sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzDanalmn / M / 33 yrs.
Referred by : Dr. Abc Xyzikhalikar.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O backache since 1 month.
C/O weakness of BLE since 4-5 days.
H/O epilepsy since 2 years.

EXAMINATION :

M.R.I of the dorso-lumbar spine was performed using the following parameters :

4 mm thick T1 Weighted and T2 Weighted sagittal images.

7 mm thick T1 Weighted and T2 Weighted axial images.

6 mm thick T1 Weighted coronal images.

OBSERVATION :

The D7 and D8 vertebral bodies appear relatively more hypointense when compared to the rest of the vertebrae on the T1 Weighted images and appear heterogeneously hyperintense on the T2 Weighted images. The D3 and D5 vertebral bodies also show a hyperintense signal on the T2 Weighted images.

There is destruction of the right transverse process of the D10 and D11 vertebrae. There is a minimal right paravertebral and right posterior paraspinal soft tissue lesion extending over the D10 to D12 vertebral levels. This lesion is of intermediate signal on the T1 Weighted images and turns hyperintense on the T2 Weighted images. There is also extension of the soft tissue lesion in the right lateral epidural space over the D9 to D12 vertebral levels, with cord compression. The dorsal spinal cord over these levels shows a subtle hyperintense signal on the T2 Weighted images suggesting cord edema/ischemia.
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A small, left paravertebral soft tissue lesion inoted at the D8 and L1 vertebral levels.

A soft tissue lesion is also noted in the sacral region extending into the epidural space at that level with probable erosion of the spinous process of S1.

The dorso-lumbar vertebral bodies appear relatively hypointense when compared to normal marrow on the T1 Weighted images but appear isointense to normal marrow on the T2 Weighted images. The visualized dorso-lumbar intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.

The conus medullaris terminates at the L1 level.

Incidentally noted is a consolidated left lung with probable underlying left pleural effusion and focal parenchymal lesions (?? cavities, in the lung fields on either side).

IMPRESSION :

Altered signal of the D3, D5, D7 and D8 vertebral bodies most likely represent osteitis, probably tuberculous osteitis. Paravertebral and right lateral epidural soft tissue lesion over the D9 to D12 levels and soft tissue lesion in the sacral region may represent granulation tissue/abscess. There is resultant cord compression and cord signal alteration suggesting cord edema/ischemia.

The possibility of the above described lesion representing a neoplasm is less likely.

Altered signal in the rest of the visualized dorso-lumbar vertebrae may represent preponderance of hematopoeitic marrow.

Changes in the thorax are described above.