Date : 00.00.00
Name of the Patient : Abc Xyzn Billmn / M / 55 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O neckpain radiating to the RUE.
C/O backache with pain radiating to the LLE.
H/O fever since 15 days.
M.R.I of the lumbo-sacral 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 by hypointense areas on the T1 Weighted images in the L5 vertebral body. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. The pedicles are also involved by the pathology. There is pre and paravertebral soft tissue extension at the L4 and L5 levels with probable involvement of the L4-L5 intervertebral disc, anteriorly. The psoas muscle at these levels on the left side shows a hyperintense signal on the T1 Weighted images suggestive of its involvement. Minimal anterior epidural extension is seen at the L5 level.
Small posterior disc herniations are seen at the L3-L4, L4-L5 and L5-S1 levels with anterior indentation of the thecal sac and slight neural foraminal narrowing bilaterally at these levels. The L3-L4, L4-L5 and L5-S1 intervertebral discs show loss of water content.
The L4-L5 and L5-S1 facet joints bilaterally show degenerative changes. The left facet joint at the L2-L3 level also shows degenerative changes.
Ligamentum flavum hypertrophy is noted at the L4-L5 and L5 levels.
The rest of the lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The rest of the facet joints are unremarkable.
The conus medullaris terminates at the L1 level and the thecal sac terminates at the S2 level.
The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
14.0 mm at L1-L2
14.0 mm at L2-L3
12.0 mm at L3-L4
8.0 mm at L4-L5
8.0 mm at L5-S1.
The dorsal spine was screened with 4 mm thick T1 Weighted sagittal images and which does not reveal any diagnostic feature of note.
The MRI features are suggestive of altered signal of the L5 vertebra with extensions as described. This may represents an infective process like tuberculosis or a neoplastic process like a round cell tumor or a secondary.