sb/ke/rg.
Date : 00.00.00

Name of Patient : Ms. Deepa Subramalmn / F / 27 yrs.
Referred by : Dr. Abc Xyzwala.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain with (occasional) paresthesias in BUE since 1 month.

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.

SOME IMAGES SHOW PATIENT MOTION INSPITE OF SEDATION.

OBSERVATION :

The C6 and C7 vertebral bodies appear hypointense on the T1 Weighted images and heterogeneously hyperintense on the T2 Weighted images. There is erosion of the superior cortical endplate of the C7 vertebral body with probable involvement of the C6-C7 intervertebral disc. The spinous processes of C6 and C7 vertebrae also seem to be involved. Destruction of the right sided pedicle, lamina and the facetal articulation of C6 and C7 vertebrae on the right is noted.

There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the prevertebral space, right paravertebral region and in the right posterior paraspinal muscles extending over C6 and C7 vertebral levels. This lesion appears hyperintense on the T2 Weighted and Fast Scan (T2 *) images. Extension into the anterior and right lateral epidural space at these levels is also noted with cord compression. The cervical spinal cord at this level shows a subtle hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images which may represent cord edema/ischemia.
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Small posterior disc bulges are noted at the C4-C5 and C5-C6 levels.

The rest of the cervical vertebral bodies and the remaining intervertebral discs show normal signal intensity. The joints of Luschka are unremarkable.

The atlanto-axial region and the cervico-medullary junction are unremarkable.

IMPRESSION :

Altered signal of the C6 and C7 vertebrae with probable involvement of the C6-C7 intervertebral disc as described most likely represents osteitis with discitis probably tuberculous in etiology. Prevertebral, paravertebral, posterior paraspinal and epidural soft tissue lesion on the right would represent granulation tissue/abscess. There is resultant cord compression and subtle cord signal alteration at C6 and C7 levels which may suggests cord edema/ischemia.

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