ke/sb/nl/rg.
] Date : 00.00.00

Name of the Patient : Abc Xyzi Nalmn / F / 45 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Pelvis.

CLINICAL PROFILE :

C/O backache radiating to BLE with paresthesias since 2-3 months.

EXAMINATION :

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

5 mm thick T1 Weighted sagittal images.

6 mm thick T1 Weighted and T2 Weighted axial images.

5 mm thick T1 Weighted and STIR coronal images.

OBSERVATION :

There is replacement of the normal marrow of the sacral vertebrae by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted and STIR images. There is extension into the presacral soft tissues with obliteration of fat plane. There is indentation and displacement of the ilio-psoas muscle anteriorly. The piriformis muscle on the right side appears bulky and is also involved by the pathology. Slight involvement of the piriformis muscle on the left is also noted. The gluteus maximus muscle on the right side also shows altered signal suggestive of its involvement. The sacral nerve roots on either side are encased by this lesion, more on the right. There is extension into the spinal canal upto the L5 level with non-visualization of the thecal sac.

The visualized lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.


The uterus and the urinary bladder appear normal.

Enlarged para-aortic and right iliac enlarged lymph nodes are noted in the pelvis.

IMPRESSION :

The MRI features are suggestive of altered signal of the sacral vertebrae with soft tissue extensions and lymph nodal enlargement as described.

These changes are not specific for a single etiology. A round cell tumor like lymphoma or an infective lesion like tuberculosis may be considered as differential diagnosis.