Clinical question: Evaluate for tethered cord. Signs and symptoms: 11-year-old man with back pain, patient had x-rayed that stated concern for spina bifida occulta at L5. Nonenhanced lumbar MRI:There is normal signal intensity and alignment of vertebral column.A thin apparent bony defect suggestive of spina bifida occulta seen on prior lumbar spine images appear as a thick band of T2 hypointensity which likely representing fibrotic tissue and without convincing evidence of a true bony defect on this exam. No evidence of Schmorl's nodes.There is normal signal intensity and caliber of the lower most visualized thoracic cord (T10), conus and the cauda equina. No evidence of fatty filum is detected.There is distinct anterior movement of the conus and the proximal cauda equina on prone sagittal T2-weighted images.There is no evidence of spinal canal or neural foraminal compromise at any level.Unremarkable perispinal soft tissues.
Unremarkable nonenhanced MRI of the lumbar spine.