Date : 00.00.00
Name of the Patient : Abc Xyz Khlmn / F / 10 yrs.
Referred by : Dr. Abc Xyzar.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
H/O fall 4-5 years back.
C/O swelling over the back with weakness of BLE with bladder/bowel involvement since 6 months.
M.R.I of the dorso-lumbar spine was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and T2 Weighted axial images.
There is evidence of an acute kypho-scoliotic deformity in the dorso-lumbar region with the apex of the kyphus at the D12-L1 level. Slight wedging of the D12 and L1 vertebral bodies is noted.
There is seen an intraspinal (most likely epidural), intermediate signal intensity mass lesion on the T1 Weighted images extending over the D9-D10 disc level upto the L2 vertebral level. This lesion appears relatively hypointense on the T2 Weighted images and is located in the posterior epidural space. There is resultant compression and anterior displacement of the lower dorsal spinal cord over these levels. The dorsal spinal cord over the affected levels appears to be slightly hyperintense to the normal cord on the T2 Weighted images. Slight widening of the spinal canal is noted at the D9, D10 and D11 vertebral levels, with scalloping of the right postero-lateral margin of these vertebrae. There is extension of the lesion through the left neural foramen at D11-D12, D12-L1 and L1-L2 levels into the left paravertebral soft tissues at these levels.
The rest of the visualized lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the L1-L2 level.
1. An acute kypho-scoliotic deformity in the dorso-lumbar region with the apex of the kyphus at the D12-L1 level.
2. An intraspinal (most likely epidural) mass lesion extending over the D9-D10 disc level upto L2 vertebral level and through the neural foramen as described is not specific for a single etiology. The differential diagnosis would include :
a. A nerve sheath tumor.
b. Meningioma less likely.
c. An organized inflammatory lesion ? of tuberculous etiology less likely.
3. Cord compression with cord signal alteration over the D9-D10 disc level to the L1 vertebral level.