Date : 00.00.00
Name of the Patient : Abc Xyza Shlmn / F / 19 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.
CLINICAL PROFILE :
C/O neckpain since 3-4 months and loss of appetite.
M.R.I of the cervical spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.
There is replacement of the normal marrow of the C2, C3, C4, C5, D1 and D2 vertebral bodies by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted and Fast Scan (T2 *) images. The C3-C4 and C4-C5 discs are involved by the pathology. A large pre and paravertebral soft tissue lesion which is of intermediate signal intensity with a peripheral hyperintense rim on the T1 Weighted images is seen extending over the C1 to the D2 vertebral levels predominantly on the left side. There is compression upon the oropharynx and larynx. This lesion is seen to turn hyperintense on the T2 Weighted images and would represent abscess formation. There is anterior epidural extension over the C2 to C5 vertebral levels with compression of the spinal cord and encroachment into the left neural foramen over the C2-C3 to C4-C5 levels. The spinal cord shows normal signal intensity.
The rest of the cervical vertebral bodies and the remaining intervertebral discs show normal signal intensity. The joints of Luschka are unremarkable.
The atlanto-axial region and the cervico-medullary junction are unremarkable.
A congenital, block, D3/D4 vertebra is noted.
The MRI features are suggestive of granulomatous infective lesion like tuberculosis involving the C2, C3, C4, C5, D1 and D2 vertebral bodies, C3-C4 and C4-C5 intervertebral discs with a fairly large pre and paravertebral abscess extending over the C2 to D2 vertebral levels as described. Anterior epidural extension of the abscess is noted over the C2 to C5 vertebral levels with mild cord compression.