Sunday, 27 December 2015 16:48

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Date : 00.00.00

Name of the Patient : Abc Xyzree R. Palmn / F / 55 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O pain in the nape of the neck and dorsal region since 1 year.
C/O radicular pain to BUE and BLE since 4 days with paresthesias.

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.

OBSERVATION :

There is loss of normal cervical lordosis and slight loss of water content of the cervical intervertebral discs.

The C7, D1 and D2 vertebral bodies appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted and Fast Scan (T2 *) images. The C7-D1 intervertebral disc also appears hyperintense on the T2 Weighted images. There is an intermediate signal intensity soft tissue lesion with a hyperintense rim on the T1 Weighted images in the prevertebral region on either side of the midline, extending over the C3 to D3 vertebral levels. This lesion appears hyperintense with a hypointense rim on the T2 Weighted and Fast Scan (T2 *) images. Similar signal intensity lesion is also noted in the anterior epidural space at the C6 to D2 vertebral levels, with cord compression. There is




encroachment into the neural foramina at the C6-C7 and C7-D1 levels with involvement of the C7 and D1 pedicles, bilaterally. The cervical spinal cord at these levels shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images which suggests cord edema/ischemia/myelitis.

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

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

T1 Weighted sagittal images of the dorsal spine from the D3 to D12 vertebral levels show no significant abnormality.

IMPRESSION :

Altered signal of the C7, D1, and D2 vertebrae and the C7-D1 intervertebral disc most likely represents osteitis with discitis, probably tuberculous in etiology. Prevertebral and anterior epidural soft tissue lesion may represent an abscess/granulation tissue. There is cord compression at the C6 to D2 vertebral levels with cord signal alteration suggesting cord edema/ischemia/myelitis.

The possibility of the above described lesion representing a neoplasm is less likely.
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