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Date : 00.00.00

Name of the Patient : Abc Xyza V. Khanolmn / F / 55 yrs.
Referred by : Dr. Abc Xyzlwalkar.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache since 2 months and paraplegia with bladder/bowel involvement since 8-10 days.
H/O fall/fever 2-3 months ago.

EXAMINATION :

M.R.I of the dorsal 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 collapse of the D7 vertebral body. The D7 vertebral body and pedicles appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. The inferior cortical endplate is broken. The superior cortical endplate and the D6-D7 and D7-D8 intervertebral discs appear intact. There is an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the prevertebral, paravertebral and anterior epidural space at the D7 vertebral level. This lesion appears hyperintense on the T2 Weighted images. There is resultant cord compression and slight posterior displacement of the cord. The dorsal spinal cord over the D6 to D8 vertebral levels appears hyperintense on the T2 Weighted images, which suggests cord edema/ischemia/myelitis.

The C3, C7, D6, D8, D9, D10, L4 and L5 vertebral bodies and the spinous processes of some these vertebrae also appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images.
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The rest of the visualized dorsal vertebral bodies and intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.

The conus medullaris terminates at the D12 level.

Parenchymal infiltrates are noted in the bases of both lungs.

IMPRESSION :

Collapse of the D7 vertebral body with altered signal most likely represents osteitis, most likely tuberculous in etiology. Prevertebral, paravertebral and anterior epidural soft tissue lesion may represent granulation tissue/abscess. There is resultant cord compression and cord signal alteration at the D7 vertebral level suggesting cord edema/ischemia/myelitis.

Altered signal of the C3, C7, D6, D8, D9, D10, L4 and L5 vertebral bodies and the spinous processes of some of these vertebrae may also suggest osteitis.

The possibility of altered signal in the above described vertebrae representing metastasis or small cell tumor cannot be entirely excluded though less likely.

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