ChiroACCESS Article



Diagnostic Imaging Case Report: A 39-year-old male reports headaches and neck pain



This information is provided to you for use in conjunction with your clinical judgment and the specific needs of the patient.

Jack Henry, DC, DACBR

  

Radiology Diagnostics, LLC



Published on

March 8, 2011

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Hello.  My name is Jack Henry, DC, DACBR.  I am Radiologist-in-Chief of Radiology Diagnostics, LLC, an industry leader of Chiropractic Radiology Services and Digitized Spinographic analyses.  All of our services are provided at no cost to doctor and  no/low cost to patients.

Selected cases will be presented for your evaluation.  The studies may or may not have abnormalities.  Use the arrow keys or the scroll bar to carefully evaluate the films.

Step 1:  Is the study abnormal or normal?

Step 2:  If the study is abnormal, what is your best diagnosis?

Step 3:  Which follow-up imaging option would be best?

Step 4:  Compare your results with the correct diagnosis.


HISTORY

A 39-year-old male reports with progressive headaches and neck pain over the last two months.  No history of recent trauma was reported.  Physical exam findings were not provided at the time of reading.







FINDINGS

The study is negative for acute fracture or dislocation.  Mild degenerative changes are present throughout the visualized C-spine most prominent at the C3/C4 level.  The soft tissues appear grossly unremarkable.  Please note the moderate expansion of the pituitary fossa's bony dimension on the lateral view measuring approximately 21 mm.


DISCUSSION

Expansion of the pituitary fossa may result from increased intracranial pressure (usually younger patients) or a para/intrasellar mass secondary to some type of tumor or aneurysm.  Projectional distortion can be readily excluded.  These lesions may present with headaches and visual disturbances and be confused with the more common cervicogenic headache.  Appropriate clinical correlations are recommended.


FOLLOW UP PROTOCOL

If clinically warranted an MRI would be the most sensitive and specific evaluation.

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