Date : 00.00.00
Name of the Patient : Abc Xyzal Mlmn / M / 42 yrs.
Referred by : Dr. Abc Xyznna / Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with swelling over the ribs on the left side since 15-20 days.
H/O fall 15 days back.
M.R.I of the lumbo-sacral 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.
There is sacralization of the L5 vertebra and the L1 vertebral body is as marked on the film.
There is replacement of the normal marrow of the D12 vertebral body by hypointense signal on the T1 Weighted images which is seen to turn hyperintense on the T2 Weighted images. The right pedicle of D12 is involved by the pathology. There is erosion of the anterior cortex with prevertebral soft tissue extension slightly to the right of the midline. This soft tissue lesion is seen to extend over the D11 to D12-L1 levels. The antero-inferior aspect of the D11 vertebra is also involved.
The lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The facet joints and the visualized paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the L1 level and the thecal sac terminates at the S1 level.
The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
13.0 mm at L1-L2
12.0 mm at L2-L3
12.0 mm at L3-L4
11.0 mm at L4-L5
11.0 mm at L5-S1.
The lower chest was screened with 5 mm thick T1 Weighted and STIR axial images and 5 mm thick T1 Weighted coronal images which shows a well-defined lesion along the antero-lateral aspect of lower chest wall on the left at the D12 vertebral level (se/im 105.12). This lesion is hypointense to muscle on the T1 Weighted images and turns hyperintense on the STIR images. Inflammation is noted in the adjacent soft tissue.
The MRI features are suggestive of altered signal of the D11 and D12 vertebral bodies with a right, prevertebral soft tissue lesions as described. This most likely represents osteitis, probably tuberculous osteitis.
Lesion along the antero-lateral chest wall on the left as described may be involving a left lower rib.
The possibility of a neoplasm seems less likely.