Transverse myelitis echocardiography and ultrasound
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Julinka Auta Fernandes
Overview
- There are no established disease-specific findings on echocardiography or diagnostic ultrasonography that confirm or exclude transverse myelitis. Neither examination is included in the published consensus diagnostic criteria for acute transverse myelitis.[1]
- Echocardiography has no routine role in the diagnostic evaluation of transverse myelitis and should be obtained only for an independent cardiovascular indication.
- Ultrasonography does not diagnose spinal-cord inflammation. Its clinically relevant role is limited to evaluating selected complications or associated problems, particularly neurogenic urinary dysfunction.
Echocardiography
| Clinical question | Evidence-based interpretation |
|---|---|
| Characteristic finding | None established. |
| Routine use | Neither transthoracic nor transesophageal echocardiography forms part of the published diagnostic criteria for transverse myelitis, and neither has an established role in diagnosing, confirming, excluding, or assessing the activity of transverse myelitis.[1] |
| Targeted use | Echocardiography may be performed when a separate cardiovascular disorder is suspected or when another clinical indication exists. Any abnormality should be interpreted according to that cardiovascular indication and not as evidence of transverse myelitis. |
Ultrasonography
| Ultrasound application | Evidence-based interpretation |
|---|---|
| Spinal ultrasonography | Routine spinal ultrasonography has no established diagnostic role in transverse myelitis. There is no confirmatory ultrasonographic appearance of spinal-cord inflammation.[1] |
| Bladder ultrasonography | In patients with urinary retention, incomplete emptying, or other symptoms of neurogenic bladder, bladder ultrasonography may be used to measure post-void residual urine volume (PVR). This evaluates urinary dysfunction and does not confirm transverse myelitis.[2][3] |
| Kidney and upper urinary tract ultrasonography | Kidney and upper urinary tract ultrasonography may be obtained according to the patient's neuro-urological risk, urinary symptoms, renal function, and suspected urinary complications. Routine surveillance should be individualized; it is not required solely because transverse myelitis is suspected.[2][4] |
| Normal ultrasound | A normal bladder, kidney, or other ultrasound examination does not exclude transverse myelitis. |
Clinical interpretation
- Echocardiographic and ultrasonographic findings must not be used to satisfy or exclude diagnostic criteria for transverse myelitis.
- Urinary ultrasonography assesses complications of neurologic bladder dysfunction; it does not identify the inflammatory spinal-cord lesion.
- Abnormal echocardiographic or ultrasonographic findings should be evaluated as separate cardiovascular, urinary, or structural abnormalities.
References
- ↑ 1.0 1.1 1.2 Transverse Myelitis Consortium Working Group. Proposed diagnostic criteria and nosology of acute transverse myelitis. Neurology. 2002;59(4):499-505. Digital object identifier: 10.1212/WNL.59.4.499. PubMed identifier: 12236201.
- ↑ 2.0 2.1 Ginsberg DA, Boone TB, Cameron AP, et al. The American Urological Association/Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction Guideline on Adult Neurogenic Lower Urinary Tract Dysfunction: Diagnosis and Evaluation. The Journal of Urology. 2021;206(5):1097-1105. Digital object identifier: 10.1097/JU.0000000000002235. PubMed identifier: 34495687.
- ↑ Panicker JN, Fanciulli A, Krbot Skoric M, et al. European Academy of Neurology/European Federation of Autonomic Societies/International Neuro-Urology Society Guidelines for Practising Neurologists on the Assessment and Treatment of Neurogenic Urinary and Sexual Symptoms (NEUROGED Guidelines). European Journal of Neurology. 2025;32(4):e70119. Digital object identifier: 10.1111/ene.70119. PubMed identifier: 40208234.
- ↑ European Association of Urology (EAU). EAU Guidelines on Neuro-urology. 2026 edition. Arnhem, the Netherlands: European Association of Urology Guidelines Office; 2026.