Eugenio Rimondi MD, Presenter: Nothing to Disclose

Giuseppe Rossi MD, Abstract Co-Author: Nothing to Disclose

Rosanna Ciminari MD, Abstract Co-Author: Nothing to Disclose

Maria Cristina Malaguti MD, Abstract Co-Author: Nothing to Disclose

Ugo Albisinni MD, Abstract Co-Author: Nothing to Disclose

Daniel Vanel MD, Abstract Co-Author: Nothing to Disclose

LCH of the spine has been described mostly in young patients, and its management ranges from observation and cast immobilization to surgical excision or radiotherapy.

From 1991 the painful LCH of the spine was treated only with corticosteroids injection (40 mg of Dopomedrol - metilprednisolone acetate). We have carried out 21 injections: 5 cervical, 7 thoracic, 7 lumbar and 2 sacral. ( 9 males and 12 females, age 3-44 years, follow-up 0.6-17 years). All lesions were solitary at the onset. A complete imaging of the lesion (RX, CT and MRI) was performed before the injection. The histological diagnosis, before the injection, was always made by a frozen CT-guided biopsy . We carried out three controls (only CT and MRI), at two, four and twelve months, the last one only in presence of pain.  

In 20 cases (95,2%) the injection led to a clinical and radiological healing, after two months in 19 cases, after four in one case. In a sacral lesion, solitary at the onset, other sites were involved three months later (pelvis, shoulder blade and lungs) and the patient underwent a systemic therapy. No sacral improvement was seen.

The possibility to reach sites, the minimal invasivity and the low radiation dose, the low cost and the high accuracy of the procedure make CT-guided percutaneous injection of corticosteroids an efficient procedure for the treatment of the painful spinal LCH.

CT-guided percutaneous injection of corticosteroids is an efficient procedure for the treatment of the painful spinal LCH

Rimondi, E, Rossi, G, Ciminari, R, Malaguti, M, Albisinni, U, Vanel, D, CT-guided Percutaneous Injection of Corticosteroids in the Painful Langerhans Cell Histiocytosis of the Spine: Experience and Results of the Last 18 Years.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8005949.html