PMC3908845_01
Baseline (preoprocedural) MRI in an axial plane at the level of the L4-L5 lumbar segment. Hypointense well delineated cystic formation compressing dural sac from the left dorsolateral side is seen on T1 SE image (A). The cyst that is hyperintense on T2 FSE image shows continuation with the left facet joint (some fluid can also be seen in the degenerated facet joint) (B).
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Presence of the fluid within the degenerated facet joint was additional finding that supported the diagnosis of intraspinal synovial cyst (Figure 1).
Intraprocedural CT in an axial plane at the level of the L4-L5 lumbar segment. A 22G needle that has entered a posterior part of a target facet joint can be seen (A). Iodine contrast media instilled through the needle has filled the facet joint, confirming the needle tip position inside the joint (B). Continuous contrast instillation resulted in intraspinal contrast opacification of the cyst (confirming the diagnosis of intraspinal synovial cyst) (C). A loss of resistance was felt at the time of cyst rupture. The procedure was terminated at that point.
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The loss of resistance suggested the rupture of the cyst and this was confirmed by CT scan (Figure 2).