Cervical Discitis

Discitis is when the vertebral disc space becomes inflamed often related to infection. Vertebral osteomyelitis may also occur due to the fact this condition share much of the same symptoms and treatment. An infection usually does not originate with in the vertebra, but rather through the blood stream spreading from other sites. Pneumonia and urinary tract infections are just a couple of known infections which may spread to the vertebral disc space. Discitis from surgical procedures is very rare, but may occur. Symptoms include neck or back pain. Some patients may present with a fever. Discitis may be detected on x-rays, CT scans, or MRI images. MRI is the modality of choice, since an MRI is able to demonstrate the narrowing of the disk space and the edema associated with the infection. IV antibiotics are used for treatment. If left untreated, death may be the outcome.

Carotid Body Tumor

I chose to write about carotid body tumors because it is a pathology I have not seen clinically. Carotid body tumors are also called paragangilomas or chemodectomas. These particular tumors are found at the branching of the carotid artery and may occur bilaterally. Symptoms of a carotid body tumor may be painless neck masses or hoarseness with in the throat located laterally to the hyoid bone. MRI/CT angiography imaging is utilized with diagnosis of these particular tumors. Patients diagnosed with these tumors have a good prognosis. They may be aggressive, so surgical removal is the patients best option. Prior to surgery some patients might endure a trans catheter embolization. Surgeons utilize this procedure to reduce the blood supply to the tumor. Radiation therapy may also be utilized in treatment.

Carcinoma of the Tongue

Tongue cancer is more common in patients older than 40. Most patients are heavy drinkers and or smokers. Some patients with chronic viral infections may develop into any type of head and neck cancer. Oral exams performed by a dentist may be utilized to diagnosis carcinomas of the tongue. Soft tissue neck MRI's may be used to determine any lymph node involvement and size of tumor. Biopsy will also be needed to diagnosis tumors. Surgery to remove the carcinomas may result in difficulties in swallowing and speech. Radiation therapy may also be utilized. Early diagnosis is key. If caught early, patients may likelihood of developing metastatic disease decreases.

Trigeminal Neuralgia

I am very familiar with this certain pathology because we run extra scans post contrast with our head protocols if patients present with facial pain. The reason they stick out in my mind so much is because these extra scans take at least eight minutes each so I am always set back on my schedule. :) Trigeminal neuralgia is swelling or inflammation of the nerve that delivers feeling to the face. Symptoms may include pain on one side of the face. Sharp spasms may also occur. Pain may also occur while chewing, drinking, shaving, or brushing teeth. No causes can be found, however abnormal blood vessels have been linked to trigeminal neuralgia. MRI is the best modality for diagnosis. Fine cuts are ran from C3 to inferior aspect of the orbit post contrast with fat saturation. Medications may be used but many patients have had a hard time with the long term. Surgery may be utilized to relieve pressure on the nerve. Patients who are not likely candidates for surgery may undergo radiation treatment to the nerve root.