Date : 00.00.00
Name of the Patient : Abc Xyz Jalmn / M / 40 yrs.
Referred by : Dr. Abc Xyzrikh.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
Alleged H/O vehicular accident 10-12 days back with backache, weakness of BLE and bladder involvement since then.
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.
FEW IMAGES SHOW PATIENT MOTION.
There is forward subluxation of the D12 over the L1 vertebral body with break in the pars interarticularis of the D12 vertebra bilaterally. A large pseudoposterior disc herniation is seen at the D12-L1 level with compression of the cord. The spinal cord at the D12 and L1 levels shows a hyperintense signal on the T2 Weighted images. This is isointense to normal cord on the T1 Weighted images suggestive of cord contusion/edema. The D12-L1 disc is seen to migrate superiorly, lying posterior to the D12 vertebral body.
There is disruption of the D12-L1 facet joints. Fluid is noted in the facet joints bilaterally (left more than right). Fracture of the transverse process, lamina and probably of the spinous process of D12 is noted.
Altered signal in the posterior paraspinal soft tissues over the D10 to D12 vertebral levels may represent soft tissue injury.
The visualized dorso-lumbar vertebral bodies and the intervertebral discs reveal normal signal intensity. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the L1 level.
Focal lesion in the right suprarenal region is of ? etiology and needs to be further evaluated.
In a known C/O trauma, the MRI features are suggestive of :
1. Forward subluxation of the D12 over the L1 vertebral body with break in the pars interarticularis of the D12 vertebra bilaterally.
2. A large pseudoposterior disc herniation at the D12-L1 level with cord compression and cord signal alteration at the D12 and L1 levels suggestive of cord contusion/
3. Disruption of the D12-L1 facet joints with fluid in the facet joints bilaterally (left more than right) and fracture of the posterior elements of D12.
4. Right suprarenal lesion needs to be further evaluated.