ke/sb/rg/nl
Date : 00.00.00
Name of the Patient : Abc Xyzapilmn / F / 15 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with tingling in BLE since 4-5 months.
H/O TB at the age of 1 year.
EXAMINATION :
M.R.I of the lumbo-sacral spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and T2 Weighted axial images.
OBSERVATION :
There is partial sacralization of the L5 vertebra on the left.
There is mild posterior subluxation of the L4 over the L5 vertebra.
A small posterior disc bulge with peridiscal osteophytes is seen at the L4-L5 level with anterior indentation of the thecal sac.
Transepiphyseal herniation of the D12-L1 and L2-L3 discs is seen at the antero-superior margin of the L1 and L3 vertebral bodies, respectively, with adjacent Type II degenerative marrow changes. These discs are reduced in height.
The rest of the lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the D12-L1 level and the thecal sac terminates at the S2 level.
The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
18.0 mm at L1-L2
17.0 mm at L2-L3
15.0 mm at L3-L4
12.0 mm at L4-L5
9.0 mm at L5-S1.
IMPRESSION :
The MRI features are suggestive of :
1. Partial sacralization of the L5 vertebra on the left.
2. A small posterior disc bulge with peridiscal osteophytes at the L4-L5 level.