Date : 00.00.00
Name of the Patient : Abc XyzedIlmn / M / 60 yrs.
Referred by : Dr. Abc Xyzbar.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
C/O weakness of BLE with paresthesias since 2 months.
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.
Hyperintense signal is seen within the dorsal spinal cord, centrally, from the D11 level upto the C3 vertebral level. This is iso to hypointense to normal cord on the T1 Weighted images with a definite hypointense punctate area over the D4 to D7 vertebral levels. The CSF space is unremarkable.
Facetal arthropathy/capsular ligament hypertrophy is noted at the D7-D8, D9-D10, D10-D11 levels with indentation upon the posterior and postero-lateral aspect of the thecal sac.
The visualized dorso-lumbar intervertebral discs show loss of water content.
Few dorsal vertebral bodies show focal fatty change.
The rest of the visualized dorso-lumbar vertebral bodies reveal normal signal intensity. The remaining facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the L1 level and the thecal sac terminates at the S1 level.
Altered signal within the dorsal spinal cord, centrally, from the D11 level upto the C3 vertebral level is not specific for a single etiology. The differential diagnosis would include :
1. Myelitis (most likely).
2. Demyelination (less likely).
The possibility of cord ischemia seems unlikely.
Hypointense signal from the D4 to D7 levels may represent myelomalacic changes.