sb/bv/nl/rg.
Name of the Patient : Abc Xyz. Tallmn / F / 42 yrs.
Referred by : Dr. Abc Xyztchha / Dr. Abc Xyzswani.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to BLE and paresthesias.
EXAMINATION :
M.R.I of the dorso-lumbar spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and T2 Weighted axial images.
OBSERVATION :
The D12 and L1 vertebral bodies appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. The D12-L1 intervertebral disc also appears hyperintense on the T2 Weighted images with erosion of the cortical endplates adjacent to this disc. There is erosion of the left lateral margin of the L1 vertebral body.
There is seen a fairly large, hypointense lesion on the T1 Weighted images in the left paravertebral region extending from about the L1 to the L5 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. Multiple septae are noted within this lesion, which most likely represents an abscess. The left psoas muscle is also involved. The left kidney is displaced slightly superiorly and laterally by the lesion.
Extension of the soft tissue lesion into the anterior epidural space at the D12 and L1 levels is noted via the left neural foramen at the D12-L1 level with mild compression of the thecal sac and the tip of the conus at that level. Minimal extension of the soft tissue lesion into the left paraspinal muscles is noted.
..2/.
The postero-superior margin of L5 shows altered signal.
There is slight loss of water content of the L4-L5 and L5-S1 intervertebral discs, with small postero-central disc herniations at these levels.
The rest of the visualized dorso-lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.
The conus medullaris terminates at the L1 level. The lower dorsal spinal cord shows normal signal intensity.
Screening, T1 Weighted sagittal images of the cervico-dorsal spine reveals focal altered signal in the C5 vertebral body. Suspicious enlarged mediastinal lymph nodes are noted.
IMPRESSION :
Altered signal in the D12 and L1 vertebral bodies and the D12-L1 intervertebral disc represents osteitis with discitis most likely tuberculous in etiology. Fairly large left paravertebral lesion extending over the L1 to L5 vertebral levels represents an abscess. Minimal soft tissue extension is noted in the anterior epidural space at the D12 and L1 levels.
The C5 and L5 vertebral bodies also show focal altered signal.