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sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyzti H. Kanlmn / F / 50 yrs.
Referred by : Dr. Abc Xyzlwalkar.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O backache with paresthesias in BLE since 1 month.
H/O fall 6-7 months ago.

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 :

There is Grade I spondylolisthesis of the L5 vertebra over the S1 vertebra with probable spondylolysis at the L5 vertebral level bilaterally. A pseudo-posterior disc bulge is identified at the L5-S1 level with ventral indentation upon the thecal sac. There is anterior wedging of the D10 and D11 vertebral bodies. The D10, D11 and D12 vertebral bodies appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. The D10-D11 and D11-D12 intervertebral discs are not completely visualized and also appear hyperintense on the T2 Weighted images and are involved by the pathology. Probable involvement of the spinous processes of the D10, D11 and D12 vertebrae is also noted.

There is an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the pre and paravertebral regions over D9 to D11 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. Extension into the anterior epidural space via the neural foramen at the D10-D11 and D11-D12 levels is noted with resultant cord compression.. The lower dorsal spinal cord at the D10 and D11 vertebral levels appear hyperintense on the T2 Weighted images suggesting cord edema/ischemia.

A loculated, approximately 3.2 cms diameter sized collection is noted along the posterior chest wall, on the right at the D9 and D10 vertebral levels.



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The rest of the visualized dorso-lumbar vertebral bodies and the intervertebral discs show normal signal intensity. The facet joints are unremarkable.

The conus medullaris terminates at the D12-L1 level.

Screening T1 Weighted sagittal images of the cervico-dorsal spine reveal a suspicious hypointense signal in the upper cervical vertebrae.

IMPRESSION :

1. Grade I spondylolisthesis of the L5 vertebra over the S1 vertebra with probable spondylolysis at the L5 vertebral level bilaterally.

2. Anterior wedging of the D10 and D11 vertebral bodies with altered signal of D10, D11 and D12 vertebral bodies and D10-D11 and D11-D12 intervertebral discs as described most likely represents osteitis with discitis, probably tuberculous in etiology. Pre, paravertebral and anterior epidural soft tissue lesions over D9 to D11 vertebral levels most likely represents granulation tissue/abscess. There is resultant cord compression and cord signal altertion at the D10 and D11 vertebral levels suggests cord edema/ischemia.

The possibility of a neoplasm seems less likely.




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