Preliminary Diagnosis: Cervical Disc Protrusion
I. What imaging technique is first-line for this diagnosis?
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Noncontrast extradural protocol MRI of the cervical spine in patients without a history of prior neck surgery
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In patients with prior neck surgery, the first-line for diagnosis is a contrast extradural protocol MRI of the cervical spine
II. Describe the advantages and disadvantages of this technique for diagnosis of cervical disc protrusion.
Advantages
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The patient is not exposed to ionizing radiation.
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Are able to differentiate granulation tissue from recurrent disc
Disadvantages
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Time consuming
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Requires significant patient cooperation to minimize motion artifact
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Expensive
III. What are the contraindications for the first-line imaging technique?
Patients who contain non-MR-compatible hardware
IV. What alternative imaging techniques are available?
CT myelography
V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of cervical disc protrusion.
CT myelography
Advantages
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May be performed in patients with non-MR-compatible hardware
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May be performed much faster than MRI exams
Disadvantages
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Exposes the patient to ionizing radiation
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Invasive procedure with additional risks
VI. What are the contraindications for the alternative imaging techniques?
CT myelography
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Patients allergic to iodinated contrast
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Patients with renal failure
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Relative contraindication in pregnancy
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