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Date : 00.00.00

Name of the Patient : Abc Xyznlmn / F / 23 yrs.
Referred by : Dr. Abc Xyzinde.
Examination : M.R.I. of the Cervico-dorsal Spine.

CLINICAL PROFILE :

C/O sudden onset of paraparesis of BLE and weakness of BUE since 15 days.
C/O backache since 7-8 months.

EXAMINATION :

M.R.I of the cervico-dorsal spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

7 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is collapse of the D3 vertebral body with retropulsion
with a small angular kyphus at that level. There is replacement of the normal marrow of the D2, D3 and D4 vertebral bodies by hypointense areas on the T1 Weighted images which are seen to turn heterogeneously hyperintense on the T2 Weighted images. The D2-D3 and D3-D4 invertebral discs are also involved. There is pre and paravertebral soft tissue extension over the D1-D2 to D4-D5 levels which shows slight hyperintense signal on the T1 Weighted images with few areas of hypointensity. This is seen to turn heterogeneously hyperintense on the T2 Weighted images
and would represent abscess/granulation tissue. Anterior epidural extension is seen over the D2 to D4 vertebral levels with severe compression of the spinal cord with subtle hyperintense signal on the T2 Weighted images over these levels. There is encroachment of the pathologic process into the D2-D3 and D3-D4 neural foramina bilaterally with encasement of the exiting nerve roots.


Subtle altered signal is also seen in the C5, D9 and D10 vertebral bodies.

The rest of the visualized cervico-dorsal vertebral bodies and intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.

Incidental note is made of gravid uterus.

IMPRESSION :

The MRI features are suggestive of altered signal of the D2, D3, D4, C5, D9 and D10 vertebrae with soft tissue extensions with cord compression and cord edema/ischemia/myelitis as described. This most likely represents a granulomatous infective process like tuberculosis.

The possibility of this being a neoplastic process like a small cell tumor is less likely.

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