sb/ke/rg.
Date : 00.00.00

Name of the Patient : Abc XyzGlmn / M / 44 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O weakness of BUE and BLE with paresthesias since 0000.
H/O fall and injury to forehead.
H/O Operation in April 0000 for a dorsal arachnoid cyst (details unavailable).

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

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

OBSERVATION :

There is loss of normal cervical lordosis and loss of water content of the C2-C3, C3-C4, C5-C6 and C7-D1 intervertebral discs.

A small right paracentral protruded disc with peridiscal osteophytes is noted at the C5-C6 level.

The cervical vertebral bodies and the remaining intervertebral discs show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

The cervical spinal cord reveals normal signal intensity.

The atlanto-axial region and the cervico-medullary junction are unremarkable.
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The dorsal spine was screened with 5 mm thick T1 Weighted and T2 Weighted sagittal images. Slight loss of water content of some of the dorsal intervertebral discs is noted. A hemangioma with fat content is noted in the D8 vertebral body.

Laminectomy of D4, D5 and D6 vertebrae is noted with post-operative changes in the posterior soft tissues at these levels. The dorsal spinal cord appears smaller in calibre without change in signal intensity. There is no cord compression.

IMPRESSION :

1. A small right paracentral protruded disc with peridiscal osteophytes at the C5-C6 level.

2. Post-operative status in the dorsal region with atrophy of the dorsal spinal cord without obvious change is signal intensity. There is no cord compression.