Thoracic Disc Injuries Workup

Updated: May 30, 2017
  • Author: Kambiz Hannani, MD; Chief Editor: Sherwin SW Ho, MD  more...
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Workup

Laboratory Studies

Laboratory testing is helpful in screening for the differential diagnosis.

  • Obtain a complete blood cell (CBC) count to check for the patient's white blood cell count and hematocrit level to rule out other disorders such as infection or multiple myeloma. Obtain serum protein electrophoresis results to evaluate for multiple myeloma.

  • Obtain a Westergren sedimentation rate measurement and C-reactive protein level to assess for osteomyelitis and/or infection.

Next:

Imaging Studies

Imaging studies are essential for making a diagnosis of disc injury. [4, 8, 9]

  • Radiography

    • Should be the initial examination that is ordered

    • Unable to distinguish actual disc herniation

    • May identify disc calcification (seen with degenerative disease in older patients)

    • May help to identify infectious or oncologic causes for the patient's pain

  • Magnetic resonance imaging (MRI)

    • Both T1- and T2-weighted imaging are needed. [10]

    • Sensitive for identification of disc herniation

    • T2-weighted images exaggerate findings.

    • Identifies calcification by low signal in T1- and T2-weighted images.

    • Can identify the bony inflammation that is seen with tumors/infection

  • Computed (CT) myelogram [11]

    • Has improved bony visualization compared with MRI

    • Not as sensitive for disc sequestration/migration

    • Invasive relative to MRI

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