MRI Thoracic Spine Without and With IV Contrast MRI thoracic spine without and with IV contrast may be the preferred initial study of choice in patients with TBP and myelopathy/radiculopathy when underlying malignancy, infection, or inflammation is clinically suspected. MRI Thoracic Spine Without IV Contrast MRI thoracic spine without IV contrast may be useful as an initial study of choice in patients with TBP and myelopathy/radiculopathy when structural/mechanical causes of compressive myelopathy or radiculopathy are clinically suspected. MRI thoracic spine without IV contrast is most useful in evaluating compressive myelopathy or radiculopathy because of its ability to accurately depict soft tissue pathology, assess vertebral marrow, and assess the spinal canal patency [20]. Heavily T2-weighted sequences such as CISS/FIESTA may be helpful to assess for structural etiologies such as dorsal thoracic arachnoid webs or for reducing metallic artifacts in patients with thoracic spinal hardware [33]. Radiography Thoracic Spine There is no relevant literature to support the use of thoracic spine radiography in the initial evaluation of patients with TBP and myelopathy. Radiography alone is not usually sufficient for diagnosing the specific pain generator in these patients or for guiding surgical or interventional options without MRI and/or CT imaging. However, it can provide complementary information that can be helpful in treatment planning, including for presurgical planning and postoperative assessment [11]. Variant 4: Adult. Thoracic back pain without or with myelopathy or radiculopathy. One or more of the following: low-velocity trauma, osteoporosis, elderly individual, or chronic steroid use. Initial imaging. Elderly (>65 years of age) individuals, those with known osteoporosis, prior benign nontraumatic compression fracture, or chronic steroid use are at risk for additional compression fractures even with minimal to no trauma [34,35].
Thoracic Back Pain. MRI Thoracic Spine Without and With IV Contrast MRI thoracic spine without and with IV contrast may be the preferred initial study of choice in patients with TBP and myelopathy/radiculopathy when underlying malignancy, infection, or inflammation is clinically suspected. MRI Thoracic Spine Without IV Contrast MRI thoracic spine without IV contrast may be useful as an initial study of choice in patients with TBP and myelopathy/radiculopathy when structural/mechanical causes of compressive myelopathy or radiculopathy are clinically suspected. MRI thoracic spine without IV contrast is most useful in evaluating compressive myelopathy or radiculopathy because of its ability to accurately depict soft tissue pathology, assess vertebral marrow, and assess the spinal canal patency [20]. Heavily T2-weighted sequences such as CISS/FIESTA may be helpful to assess for structural etiologies such as dorsal thoracic arachnoid webs or for reducing metallic artifacts in patients with thoracic spinal hardware [33]. Radiography Thoracic Spine There is no relevant literature to support the use of thoracic spine radiography in the initial evaluation of patients with TBP and myelopathy. Radiography alone is not usually sufficient for diagnosing the specific pain generator in these patients or for guiding surgical or interventional options without MRI and/or CT imaging. However, it can provide complementary information that can be helpful in treatment planning, including for presurgical planning and postoperative assessment [11]. Variant 4: Adult. Thoracic back pain without or with myelopathy or radiculopathy. One or more of the following: low-velocity trauma, osteoporosis, elderly individual, or chronic steroid use. Initial imaging. Elderly (>65 years of age) individuals, those with known osteoporosis, prior benign nontraumatic compression fracture, or chronic steroid use are at risk for additional compression fractures even with minimal to no trauma [34,35].