ke/sb
Date : 00.00.00

Name of the Patient : Abc Xyzam Badlmn / M / 60 yrs.
Referred by : Dr. Abc Xyzchale.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE:

C/O neckpain radiating to the LUE with paresthesias since 8-9 months.

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.

IMAGES SHOW PATIENT MOTION.

OBSERVATION :

A small posterior disc bulge with peridiscal osteophyte is seen at the C5-C6 level with anterior indentation of the cord. The cord at this level shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images which is isointense to the normal cord on the T1 Weighted images, suggestive of cord edema/ischemia.

Small posterior disc bulges are seen at the C2-C3 and C4-C5 levels.

A large intermediate signal intensity mass lesion is seen in the left paravertebral region at the D1 and D2 levels on the T1 Weighted images which is seen to turn heterogeneously hyperintense on the Fast Scan (T2 *) images. There is a suggestion of destruction of the, left rib at the D1 level.



Gross inhomogeneity of the marrow is seen in the cervical and dorsal vertebrae. The lower cervical, upper and lower dorsal vertebrae show an ill-defined hyperintense signal on the T2 Weighted images.

There is destruction of the lateral segment of the left ribs in the mid-dorsal region (se/im109/12), with a soft tissue mass lesion.

The cervico-dorsal and dorso-lumbar spines were screened with 5 mm thick T2 Weighted sagittal images which shows a small disc herniation with peridiscal osteophyte at the D12-L1 level. Marrow changes are also noted as described.

The cervical intervertebral discs show loss of water content.

The joints of Luschka and the visualized prevertebral soft tissues are unremarkable.

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

Incidental note is made of enlarged lymph nodes in the paratracheal region on the left side.

IMPRESSION :

1. A small posterior disc bulge with peridiscal osteophyte at the C5-C6 level with cord signal alteration at this level suggesting cord edema/ischemia.
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2. Small posterior disc bulges at the C2-C3 and C4-C5 levels.

3. A large mass lesion in the left paravertebral region at the D1 and D2 levels with a suggestion of destruction of the left rib at the D1 level and destruction of the lateral segments of the left ribs in the middorsal region may be due to a neoplastic process, ? metastasis. However an infective process cannot be ruled out.

4. Gross inhomogeneity of the marrow in the cervical and dorsal vertebrae as described is also ? due to metastasis (less likely to tbe infective in etiology).