Date : 00.00.00
Name of the Patient : Abc Xyzm Z. lmn / F / 18 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to BLE with paresthesias since 1 1/2 years.
H/O fever +.
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 near complete collapse of the D11 vertebral body with wedging of the D9, D10 and D12 vertebral bodies and an angular kyphus at these levels.
There is replacement of the normal marrow of the D6, D7, D8, D9, D10, D11 and D12 vertebral bodies by hypointense areas on the T1 Weighted images. This is seen to turn heterogeneously hyperintense on the T2 Weighted images. The cortical endplates of the D12, D11, D10, D9 and the D7 vertebral bodies are breached with involvement of the D9-D10, D10-D11, D11-D12 and D7-D8 intervertebral discs. There is pre and paravertebral soft tissue extension over the D5 to D12 levels, right more than left. A small, extrapleural collection is noted at the D9 and D10 levels on the left side which is slightly hypointense to the muscle on the T1 Weighted images and turns hyperintense on the T2 Weighted images and would represent an abscess formation.
There is anterior epidural extension over the D9 to D11 vertebral levels with indentation upon the cord.
The visualized dorsal spinal cord shows normal signal intensity.
The rest of the visualized dorso-lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.
The conus medullaris terminates at the L2 level.
Near complete collapse of the D11 vertebral body with wedging of the D9, D10 and D12 vertebral bodies, angular kyphus at these levels, altered signal of the D6, D7, D8, D9, D10, D11 and D12 vertebral bodies, the D9-D10, D10-D11, D11-D12 and D7-D8 intervertebral discs with extensions as described and an abscess formation at the D9 and D10 levels is most probbaly due to a granulomatous infective process like tuberculosis.
The possibilitiy of this being a round cell tumor cannot be entirely ruled out, though less likely.