Computed tomography (CT) both with and without contrast agents has been used to diagnose syringomyelia. We report a case in which the diagnosis was made by injection of metrizamide into a ventriculoperitoneal shunt. Continuity of the syringomyelic cavity with the ventricular system was demonstrated. This case supports the hydrodynamic concept of syringomyelia formation and illustrates a potentially useful approach to its diagnosis.