Ariyaratne Sisith, Jenko Nathan, Iyengar Karthikeyan P, Davies Mark, Azzopardi Christine, Hughes Simon, Botchu Rajesh
Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham B31 2AP, UK.
Department of Orthopedics, Southport and Ormskirk Hospitals, Mersey and West Lancashire Teaching NHS Trust, Southport PR8 6PN, UK.
Diseases. 2024 Nov 26;12(12):302. doi: 10.3390/diseases12120302.
The spinous processes act as a lever for attachments of muscles and ligaments. Spinal imaging is commonly performed as a diagnostic test for pain and radiculopathy. A myriad of incidental or unexpected findings, both potentially asymptomatic and symptomatic, may be encountered during the interpretation of these images, which commonly comprise radiographs, Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). Isolated lesions of the spinous process, although less common, are some of the lesions that may be encountered and can present a diagnostic dilemma. These can range from congenital abnormalities, traumatic lesions, neoplasms and lesions of inflammatory, infective and metabolic aetiology. The literature specifically reviewing these lesions is sparse. The article reviews a range of pathologies affecting the spinous process, along with their pertinent imaging features, based on isolated pathologies of spinous process lesions identified on imaging by the authors at a tertiary orthopaedic centre over a 10-year period. A search on the hospital Picture Archive and Communication System (PACS) and Radiology Information System (RIS) was performed using the keyword "spinous process" and a list of the isolated pathologies of the spinous process based on the imaging reports was compiled for the purpose of this narrative review. It is important that radiologists consider these lesions when they are identified on routine imaging of the spine.
棘突起到肌肉和韧带附着点的杠杆作用。脊柱成像通常作为疼痛和神经根病的诊断检查。在解读这些通常包括X线片、计算机断层扫描（CT）和磁共振成像（MRI）的图像时，可能会遇到无数偶然或意外的发现，既有潜在无症状的，也有有症状的。孤立的棘突病变虽然不太常见，但也是可能遇到的病变类型，可能会带来诊断难题。这些病变范围包括先天性异常、创伤性病变、肿瘤以及炎症性、感染性和代谢性病因引起的病变。专门综述这些病变的文献较为稀少。本文基于作者在一家三级骨科中心10年间通过成像识别出的孤立性棘突病变，综述了一系列影响棘突的病理情况及其相关的影像学特征。为进行本叙述性综述，利用关键词“棘突”在医院图像存档与通信系统（PACS）和放射信息系统（RIS）中进行了检索，并根据影像学报告编制了一份棘突孤立性病变列表。放射科医生在脊柱常规成像中识别出这些病变时，考虑这些病变非常重要。
