hs/bv
Date : 00.00.00

Name of the Patient : Abc Xyzed Samlmn / M / 18 yrs.
Referred by : Dr. Abc Xyzlwalkar.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O neckpain since 4-5 months with painful movements.
H/O fever prior to this.

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.

Flexion and Extension images were obtained using 5 mm thick T1 Weighted sagittal images.

OBSERVATION :

Irregularly defined areas of hypointensity on the T1 Weighted images which turn heterogeneously hyperintense on the T2 Weighted and Fast Scan (T2 *) images are seen to involve the odontoid process and left lateral mass of the C2 vertebra. There appears to be extension of this pathologic process into the periodontoid space (the odontoid is displaced to the right) and anterior to the left lateral mass of the C2 vertebra. There is mild indentation upon the cervico-medullary junction and upper cord by the odontoid process. There is suspicious involvement of the right occipital condyle by the lesion.

The atlanto-dens interval is seen to measure approximately 5.0 mms. There is no significant change on the flexion and extension images.
- 2 - Scan - 00001


Enlarged cervical lymph nodes are seen deep to the sternomastoid muscle bilaterally.

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

The cervical spinal cord shows normal signal intensity.

Screening of the dorsal and lumbar spine shows no significant feature of note. Note is made made of a distended bladder.

IMPRESSION :

The MRI features are suggestive of a pathologic process involving the C2 vertebra and right occipital condyle with minimal atlanto-axial subluxation as described. This may be the result of an infective process like tuberculosis.

The possibility of a neoplastic process like a small cell tumor is less likely.