Sunday, 27 December 2015 16:48

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sb/bv/nl/nl
Date : 00.00.00

Name of the Patient : Abc XyzMlmn / M / 12 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

H/O fall of weight on the back on 00.00.00 with paraplegia and bladder involvement since then.

EXAMINATION :

M.R.I of the dorso-lumbar 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 anterior wedging of the D12 vertebral body with slight retropulsion of the same. The D12 vertebra shows a hypointense signal on the T1 Weighted images which appears hyperintense on the T2 Weighted images. The D11-D12 and D12-L1 intervertebral discs appear unremarkable. Fracture of the pedicles, transverse process, the laminae and probably the spinous process of the D12 vertebra is noted. There is rupture of the posterior longitudinal ligament. The anterior longitudinal ligament appears intact but is probably stripped away from the D12 vertebra. The D11-D12 facet joints show diastasis. Intermediate signal on the T1 Weighted images in the anterior epidural space at the D12 vertebral level, which appears relatively hypointense to CSF on the T2 Weighted images may represent epidural haemorrhage. There is resultant mild cord compression at the D12 vertebral level. The lower dorsal spinal cord over about D6 upto the conus medullaris shows a hyperintense signal on the T2 Weighted images (iso to hypointense to normal cord on the T1 Weighted images) which suggest cord contusion/edema in the given clinical setting.



Ill-defined, hyperintense signal on the T2 Weighted images is noted in the prevertebral, paravertebral and posterior paraspinal soft tissues over the D11 to L1 vertebral levels, which may represent soft tissue injury.

Mild central wedging of the L1 vertebral body is noted with subtle altered signal along its superior cortical endplate.

The rest of the visualized dorso-lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.

The conus medullaris terminates at the L1-L2 level.

IMPRESSION :

Anterior wedging of the D12 vertebral body with slight retropulsion and fracture of the posterior elements of D12 as described is the sequelae of previous trauma. Cord signal alteration over about D6 upto the conus medullaris would represent cord contusion/edema. There is mild cord compression at the D12 vertebral level.



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