Date : 00.00.00
Name of the Patient : Abc Xyzt V. Klmn / M / 25 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
H/O fever 1 month back with backache and paresthesias in BLE (right more than left) since then.
M.R.I of the dorsal spine was performed using the following parameters :
4 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 by hypointense areas on the T1 Weighted images involving the D11 and D12 vertebral bodies. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. The D11-D12 intervertebral disc is involved with a breach in the inferior and superior cortical endplates aspect of the D11 and D12 vertebral bodies, respectively. There is pre and paravertebral soft tissue extension over the D11 and D12 levels with involvement of the costo-vertebral and costo-transverse joints at the D11-D12 and D12-L1 levels. Bilateral antero-lateral epidural extensions are noted over the D10-D11 to D12 levels. There is resultant compression of the spinal cord at the D11 and D12 levels. The spinal cord over the D10 to the D12 levels shows a hyperintense signal on the T2 Weighted images. This is isointense to cord on the T1 Weighted images and would represent cord edema/ischemia/myelitis. There is also encasement of the exiting nerve roots at the D11-D12 level bilaterally.
The rest of the visualized dorsal vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.
The conus medullaris terminates at the L1 level.
The cervico-dorsal spine was screened with 4 mm thick T2 Weighted sagittal images and which does not reveal any diagnostic feature of note.
The MRI features are suggestive of altered signal in the D11 and D12 vertebral bodies, D11-D12 intervertebral disc with extensions as described and cord compression at the D11 and D12 levels with cord signal alteration over the D10 to D12 levels suggesting cord edema/ischemia/myelitis. This most likely represents a granulomatous infective process like tuberculosis.
The possibility of a neoplastic process like a round cell tumor seems less likely.