Date : 00.00.00
Name of the Patient : Abc Xyz Nalmn / F / 12 yrs.
Referred by : Dr. Abc Xyzshi.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
C/O backache since 2 months and weakness of BLE with bladder/bowel involvement since 2 days.
H/O paraspinal abscess since 6 months. On AKT.
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.
There is near complete collapse of the D7 vertebral body with resultant retropulsion and compression upon the spinal cord at this level. The cord at this level shows a hyperintense signal on the T2 Weighted images suggestive of cord edema/isclmn / Myelitis. Also seen is a resultant kyphus at this level.
Areas of hypointensity on the T1 Weighted images which turn heterogeneously hyperintense on the T2 Weighted images are seen to involve the D6, D7 and D8 vertebral bodies (with slight involvement of the D9 and D10 vertebral bodies). Also seen is involvement of the D6 to D9 pedicles bilaterally and the right pedicle of the D10 vertebra. The D6-D7 and D7-D8 intervertebral discs are also involved.
There is extension of the pathologic process into the anterior epidural space over the D6 to D8 vertebral levels and into the pre and left paravertebral soft tissues over the D5 to D8 vertebral levels. Also seen is extension into the right paravertebral soft tissues over the D5 to D10 vertebral levels.
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The D6 to D10 ribs on the right side are involved with presence of a right sided pleural effusion (? loculated).
The rest of the visualized dorsal vertebral bodies and remaining intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.
The conus medullaris terminates at the L1 level.
The MRI features are suggestive of an infective process involving the D6 to the D10 vertebrae and the D6-D7 and D7-D8 intervertebral discs with near complete collapse of the D7 vertebral body with cord compression and cord edema/isclmn / Myelitis as described. This most likely represents tuberculosis.
The possibility of this being a neoplastic process like a round cell tumor is less likely.