Date : 00.00.00
Name of the Patient : Abc XyzAmbalmn / M / 40 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
C/O backache radiating to BLE with paresthesias and weakness since 2 months.
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.
The D4 and D11 vertebral bodies are as marked on the film.
There is near complete collapse of the D6 and D7 vertebral bodies and D6-D7 intervertebral disc, with a resultant kyphus at that level. In place, there is seen an intermediate signal intensity lesion on the T1 Weighted images which turns hyperintense on the T2 Weighted images. This soft tissue lesion is seen to extend into the anterior epidural space over the D5 to D8 vertebral levels with resultant cord compression. The dorsal spinal cord over these levels shows a hyperintense signal on the T2 Weighted images which suggests cord edema/ischemia.
Extension of the soft tissue lesion into the pre and paravertebral regions over the D5 to D8 vertebral levels is also noted. There is involvement of the costo-vertebral joints at the D6 and D7 vertebral levels. The anterior longitudinal ligament appears lifted away from the lesion.
The D5 vertebral body appears hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. The D7-D8 intervertebral disc is unremarkable. Involvement of the posterior elements of the D5 and D6 vertebrae is noted. There is destruction of the cortical endplates anteriorly, of the D5 vertebra (inferior endplate) and D6 vertebra (superior endplate) with involvement of the D5-D6 intervertebral disc.
The rest of the visualized dorsal vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.
Screening T1 Weighted sagittal images of the cervical and lumbar spines reveal hypointense signal involving the C5, L1, L3, S1 and S2 vertebral bodies.
Near complete collapse of the D6 and D7 vertebral bodies with involvement of the intervening disc with a soft tissue lesion in that region most likely represents osteitis with discitis probably tuberculous in etiology. Prevertebral, paravertebral and anterior epidural soft tissue lesion represents granulation tissue/abscess. There is resultant cord compression and cord signal alteration suggesting cord edema/ischemia over the D5 to D8 vertebral levels. Altered signal of the C5, L1, L3, S1 and S2 vertebral bodies may also represent osteitis.
The possibility of this lesion representing a neoplasm like a round cell tumor seems less likely.