Sunday, 27 December 2015 16:48

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Date : 00.00.00

Name of the Patient : Abc Xyznnisa lmn / F / 55 yrs.
Referred by : Dr. Abc Xyzpase.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache with pain radiating to BLE since 2-3 months.
C/O weakness of 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 slight wedging of the D9 and D10 vertebral bodies which appear hypointense on the T1 Weighted images and heterogeneously hyperintense on the T2 Weighted images. The D9-D10 intervertebral disc is also involved and appears more hyperintense (as compared to normal) on the T2 Weighted images.

There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the anterior epidural space over the D9 and D10 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. There is resultant cord compression at these levels with cord signal alteration (hyperintense on the T2 Weighted images and iso to hypointense on the T1 Weighted images) over D9 to D10 vertebral levels, suggesting cord edema/ischemia. Similar signal intensity soft tissue lesion is also noted in the left paravertebral region over D8 and D9 vertebral levels with resultant involvement of the costo-transverse and costo-vertebral joints at the D9 vertebral level. The pedicles of these vertebrae are also involved by the pathologic process.




Involvement of the left transverse process of D9 is also noted. Minimal soft tissue extension is noted in the prevertebral region at the D9/D10 vertebral levels.

The rest of the visualized dorsal vertebral bodies show spotty fatty marrow changes. The remaining dorsal intervertebral discs show slight loss of water content. The facet joints are unremarkable.

The conus medullaris terminates at the D12-L1 level.

The T1 Weighted sagittal images of the lumbar spine show degenerative changes in the upper and mid lumbar region.

IMPRESSION :

Altered signal of the D9 and D10 vertebral bodies and the D9-D10 intervertebral disc as described, most likely represents osteitis with discitis, probably tuberculous in etiology. Anterior epidural and left paravertebral soft tissue lesion would represent granulation tissue/abscess. There is resultant cord compression and cord signal alteration over the D9 and D10 vertebral levels which represent cord edema/ischemia.

The possibility of this lesion representing a neoplasm seems less likely.


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