ke/sb/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyza Nlmn / F / 9 yrs.
Referred by : Dr. Abc Xyzshi.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

H/O CDH which was operated in 0000.
C/O gibbus with kyphoscoliosis of the dorso-lumbar spine.
C/O difficulty in walking.

EXAMINATION :

M.R.I of the dorso-lumbar 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.

3 mm thick Fast Scan (T2 *) coronal images.

OBSERVATION :

There is collapse of the L3 vertebral body with an angular kyphus at that level.

There is replacement of the normal marrow of the L2, L3 and L4 vertebral bodies by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted and Gradient images. There is involvement of the L2-L3 and L3-L4 intervertebral discs. Mild pre and paravertebral soft tissue extension is noted over the L2 to L4 levels. A large, right paravertebral lesion is seen extending over the L3-L4 to the S1 levels which is of intermediate signal intensity on the T1 Weighted images and turns hyperintense on the T2 Weighted images and represents abscess/granulation tissue. Minimal anterior epidural extension, to the left of the midline is seen at the L2, L3 and L4 levels.


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

The conus medullaris terminates at the L2 level.

IMPRESSION :

The MRI features are suggestive of collapse of the L3 vertebral body with kyphus and altered signal of the L2, L3 and L4 vertebral bodies with involvement of the L2-L3 and L3-L4 intervertebral discs, pre and paravertebral soft tissue extension and granulation tissue/abscess
over the L3-L4 to the S1 levels as described. These changes most probably represent a granulomatous infective process like tuberculosis.

The possibility of a round cell tumor, is less likely.