sb/hs
Date :00.00.00

Name of the Patient : Abc Xyzralmn / M / 38 yrs.
Referred by : Dr. Abc Xyzabhat / Dr. Abc Xyzpadia.
Examination : M.R.I. of the Pelvis & Sacro-iliac Joints.

CLINICAL PROFILE :

C/O backache radiating to the LLE since 3-4 months.

EXAMINATION :

M.R.I of the pelvis and sacro-iliac joints was performed using the following parameters :

7 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.

6 mm thick T1 Weighted and STIR coronal images.

5 mm thick T1 Weighted sagittal images through the lumbo-sacral spine.

OBSERVATION :

There is an ill-defined hypointense signal on the T1 Weighted images involving the S1 and S2 vertebral segments and the ala of the sacrum on the left. This lesion appears hyperintense on the T2 Weighted and STIR images. There is seen a fairly large, intermediate signal intensity (on the T1 Weighted images) mass lesion in the presacral soft tissues extending over the S1 to S3 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. Ill-defined hyperintense signal on the T1 Weighted images is also noted within the lesion. The lesion measures approximately 6.0 x 5.0 x 7.0 cms. There is extension of this soft tissue lesion into the anterior epidural space to the left of the midline at the S1 vertebral level with indentation on the traversing left S1 nerve root. The rectum is displaced anteriorly by this lesion.


The left sacro-iliac joint per se is unremarkable. The right sacro-iliac joint and the hip joints on either side are unremarkable.

The visualized dorso-lumbar spine is also unremarkable. Probable involvement of the L5-S1 and S1-S2 intervertebral discs is noted.

There are no abnormally enlarged pelvic lymphnodes identified.

IMPRESSION :

Altered signal in the S1 and S2 vertebral segments and the ala of the sacrum on the left with a fairly large presacral soft tissue mass lesion as described is not specific for a single etiology. This most likely is a neoplastic lesion. A round cell tumor or a sacral chordoma may be considered as a differential diagnosis. The possibility of an infective etiology seems less likely,

Slight extension of the lesion into the anterior epidural space to the left at the S1 vertebral level is noted with indentation on the traversing left S1 nerve root.