Date : 00.00.00
Name of the Patient : Abc Xyz Kandlmn / F / 24 yrs.
Referred by : Dr. Abc Xyzonawalla.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
C/O backache with paresthesias in the LLE since 1 1/2 months.
Also H/O fever since 15 days.
M.R.I of the dorsal spine was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
6 mm thick T1 Weighted and T2 Weighted axial images.
There is wedging of the D8 vertebral body. There is replacement of the normal marrow of the D5, D6 and the D8 vertebral bodies by hypointense areas on the T1 Weighted images. The pedicles of these vertebrae bilaterally and the spinous process of the D6 and D7 vertebrae also appear to be involved. There is slight pre and paravertebral soft tissue extension over the D4-D5 to the D8-D9 levels. Anterior and left lateral epidural extension is seen at the D6 and D7 levels. Circumferential epidural extension is noted at the D5 and D6 levels. A small extrapleural lesion is noted on the left side at the D4-D5 level which is hypointense on the T1 Weighted images and turns hyperintense on the T2 Weighted images. Minimal soft tissue extension into the left paraspinal muscles is seen over the D2 to D4 levels.
Probable involvement of the D5-D6 and D7-D8 intervertebral discs is noted.
The rest of the visualized dorsal vertebral bodies and remaining intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.
The visualized dorsal spinal cord over the D4 to D7 vertebral levels reveals a subtle hyperintense signal on the T2 Weighted images suggesting cord edema/ischemia.
The conus medullaris terminates at the D12-L1 level.
The MRI features are suggestive of altered signal of the D5, D6 and D8 vertebral bodies with extensions as described. This most likely represents an infective etiology like tuberculosis. Prevertebral, paravertebral and epidural soft tissue lesion may represent granulation tissue/abscess. Altered cord signal may represent cord edema/ischemia.
The possibility of this being a neoplastic process like round cell tumor is less likely.