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Erosive retro-odontoid soft tissue with DISH-MRI and CT

This is 77 yr old man with walking difficulty and episodes of respiratory arrest. Magnetic resonance imaging (MRI) showed a heterogeneously enhancing soft-tissue mass causing erosion of the dens and the inner surface of the lateral masses of the C1 vertebrae. The soft-tissue mass was predominantly isointense on T1-weighted imaging and hypointense on T2- weighted imaging. There was significant enhancement after gadolinium administration. MRI also showed patches of ossification of the posterior longitudinal ligament at the C2 to C7 levels and anterior marginal osteophytes and bridging osteophytes (syndesmophytes) along the cervical vertebral column, in keeping with DISH. Cervicodorsal syringohydromyelia is noted.

Similar case report was found in Erosive Inflammatory Pseudotumor of the Odontoid Process in Association With Forestier’s Disease (Diffuse Idiopathic Skeletal Hyperostosis). Am J Orthop. 2009;38(2):E41-E44. According to them DISH can be a causative agent for either fracture or pseudotumor of the odontoid process.
Erosive retro-odontoid soft tissue with DISH-MRI and CT Reviewed by Sumer Sethi on Saturday, August 08, 2009 Rating: 5

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