PROVISIONAL REPORT
sb/sb/nl/nl
Date : 00.00.00
Name of the Patient : Abc Xyzlmn / M / 18 yrs.
Referred by : Dr. Abc Xyzrnad.
Examination : M.R.I. of the Cervico-dorsal Spine.
CLINICAL PROFILE :
C/O neckpain with swelling over the neck since 2-3 months.
C/O weakness of all four extremities with bladder involvement.
EXAMINATION :
M.R.I of the cervico-dorsal spine was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
7 mm thick T1 Weighted and T2 Weighted axial images.
OBSERVATION :
There is collapse of C7, D2 and D3 vertebral bodies with a kyphus at that level. The C6 to D4 vertebral bodies appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. Some of the intervening intervertebral discs also appear more hyperintense on the T2 Weighted images. The posterior elements of C7, D1 and D2 vertebrae appear to be destroyed.
There is seen a fairly large, intermediate signal intensity mass lesion on the T1 Weighted images in the prevertebral and paravertebral soft tissues, extending over C5 to D6 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. Extension into the epidural space, circumferentially over the C6 to D2 vertebral levels is noted with resultant cord compression. The cervico-dorsal
spinal cord over these levels appears hyperintense on the T2 Weighted images, suggesting cord edema/ischemia. There is also extension of this soft tissue lesion into the posterior paraspinal region at D2 vertebral level.
Probable involvement of the head and neck of the first and second ribs is noted bilaterally.
The mediastinal structures are displaced anteriorly by the prevertebral soft tissue lesion.
Suspicious signal change is noted in the D9 and D11 vertebral bodies. The visualized lumbar vertebrae do not show any obvious signal change on this study.
The conus medullaris terminates at the D12-L1 level.
IMPRESSION :
Collapse of the C7, D2 and D3 vertebral bodies with altered signal of the C6 to D4 vertebral bodies and some of the intervening intervertebral discs as described, most likely represents osteitis with discitis, probably tuberculous in etiology.
Fairly large pre and paravertebral soft tissue lesion over C5 to D6 vertebral levels represents an abscess. Extension of the soft tissue lesion into the epidural space is noted, with cord compression and cord signal alteration as described, suggesting cord edema/ischemia.
The possibility of the above described lesion being neoplastic lesion seems less likely.