Date : 00.00.00
Name of the Patient : Abc Xyzi Ablmn / M / 82 yrs.
Referred by : Dr. Abc Xyzgaonkar.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
H/O acute onset paraplegia.
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.
Areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted images are seen to involve the D8 and D9 vertebral bodies and pedicles. Also seen is involvement of the D8-D9 intervertebral disc with erosion of the adjacent cortical endplates.
There is extension of this pathologic process into the pre and paravertebral soft tissues and anterior epidural space at the D8 and D9 vertebral bodies. There is cord compression at these levels. The cord at these levels show a hyperintense signal on the T2 Weighted images suggestive of cord edema/isclmn / Myelitis. The D8-D9 costo-vertebral joints are also involved.
There is encroachment of this pathologic process into the D8-D9 neural foramina bilaterally.
The rest of the visualized dorsal vertebral bodies show areas of fatty replacement of normal marrow suggestive of osteoporotic changes.
The cervical spine was screened with 4 mm thick T2 Weighted sagittal images and shows degenerative changes with cord compression at the C3-C4 and C4-C5 levels with probable cord signal alteration (edema/ischemia).
The MRI features are suggestive of osteitis with discitis involving the D8 and D9 vertebrae and the D8-D9 intervertebral disc with cord compression and cord edema/ischemia/myelitis as described. This is most likely tuberculous in etiology.
The possibility of this being a neoplastic process though less likely cannot be entirely excluded.