Date : 00.00.00
Name of the Patient : Abc XyzShlmn / F / 50 yrs.
Referred by : Dr. Abc Xyzbar.
Examination : M.R.I. of the Cervical Spine.
CLINICAL PROFILE :
Alleged H/O vehicular accident 3 months back with neckpain since then.
C/O weakness of BUE and BLE since 1 month.
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 loss of normal cervical lordosis and loss of water content of the cervical intervertebral discs.
There is collapse of the C4 vertebral body which is retropulsed. The C4 vertebral body and its appendages appear hypointense to normal marrow on the T1 Weighted images and appear iso to hyperintense to the rest of the vertebrae on the T2 Weighted and Fast Scan (T2 *) images. The appendages of the C4 vertebra appear expansile. There is resultant cord compression at C4. The cervical spinal cord at this level appears hyperintense on the T2 Weighted and Fast Scan (T2 *) images suggesting cord edema/ischemia. The C3-C4 and C4-C5 intervertebral discs do not seem to be involved by the lesion. A right paravertebral and right posterior paraspinal soft tissue component of the lesion is noted over the C4 and C5 vertebral levels, with encasement of the right vertebral artery over these levels.
The rest of the cervical vertebral bodies show normal signal intensity. The joints of Luschka are unremarkable.
The atlanto-axial region and the cervico-medullary junction are unremarkable.
Collapse of the C4 vertebral body with altered signal of the C4 body and its appendages as described is not specific for a single etiology. A metastasis/round cell tumor may be considered as a differential diagnosis. The possibility of an infective etiology seems less likely. There is resultant cord compression and cord signal alteration at the C4 vertebral level suggesting cord edema/ischemia.