Dr.

Neni Irianty, SpRad

Introduction

Low back pain (LBP) with or without radiculopathy is one of the most common health

problems. Acute low back pain. Lumbosacral pain of less than 6-weeks duration or without progressive or disabling symptoms. Most low back pain is triggered by some combination of overuse, muscle strain, and injury to the muscles, ligaments, and discs that support the spine.

Possible condition Findings from medical history Fracture Major trauma (motor vehicle accident, fall from height) , Minor trauma in older or osteoporotic patient Tumor or infection Age >50 years or <20 years History of cancer , Constitutional symptoms (fever, chills, unexplained weight loss) Recent bacterial infection Intravenous drug use Immunosuppression (corticosteroid use, transplant recipient, HIV infection) Cauda equina syndrome Saddle anesthesia,recent onset of bladder dysfunction, Severe or progressive neurologic deficit in lower extremity

SPONDYLOLISTHESIS 1 GRADE 1

grade 1 spondylolisthesis . The arrow marks a fracture through the pars interarticularis.

DEGENERATIVE CHANGES

SKOLIOSIS

Ankylosing spondylitis

kompressi

Spondylitis TB

Complit Burst Fracture

Tuberculous spondylitis

Calcified psoas abscess

SPONDYLITIS TB

tn.X, 25 th

spinal canal stenosis

kompressi

LUMBAR HERNIATED DISC

Tuberculosis Involving the Central Nervous System

result of hematogenous spread
two related pathologic processes: tuberculous

meningitis and intracranial tuberculomas. Meningeal involvement is iso- or hyperattenuating relative to the basal cisterns at unenhanced CT and demonstrates intense, often homogeneous enhancement after contrast material administration

 Sequelae of meningeal involvement include

hydrocephalus and infarcts in the middle cerebral artery. MR imaging findings vary depending on the stage of the disease In the early stages, findings at unenhanced spinecho imaging may be normal. In later stages, there is distention of the affected subarachnoid spaces. Gadolinium-enhanced T1-weighted imaging demonstrates abnormal meningeal enhancement that is more pronounced in the basal cisterns

 The differential diagnosis for tuberculous meningitis

includes other infectious agents (nontuberculous bacteria, viruses, fungi, parasites), noninfectious inflammatory disease affecting the leptomeninges (rheumatoid disease, sarcoidosis), and primary or secondary neoplastic involvement of meningeal surfaces (meningiomatosis, neoplastic meningitis from a peripheral tumor source, cerebrospinal fluid seeding from a primary tumor of the central nervous system).

Cranial tuberculous meningitis.

Cranial tuberculomas

Meningoencephalitis TB

Solid caseating tuberculous granulomas Tuberculous granulomas involving the involving the cerebellum. Axial T2-weighted cerebellum. Axial T1-weighted