ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzrprasad Sultlmn / M / 52 yrs.
Referred by : Dr. Abc Xyzatanpal.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain radiating to the RUE with paresthesias since October 0000.
Detected to have tuberculous spine in December in 0000. On AKT since then.

EXAMINATION :

M.R.I of the cervical spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

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

OBSERVATION :

There is partial collapse of the C5 vertebral body with loss of normal curvature of the cervical spine.

There is replacement of the normal marrow of the C5 vertebral body by hypointense areas on the T1 Weighted images which are seen to turn heterogeneously hyperintense on the T2 Weighted and Fast Scan (T2 *) images. There is pre and paravertebral soft tissue extension over the C4 and C5 levels. There is posterior bulging of the C5 vertebral body with an anterior epidural lesion which is of intermediate signal intensity on the T1 Weighted images and turns heterogeneously hyperintense on the T2 Weighted and Fast Scan (T2 *) images. There is compression upon the spinal cord at the C4-C5 level which shows a subtle hyperintense signal on the Fast Scan (T2 *) images (isointense to normal cord on the T1 Weighted images). There is breach in the superior cortex of the C5 vertebra with involvement of the C4 vertebral body in its inferior aspect as well as the C4-C5 intervertebral disc.

The cervical intervertebral discs show loss of water content.
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The C2 and C3 vertebral bodies show diffuse fatty changes. The rest of the cervical vertebral bodies show normal signal intensity. The joints of Luschka are unremarkable.

The atlanto-axial region and the cervico-medullary junction are unremarkable.

Altered signal is also noted in the D1, D2 and D3 vertebral bodies.

The rest of the dorsal spine was screened with 5 mm thick T1 Weighted sagittal images and does not reveal any diagnostic feature of note.

IMPRESSION :

The MRI features are suggestive of partial collapse of the C5 vertebral body with altered signal in the C4, C5, D1, D2 and D3 vertebrae with involvement of the pre and paravertebral soft tissues and cord signal alteration at the C4-C5 level as described. This is most probably due to granulomatous infective process like tuberculosis.

The possibility of this being a neoplastic process or metastasis cannot be entirely ruled out.