Date : 00.00.00
Name of the Patient : Abc XyzLakhlmn / F / 52 yrs.
Referred by : Dr. Abc Xyzdi.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
C/O backache since 3-4 months which has increased since 1 month,
with occasional tingling in the LLE.
M.R.I of the dorso-lumbar 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.
There is replacement of the normal marrow of the D12 and the L1 vertebral bodies by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. The pedicles of these vertebrae are involved by this pathologic process. There is prevertebral soft tissue extension over the D12 and L1 vertebral levels with involvement of the left psoas muscle at the L1 level which shows a hyperintense signal with a hypointense centre on the T1 Weighted images and turns hyperintense on the T2 Weighted images. Very minimal left antero-lateral epidural extension is seen at the D12-L1 and the L1 levels. The D12-L1 intervertebral disc is reduced in height and is also involved.
The rest of the visualized dorso-lumbar vertebral bodies and remaining intervertebral discs reveal normal signal intensity. The facet joints and the visualized paravertebral soft tissues are unremarkable.
The visualized dorso-lumbar spinal cord reveals normal signal intensity.
The conus medullaris terminates at the L1-L2 level.
Focal altered signal in the S1 body is ? Schmorls node, focal osteitis.
The MRI features are suggestive of a pathologic process involving the D12 and L1 vertebral bodies with extensions as described. This most likely represents an infective etiology like tuberculosis.
The possibility of this being a neoplastic process like small cell tumor cannot be entirely ruled out though less likely.