Clinical question: History of gunshot wound thoracic spine 12-2014, T7 fracture, paraplegic, follow-up TLSO brace. Signs and symptoms: Follow-up TLSO brace, T7 fracture. Nonenhanced thoracic MRI:Examination demonstrates significant interval decreased bone marrow T2/T2 STIR hyperintensity consistent with edema secondary to fracture of the T7 and T8 vertebral bodies and the posterior elements since prior exam. Only trace residual edema ( T1 hypointense and T2 STIR hyperintense) remains in the superior left articulating facet of T8.There is normal signal intensity and the alignment of vertebral column otherwise.Examination demonstrate significant interval myelomalacia of the cord at T8-T10 with significant decreased cord caliber and to a lesser degree of the rest the of the thoracic cord.There is no detectable paraspinal soft tissue abnormalities.
1.Significant interval myelomalacia of the thoracic cord most severe at T8 to T10 levels as detailed.2.Near complete resolution of bone marrow edema secondary to prior fracture at T7 and T8 levels with only trace residual T2 hyperintensity in the left superior articulating facet of T8.3.Normal signal intensity and alignment of vertebral column otherwise.4.No spinal stenosis or neural foraminal compromise and no paraspinal soft tissue abnormalities.