Date : 00.00.00
Name of the Patient : Abc Xyzer Jhilmn / M / 55 yrs.
Referred by : Dr. Abc Xyzidhwa.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
Alleged H/O fall 2 months back with backache since then.
Radiological features s/o ankylosing spondylitis.
M.R.I of the dorsal 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.
The cervical and lumbar spines were screened with 5 mm thick T1 Weighted sagittal images.
There is slight scoliosis of the dorsal spine with convexity to the left. The cervical and lumbar spines show loss of normal lordosis. All the vertebral bodies in the spinal axis except the D8 vertebral body show fatty marrow changes. Ankylosis of the costo-vertebral and costo-transverse joints and the facet joints in some places in the dorsal region is noted. The cervical discs show a hyperintense signal on the T1 Weighted images which may suggest calcification/ossification. There is slight loss of water content of some of the dorsal intervertebral discs.
The D8 vertebral body and appendages show a hypointense signal on the T1 Weighted images which appears heterogeneously hyperintense on the T2 Weighted images. The D7-D8 and D8-D9 intervertebral discs appear intact. There is minimal soft tissue lesion noted in the prevertebral and paravertebral spaces at the D8 vertebral level (this may be an extension of the vertebral body itself). There is no cord compression.
Anterior peridiscal osteophytes are noted in the dorsal region. Slight facetal hypertrophy is noted at the D8-D9 level.
The visualized dorsal spinal cord reveals normal signal intensity.
The conus medullaris terminates at the D12-L1 level.
In a known C/O ankylosing spondylitis :
1. There is evidence of fatty marrow changes of all the vertebrae except for the D8 vertebra. Ankylosis of the costo-vertebral and costo-transverse joints and the facet joints in some places is noted. Calcification/ossification of the cervical discs is noted. Loss of normal lordosis of the cervical and lumbar vertebrae is noted.
2. Altered signal of the D8 vertebra is not specific for a single etiology. This may be post-traumatic in etiology, (previous h/o trauma superimposed on an ankylosed spine, with features of osteoporosis).
Osteitis and a neoplastic etiology should however be excluded.