Editor-in-Chief: Alaa Abd-Elsayed, MD, PhD

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  1. IPM 2020;4;1-4 Particulate Epidural Steroid may not be Detectable on Magnetic Resonance Imaging
    Brief Commentary
    Ruben H. Schwartz, DO, Ivan Urits, MD, Alan D. Kaye, MD, PhD, Richard D. Urman, MD, Omar Viswanath, MD, and Musa Aner, MD.

Lumbar epidural steroid injections (LESI) have become a staple in the interventional pain physician’s armamentarium. For patients with radicular symptomatology, LESIs provide substantial pain relief with a favorable safety profile. Adverse effects, although rare, can occur as with any procedure. One of the most dreaded complications is the development of an epidural hematoma, which should be readily seen on Magnetic Resonance Imaging (MRI). It has been previously thought that particulate steroid injections should also be seen on MRI potentially obscuring a physician’s clinical judgment. We present two cases where patients underwent an uncomplicated LESI and subsequently went for a lumbar MRI that displayed no injectate in the epidural space.

KEY WORDS: Epidural steroid injection, magnetic resonance imaging, particulate injection, hematoma