ke/hs/nl/nl
Date : 00.00.00
Name of the Patient : Abc Xyztali Mulmn / M / 44 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with paresthesias in BLE since 4 years.
H/O fever since 1 month.
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 :
There is a posterior disc herniation at the L4-L5 level with anterior indentation of the thecal sac and bilateral neural foraminal narrowing. The L4-L5 facet joints show mild degenerative changes.
A mild posterior disc bulge is noted at the L3-L4 level.
The L2-L3 and L3-L4 facet joints show mild degenerative changes.
The lumbar vertebral bodies and intervertebral discs reveal normal signal intensity. The remaining 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 :
14.0 mm at L1-L2
14.0 mm at L2-L3
13.0 mm at L3-L4
11.0 mm at L4-L5
12.0 mm at L5-S1.
IMPRESSION :
1. A posterior disc herniation at the L4-L5 level.
2. Mild facetal arthropathy at the L2-L3, L3-L4 and L4-L5 levels.