ke/hs/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz lmn / F / 34 yrs.
Referred by : Dr. Abc Xyzshi.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache with paresthesias in BLE since 15 days.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is collapse of the D7 vertebral body.

There is replacement of the normal marrow by hypointense areas on the T1 Weighted images of the D5, D6, D7 and D8 vertebral bodies. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. The pedicles of the D7 and D8 vertebrae and the D6-D7 and D7-D8 intervertebral discs are involved by the pathology.

There is pre and paravertebral soft tissue extension over the D6 to the D8 vertebral levels. This is of intermediate signal intensity on the T1 Weighted images and turns hyperintense on the T2 Weighted images. Anterior and right lateral epidural extension is seen over the D6 to D8 vertebral levels with compression of the spinal cord, maximum at the D7 vertebral level. The spinal cord over these levels shows a subtle hyperintense signal on the T2 Weighted images. This is isointense to normal cord on the T1 Weighted images and is suggestive of cord edema/ischemia/myelitis. Extension into the D6-D7 and D7-D8 neural foramina on the right side is seen.

Note is made of bilateral pleural reaction (left more than right).
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The rest of the visualized dorsal vertebral bodies and intervertebral discs are unremarkable. The facet joints are unremarkable.

The conus medullaris terminates at the L1 level.

The cervico-dorsal spine was screened with 5 mm thick T1 Weighted sagittal images and shows hypointense areas replacing normal marrow of the C7 vertebral body.

IMPRESSION :

The MRI features are suggestive of an infective process involving the C7, D5, D6, D7 and D8 vertebrae with collapse of the D7 vertebra and extensions as described. There is cord compression and cord edema/ischemia/myelitis over the D6 to D8 level. This most probably represents a granulomatous infective process like tuberculosis.

The possibility of this being a neoplastic process like a round cell tumor cannot be entirely excluded.