Spinal Cord Compression, Spinal Trauma, and Degenerative Spine Pathologies — WACS Viva & Clinical Scenarios (Neuroradiology and Head and Neck Imaging)

Exam-style spinal cord compression, spinal trauma, and degenerative spine pathologies viva scenarios with examiner probes and model answers for Radiology…

Scenarios covered

• SCENARIO 1: A 42-year-old patient presents with progressive paraparesis, lower back pain, night sweats, and weight loss. Review the provided sagittal and axial T1, T2, STIR, and contrast-enhanced MR images of the thoracolumbar spine. Formulate the comprehensive radiological diagnosis, highlight differentiating features between tuberculous and pyogenic spondylodiscitis, and grade the severity of spinal cord compromise.
• SCENARIO 2: A 28-year-old driver involved in a road traffic crash presents with severe neck pain and acute quadriplegia. Review the multi-detector CT cervical spine reformations and subsequent urgent MRI. Identify all fracture lines, evaluate facet joint alignment, determine cervical spinal column stability using standard classification criteria, and detail cord contusion and posterior ligamentous complex injuries.
• SCENARIO 3: A 55-year-old manual worker presents with severe right L5 radiculopathy and neurogenic claudication. Evaluate the non-contrast lumbar spine MRI. Classify the intervertebral disc pathology using standardized consensus nomenclature, differentiate disc extrusion from protrusion, and report the precise anatomical impact on the central canal, lateral recesses, and neural exit foramina.
• SCENARIO 4: A 60-year-old female presents with progressive thoracic myelopathy and a sensory level at T8. Review the contrast-enhanced spine MRI. Localize the spinal mass into its exact anatomical compartment (extradural, intradural extramedullary, or intramedullary), generate the radiological differential diagnosis, and describe characteristic imaging hallmarks.
• SCENARIO 5: A 35-year-old male presents following a fall from height with acute back pain and lower limb weakness. Review the thoracolumbar plain radiographs and CT reconstructions. Differentiate between a Denis three-column burst fracture and a flexion-distraction (Chance) injury, and establish the imaging criteria dictating surgical instability.