ke/bv/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzen Sagalmn / F / 44 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the LLE with tingling.
H/O fall prior to this.

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 :

The L1-L2, L3-L4 and L4-L5 intervertebral discs show loss of water content.

There is scoliosis of the lumbar spine with convexity to the left and clockwise rotational anomaly of the upper lumbar vertebrae.

Postero-central disc herniations are seen at the L3-L4 and L4-L5 levels with anterior indentation of the thecal sac. The L3-L4 facet joints bilaterally and the L4-L5 facet joint on the left side show degenerative changes.

A small left far lateral disc bulge is seen at the L2-L3 level and a postero-central disc protrusion at the L5-S1 level.

Schmorls node is seen in the superior aspect of the L2 vertebral body.


Hypointense area is seen in the left sacral ala on the T1 Weighted images which is seen to turn heterogeneously hyperintense on the T2 Weighted images ? inflammatory. The left sacro-iliac joint appears spared by the pathology.

The lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the L1 level and the thecal sac terminates at the S1 level.

The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

12.0 mm at L1-L2
13.0 mm at L2-L3
12.0 mm at L3-L4
12.0 mm at L4-L5
13.0 mm at L5-S1.

IMPRESSION :

1. Scoliosis of the lumbar spine with convexity to the left side.

2. Postero-central disc herniations at the L3-L4 and L4-L5 levels with degenerative changes of the L3-L4 facet joints bilaterally and the L4-L5 facet joint on the left side.

3. A small left far lateral disc bulge at the L2-L3 level.

4. Altered signal in the left sacral ala with sparing of the left sacro-iliac joint, ? inflammatory.