Table 5 Summary of the paraspinal tumours-like lesions discussed in this article with their clinical and imaging features
From: Understanding a mass in the paraspinal region: an anatomical approach
Tumour mimics | Notable clinical signs | US (For superficial masses) | Notable CT pattern | Notable MRI pattern |
|---|---|---|---|---|
Traumatic disorders | History of trauma | Haematoma: Compressible fluid collection Low echogenicity Septa Fat necrosis: Compressible fluid collection Morel lavallée: Compressible fluid collection | Haematoma: Hyperdensity | Haematoma: Signal changes on T1 and T2 with evolving breakdown products Low signal on T2WI Blooming artefact of T2WI Fat necrosis: Fibrous tissue (low signal) intermixed with adipose tissue (high signal) Peripheral enhancement Morel lavallée: Fluid collection |
Degenerative disorders | > 50 y Spinal degenerative disorders Lumbar predominance | – | Degenerative features: Vertebral narrowing, facet hypertrophy, sclerosis, osteophyte | Bursitis: fluid-like signal Cystic formation Fibrous nodules: Low signal on all sequences |
Infection | Increase with age | – | Erosive facet joint Erosive vertebral endplate | Inflammation: Imaging psoas sign Abscess: Rim enhancement Central attenuation |
HEM | Myeloproliferative neoplasm Chronic haematological disorders | – | Multifocal—bilateral Skeletal changes related with chronic anaemia | Smoothy loculated Homogeneous signal Fatty replacement and iron deposition in older masses |
MOC | History of trauma Repeated minor injuries Rapidly growing painful | – | Peripheral zonal ossification | Change with time |