sb/ke
Date : 00.00.00

Name of the Patient : Abc Xyza Blmn / M / 22 yrs.
Referred by : Dr. Abc Xyzrankar.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

H/O fall from a train on 00.00.00 with weakness of BUE since than.

EXAMINATION :

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

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

3 mm thick Fast Scan (T2 *) coronal images and 4 mm thick T2 Weighted coronal images (with fat saturation) through the brachial plexus.

OBSERVATION :

There is slight loss of water content of the C5-C6 and C6-C7 intervertebral discs.

There is seen a horizontal fracture line passing through the base of the odontoid process
and the right lateral mass of C2. Minimal lateral translation and anti-clockwise rotation of the fractured fragment is noted with slight right neural foraminal narrowing at the C2-C3 level. The cervical spinal cord at the C2 vertebral level, at the fracture site, shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images suggesting cord contusion, in the given clinical setting. There is however no cord compression identified. The C2 vertebral body shows a subtle hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images which may suggest bone bruise in the given clinical setting.

A hyperintense signal on the Fast Scan (T2 *) images is noted in the periodontoid space, posteriorly and to the left, which may represent soft tissue injury, in the given clinical setting. The transverse ligament however appears intact. Hyperintense signal on the T2 Weighted images is also noted in the prevertebral space over the C2 to C4 vertebral levels which may also represent soft tissue injury.
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No significant abnormality is detected along the brachial plexus on either side.

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

IMPRESSION :

1. A horizontal fracture line passing through the base of the odontoid process
and the right lateral mass of C2 with minimal lateral translation and anti-clockwise rotation of the fractured fragment

2. Altered signal in the cervical spinal cord at the C2 vertebral level, at the fracture site, suggests cord contusion, in the given clinical setting.

3. Altered signal in the C2 vertebral body may suggest bone bruise in the given clinical setting.

4. Signal alteration in the periodontoid space, posteriorly and to the left and in the prevertebral space over the C2 to C4 vertebral levels may represent soft tissue injury, in the given clinical setting.