Scoliosis MRI

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]

Overview

Magnetic resonance imaging (MRI) is the gold standard test indicated for neuromuscular and congenital scoliosis. MRI is seldom used for adolescent idiopathic scoliosis. However, in some unusual situations with adolescent idiopathic scoliosis, M.R.I. is indicated.

MRI

Coronal T2: L1 hemivertebra is causing congenital scoliosis. Source: Case courtesy of Dr Ahmed Almuslim, Radiopaedia.org, rID: 6919

• Magnetic resonance imaging (MRI) is the diagnostic test indicated for neuromuscular and congenital scoliosis.
• MRI is seldom used for adolescent idiopathic scoliosis.
• However, in some atypical situations with adolescent idiopathic scoliosis, MRI is indicated.
• MRI is used with increasing frequency to evaluate patients with an unusual curve pattern or alarming clinical manifestations.

Chief Indications for MRI

• Congenital neuropathic abnormality such as arnold-chiari malformation, tethered cord, and dysraphism - related anomalies.
• Dysplasia such as neurofibromatosis, osteogenesis imperfecta, and marfan's syndrome.
• Pain suggestive of bone tumor, infection, and intervertebral disc herniation.
• Neurologic deterioration with abnormality at electroneurography or evoked electromyography.
• Idiopathic scoliosis with specific clinical or neurological features.

Indications of MRI for Idiopathic Scoliosis

• Clinical features
  • Age < 10 years
  • Signs of neurological deterioration
  • Rapid progression
  • Foot deformity
  • Back pain, neck pain, headache

• Radiological features
  • Curve type commonly associated with neuropathy such as:
    • Left thoracic
    • Double thoracic
    • Triple major
    • Short segment
    • Long right thoracic curve
    • Severe curve after skeletal maturity
  • Presence of intramedullary non osseous lesions with features such as:
    • Wide spinal canal
    • Thin pedicle
    • Wide neural foramina