A Young Back, An Old Problem: Rethinking The Usual Suspects

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A Young Back, An Old Problem: Rethinking The Usual Suspects - Page #3

Lab Studies: N/A Other Studies: Lumbar radiographs showed no acute bony abnormality. MRI of the lumbar spine showed no disc herniation, spinal canal stenosis, fracture, or other typical compressive spine lesion. However, there was increased signal intensity within the left paraspinal venous structures, and the inferior vena cava appeared poorly developed. CT with intravenous contrast Case Photo #1 and delayed venous phase imaging confirmed absence of the IVC below the right renal vein. It also showed extensive occlusive venous thrombosis involving the iliac and femoral venous systems with prominent collateral venous formation. The collateral venous engorgement was adjacent to the lumbar nerve roots. Consultations: Interventional radiology Vascular surgery Hematology Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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