hs/sb/nl/nl






Name of the Patient : Abc Xyzakant Glmn / M / 57 yrs.
Referred by : Dr. Abc Xyztrak.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O paresthesias in BUE.

EXAMINATION :

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

4 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.

OBSERVATION :

There is mild retroplacement of the C5 vertebra over the C6 vertebra and mild forward placement of the C6 vertebra over the C7 vertebra. There is a suspicious break in the continuity of the ligamentum flavum at the C5-C6 level (se/im:102/4).

There is loss of water content of the cervical intervertebral discs and reduction in height of the C5-C6 disc.

A posterior disc herniation with peridiscal osteophytes is seen to indent the thecal sac at the C5-C6 level. The joints of Luschka at this level show degenerative changes with resultant bilateral neural foraminal narrowing.

A posterior disc bulge with peridiscal osteophytes is seen to indent the thecal sac at the C6-C7 level.


There are postero-central disc protrusions with peridiscal osteophytes at the C3-C4 and C4-C5 levels. Anterior disc herniations with peridiscal osteophytes are seen in the cervical region.

The C5-C6 facet joints bilaterally and on the left side at the C4-C5 and C6-C7 levels show hypertrophic degenerative changes.

The tip of the odontoid process is irregularly defined and areas of intermediate signal intensity on the T1 Weighted images which turn hypointense on the T2 Weighted images are seen within the periodontoid space (more so posteriorly). There is resultant bulging of the transverse ligament.

The cervical vertebral bodies show fatty marrow changes.

There is severe ectasia of the vertebro-basilar system with indentation upon the right ventro-lateral aspect of the medulla.

The rest of the joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

The cervical spinal cord reveals normal signal intensity.

IMPRESSION :

The MRI features are suggestive of :

1. Mild retroplacement of the C5 vertebra over the C6 vertebra and mild forward placement of the C6 vertebra over the C7 vertebra with a suspicious break in continuity of the ligamentum flavum at the C5-C6 level.

2. A posterior disc herniation with peridiscal osteophytes at the C5-C6 level.
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3. A posterior disc bulge with peridiscal osteophytes at the C6-C7 level.

4. Postero-central disc protrusions with peridiscal osteophytes at the C3-C4 and C4-C5 levels.

5. Degenerative changes of the joints of Luschka at the C5-C6 level.

7. Hypertrophic facetal arthropathy at the C5-C6 level bilaterally and on the left side at the C4-C5 and C6-C7 levels.

8. Irregularly defined tip of the odontoid process with altered signal within the periodontoid space (more so posteriorly). Such changes may be seen with pannus (rheumatoid arthritis). However the possibility of these changes being due to trauma or an old infective process cannot be excluded.