Oncological Emergencies Dr. Gary Harding md, frcpc

Images whole spine

High detail

Spares lumbar puncture

Patients in pain must lie still

Roughly equivalent in terms of sensitivity and specificity

• Roughly equivalent in terms of sensitivity and specificity

• Presently no large comparative studies b/c MRI in the US has become so readily available

• MRI standard of care in centers that have access

Bone Scan

• More sensitive than plain radiograph

• Visualizes entire skeleton

• Can miss neoplasms that do not have increased blood flow

CT Scan alone

• Does not visualize spinal cord and epidural space clearly

Intramedullary Metastases

• Less common

• Often present with hemicord symptoms

• Unilateral weakness below lesion
• Contralateral diminution of pain and temperature sensation
• Can progress to bilateral dysfunction

Radiation Myelopathy

• Can mimic ESCC

• MR imaging can make distinction

Treatment