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Date : 00.00.00 Name of the Patient : Abc Xyz lmn / F / 25 yrs.Referred by : Dr. Abc Xyzmpat. Examination : M.R.I. of the Cervical Spine.CLINICAL PROFILE : H/O pulmonary kochs in September 0000. AKT taken irregularly for 1 year. Developed cervical lymphadenopathy in October 0000. Cervical lymphadenectomy done. Subsequently developed headaches and abnormal behaviour in March 0000. For follow-up.EXAMINATION :
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.
4 mm thick T1 Weighted sagittal images were obtained in flexion and extension.
There is atlanto-dens subluxation with the atlanto-dens interval measuring 5.0 mms in the neutral position. The peridental fat shows an ill-defined, hypointense signal on the T1 Weighted images which turns hyperintense on the T2 Weighted and Fast Scan (T2 *) images. On the flexion images, the atlanto-dens interval measures approximately 5.0 mms and on the extension images the atlanto-dens interval is approximately 3.0 mms. Minimal posterior disc bulges are noted at the C3-C4 and C4-C5 levels. Scan-00007

The cervical vertebral bodies and intervertebral discs reveal normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.The cervical spinal cord reveals normal signal intensity. There is no cord compression.The cervico-medullary junction is unremarkable.IMPRESSION :
1. Mobile atlanto-dens subluxation.
2. Altered signal in the peridental soft tissue may represent granulation tissue/fibrous tissue.
As compared to the previous MRI (study no:0000/4) dated 10/00.00.00, there is near complete resolution of the soft tissue in the right paravertebral region. The signal change in the right lateral mass of C1 and left lateral mass of C2 has also nearly resolved. Signal change in the peridental soft tissue represents granulation/fibrous tissue. There is no increase in the degree of the atlanto-dens subluxation.

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