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Date : 00.00.00

Name of the Patient : Abc Xyzroop lmn / M / 56 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O backache since 1 month.

EXAMINATION :

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.

The cervical spine was screened with 4 mm thick T2 Weighted sagittal images.

OBSERVATION :

There is collapse of the D5 vertebral body with an angular kyphus at that level.

Hypointense areas are seen to replace the D5 vertebral body on the T1 Weighted images and is seen to remain predominantly hypointense on the T2 Weighted images. The pedicles are also involved by the pathology. There is slight pre and paravertebral soft tissue bulging of the vertebra. Right antero-lateral epidural extension is also seen at the D5 level which is seen to displace and compress the spinal cord to the left. The spinal cord at this level shows a hyperintense signal suggestive of cord edema/ischemia.

The visualized dorsal and the lumbar vertebral bodies show hypointense areas replacing the normal marrow on the T1 Weighted images which are iso to hyperintense to the normal marrow on the T2 Weighted images.

The dorsal intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.
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Rib/pleural lesions are seen on the right side at the D4, D5 and D6 levels.

The conus medullaris terminates at the L1-L2 level.

The cervico-dorsal spine was screened with 4 mm thick T2 Weighted sagittal images which show degenerative changes and changes in the marrow as described above.

IMPRESSION :

The MRI features are suggestive of collapse of the D5 vertebral body with extensions as described and altered signal intensity of the visualized spinal axis is not specific for a single etiology.

The possibilities to be considered are,

1. Multiple metastasis.

2. Round cell tumor like multiple myeloma.

3. Multifocal tuberculosis (less likely).
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