hs/sb/nl/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzu Rlmn / M / 16 yrs.
Referred by : Dr. Abc XyzSampat.
Examination : M.R.I. of the Right Tibia.

CLINICAL PROFILE :

H/O boils on the right shin with (occasional) pain since 3 years.
H/O tuberculosis 4 years ago.

EXAMINATION :

M.R.I. of the right tibia was performed using the following parameters :

7 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.

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

5 mm thick T1 Weighted and STIR sagittal images.

OBSERVATION :

There is evidence of areas of altered signal intensity within the diaphysis of the right tibia. This is seen to extend over a distance of approximately 13.0 cms and its inferior aspect is located at a distance of approximately 14-15.0 cms from the right ankle joint.

The superior aspect of this lesion shows diffuse irregularly defined areas of hypointensity on the T1 Weighted images. Few of these remain hypointense on the T2 Weighted and STIR images (areas of sclerosis) whereas a few turn hyperintense. There is slight irregularity of the endosteum at this level. Also seen is periosteal reaction at this level. The





inferior aspect of this lesion is well-defined and is hypointense on the T1 Weighted images and turns markedly hyperintense on the T2 Weighted and STIR images and may represent a cystic component (The possibility of the cystic lesion being a simple bone cyst cannot be ruled out).

There appears to be a break in the skin surface, medial to the left tibia at the level of the tibial tubercle.

The visualized fibula shows normal signal intensity.
The visualized right knee and ankle joints are unremarkable.

The muscles around the right tibia are also unremarkable.

IMPRESSION :

The MRI features are suggestive of a lesion within the diaphysis of the right tibia as described.

The differential diagnosis would include :

1. Osteomyelitis.

2. Neoplastic processes like an Ewings sarcoma.