ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyz. Ralmn / F / 15 yrs.
Referred by : Dr. Abc XyzShah.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache since 2-3 months with fever and loss of appetite and weight since then.
C/O weakness of BLE since 3 days.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted sagittal images.

6 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is slight anterior wedging of the D8 vertebral body with forward translation of the D7 over the D8 vertebra with a resultant kyphus at that level.

There is replacement of the normal marrow of the D5, D6, D7, D8 and D9 vertebral bodies by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. The pedicles of these vertebrae and the posterior appendages of the D7 and D8 vertebrae are involved by the pathology. The superior and inferior cortical endplates of the D8 and D7 vertebrae are breached with involvement of the D7-D8 intervertebral disc. There is pre and paravertebral soft tissue extension over the D5 to D9 vertebral levels which is hypointense with a hyperintense periphery on the T1 Weighted images and turns hyperintense on the T2 Weighted images and would





represent abscess formation. The costo-vertebral and costo-transverse joints at the D7-D8 and D8-D9 levels are involved. There is slight extension into the posterior paraspinal soft tissues at the D7 and D9 vertebral levels. There is circumferential epidural extension of the soft tissue lesion over the D7 and D8 levels with severe compression of the spinal cord at the D7-D8 and D8 levels. The spinal cord at these levels shows a subtle hyperintense signal on the T2 Weighted images (isointense to normal cord on the T1 Weighted images) suggestive of cord edema/ischemia/myelitis.

The aorta and IVC are displaced anteriorly by the pre and paravertebral soft tisse lesion.

The rest of the visualized dorsal vertebral bodies and remaining intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.

The conus medullaris terminates at the D12-L1 level.

The cervico-dorsal and the dorso-lumbar spines were screened with 5 mm thick T1 Weighted sagittal images and do not reveal any diagnostic feature of note.

IMPRESSION :

Altered signal of the D5, D6, D7, D8 and D9 vertebral bodies and the D7-D8 intervertebral disc suggests osteitis discitis, most likely tuberculous in etiology. Pre and paravertebral soft tissue lesion over the D5 to D9 vertebral levels may suggest an abscess formation. There is cord compression and cord signal alteration over the D7-D8 to D8 levels suggestive of cord edema/ischemia/myelitis.

The possibility of a round cell tumor seems less likely.