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Case 100¹

¹ From the College of Medicine and King Khalid University Hospital, King Saud University Riyadh, Saudi Arabia. Received January 29, 2004; revision requested March 31; revision received May 4; accepted May 24; final version accepted June 25. Address correspondence to S.M.E.K., Department of Radiology and Medical Imaging, Mansoura University Hospital, PO Box 310, Mansoura 35511, Egypt (e-mail: selkhamary{at}hotmail.com).

	HISTORY

TOP HISTORY

 
A previously healthy 13-year-old girl presented with gradual onset of weakness in both legs and bowel and bladder incontinence. Her symptoms worsened over a 2-month period. A neurologic examination revealed muscle tone and tendon reflexes were increased in the legs. There was no muscle wasting, and power was graded as 4 out of 5 in all muscle groups (ie, active movement against activity, with some resistance). Sensation was impaired from T7 through T11. There was no back pain or deformity or tenderness over the spine. There was no fever or sign of an upper respiratory tract infection and no history of trauma, night sweats, or hematologic disease. Magnetic resonance (MR) imaging of the dorsal spine was performed (Figs 1, 2).

View larger version (86K): [in this window] [in a new window] [Download PPT slide]   Figure 1a: Fast spin-echo sagittal (a) T1-weighted (repetition time msec/echo time msec, 500/20; section thickness, 4 mm) and (b) T2-weighted (4000/111; section thickness, 4 mm) MR images of the dorsal spine.

View larger version (91K): [in this window] [in a new window] [Download PPT slide]   Figure 1b: Fast spin-echo sagittal (a) T1-weighted (repetition time msec/echo time msec, 500/20; section thickness, 4 mm) and (b) T2-weighted (4000/111; section thickness, 4 mm) MR images of the dorsal spine.

View larger version (86K): [in this window] [in a new window] [Download PPT slide]   Figure 2a: Gadopentetate dimeglumine–enhanced (Magnevist; Schering, Berlin, Germany) (a) sagittal and (b) transverse T1-weighted fast spin-echo MR images of the dorsal spine obtained with frequency-selective fat saturation (467/15; section thickness, 4 mm).

View larger version (69K): [in this window] [in a new window] [Download PPT slide]   Figure 2b: Gadopentetate dimeglumine–enhanced (Magnevist; Schering, Berlin, Germany) (a) sagittal and (b) transverse T1-weighted fast spin-echo MR images of the dorsal spine obtained with frequency-selective fat saturation (467/15; section thickness, 4 mm).

	FOOTNOTES

 
Editor's Note: Beginning with this issue, we will present two new cases for Diagnosis Please each month. Since its inception, Diagnosis Please has been one of the most popular features in Radiology, not only for our readers but also for those who wish to submit cases. During the past 9 years, we have published many excellent cases, but we also now have available many more to publish during my remaining time as Editor through December 2007. Thus, we have decided to publish two per month.

Also, beginning this month, readers will have the opportunity to submit their most likely diagnosis by using the Web. Instructions can be found at the Diagnosis Please Web site (http://rsna.org/dxplease). RSNA members can use their member login; others will need to create an account (at no charge). If you submit the most likely diagnosis through the former e-mail site (dxplease@rsna.org), you will receive an automatic reply directing you to the new Web site for your submission.

Submit the most likely diagnosis to http://rsna.org/dxplease (use only for submission of diagnosis). Select the case from the Active Case List for which you are submitting a diagnosis. Only one case, one name, and one diagnosis per submission. Multiple diagnoses and multiple submissions will not be considered. Deadline: Midnight U.S. Central Time, September 15, 2006. Answer will appear in the November issue. Authors wishing to submit cases for Diagnosis Please should first write to the Editor to obtain approval for the case and further information.

 

Authors stated no financial relationship to disclose.

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This Article Figures Only Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by El Khamary, S. M. Articles by Alorainy, I. A. Search for Related Content PubMed Articles by El Khamary, S. M. Articles by Alorainy, I. A.