sb/bv/nl/rg.
can No : 00003 Date : 00.00.00

Name of the Patient : Abc Xyz Ghlmn / F / 24 yrs.
Referred by : Dr. Abc Xyzhatt.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O backache and weakness of the RUE since 10-12 days.
Known C/O rheumatoid arthritis, M.S and lymph node tuberculous. Completed AKT 2 months back.

EXAMINATION :

M.R.I of the cervical spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

OBSERVATION :

There is an ill-defined, hypointense signal on the T1 Weighted images involving the marrow of the tip of the odontoid process and probably the right lateral mass of C2, superiorly. This lesion appears heterogeneously hyperintense on the T2 Weighted and Fast Scan (T2 *) images. The periodental fat is effaced with the atlanto-axial joint showing increased signal on the T2 Weighted images. The transverse ligament is well identified. There is no atlanto-dens subluxation. Minimal soft tissue extension of the lesion is noted in the right paravertebral and right anterior epidural region at C1-C2 level.

The rest of the cervical vertebral bodies and the intervertebral discs show normal signal intensity. The joints of Luschka are unremarkable.

The cervical spinal cord reveals normal signal intensity.


The cervico-medullary junction is unremarkable.

Incidentally noted are lymph nodes deep to the sternocleidomastoid muscles bilaterally measuring upto 1.5 cms in maximum dimension.

Probable scarring is noted at the apex of the lungs on either side.

Screening, T2 Weighted axial images of the brain reveal inflammatory changes in the ethmoidal air cells bilaterally. No other significant abnormality is detected.

IMPRESSION :

Altered signal in the tip of the odontoid process and probably the right lateral mass of C2, superiorly, as described is not specific for a single etiology. In a known C/O tuberculous lymphadenitis, these changes most likely represent tuberculous osteitis with granulation tissue in the right paravertebral region at that level. The possibility of these changes being due to rheumatoid arthritis seems less likely.