures .MRI evaluation is very helpful in the decision making for the line of management.