sb/hs/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzr Plmn / M / 70 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to the LLE with paresthesias and weakness.

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 an ill-defined, hypointense signal on the T1 Weighted images in the L2 and L3 vertebral bodies and pedicles. This signal appears hyperintense on the T2 Weighted images. The cortical endplates adjacent to the L2-L3 intervertebral disc appear irregular with involvement of the L2-L3 intervertebral disc. Similar altered signal is also noted in the L4 and L5 vertebral bodies adjacent to the L4-L5 intervertebral disc, more to the right of the midline. The L4-L5 and L5-S1 intervertebral discs appear more hyperintense (when compared to normal) on the T2 Weighted images.

There is an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the prevertebral and paravertebral regions at the L2 and L3 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. Similar signal intensity soft tissue lesion is noted in the psoas muscles on either side at the L2 to L5 vertebral levels, in the anterior and left lateral epidural space at L2 level and in the anterior and right lateral epidural space at the L5 and S1 vertebral levels. A probable ..2/.






intradural component is noted at the L5 and S1 levels. Encasement of the left L2 nerve root in the left neural foramen at the L2-L3 level and the L5 nerve roots, bilaterally, at the L5 vertebral level is noted. Altered signal is also noted in the posterior paraspinal soft tissues at the L4 and L5 levels.

Posterior disc herniations are seen at the L4-L5 and D12-L1 levels.

Posterior disc bulges with posterior peridiscal osteophytes are noted at the L2-L3 and L3-L4 levels.

A postero-central protruded disc is noted at the L1-L2 level.

Bilateral far lateral (extraforaminal) disc bulges are seen at the L3-L4 and L4-L5 levels.

Facetal hypertrophy is noted at the L4-L5 and L5-S1 levels.

The conus medullaris terminates at the L1-L2 level and the thecal sac terminates at the S2 level.

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

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

Screening, T1 Weighted sagittal images of the dorsal spine, reveal an ill-defined hypointense signal in the D10 vertebral body.

Incidentally noted is a parenchymal cyst in the right kidney.
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- 3 - Scan-00007

IMPRESSION :

Altered signal in the L2, L3, L4 and L5 vertebrae and the L2-L3, L4-L5 and L5-S1 intervertebral discs, most likely represents osteitis with discitis, probably tuberculous in etiology. Prevertebral, paravertebral and epidural soft tissue lesion at these levels as described may represent granulation tissue/abscess. Encasement of the traversing and exiting nerve roots is as described above. The possibility of these changes representing a neoplasm seems less likely.