Date : 00.00.00
Name of the Patient : Abc Xyz Shlmn / F / 24 yrs.
Referred by : Dr. Abc Xyzni.
Examination : M.R.I. of the Cervical Spine.
CLINICAL PROFILE :
C/O neckpain radiating to LUE/LLE more than RUE/RLE with paresthesias in the LUE and LLE.
M.R.I of the cervical spine was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.
There is replacement of the normal marrow of the left occipital condyle, both the lateral masses of the atlas, the C2 vertebra including the odontoid process by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted and Fast Scan (T2 *) images. There is pre and paravertebral (retropharyngeal) soft tissue extension from the level of the foramen magnum predominantly on the left side till the C4-C5 level. There is indentation upon the left postero-lateral aspect of the nasopharynx. This pathology is also seen to extend in between the odontoid process and the lateral mass of atlas bilaterally. Anterior epidural extension is seen from the level of the clivus upto the C2-C3 level. There is mild indentation upon the anterior aspect of the spinal cord upto the C1 and C2 levels. The
left vertebral artery appears to be partially encased by the pathology. However it shows normal flow void signal on all the pulse sequences. Slight indentation upon the right C1 and C2 nerve roots is noted. This lesion is slightly hyperintense to muscle on the T1 Weighted images and turns hyperintense on the Fast Scan (T2 *) images and would represent abscess formation.
The C2-C3 disc shows loss of water content.
The rest of the cervical vertebral bodies and the remaining intervertebral discs show normal signal intensity. The joints of Luschka are unremarkable.
Centimetre and subcentimetre lymph nodes are identified deep to the sternomastoid muscles bilaterally.
The cervical spinal cord reveals normal signal intensity.
The MRI features are suggestive of altered signal in the left occipital condyle, both the lateral masses of the atlas, the C2 vertebra including the odontoid process with soft tissue involvement as described is mot probably due to a granulomatous infective process like tuberculosis.
The possibility of a neoplastic process like a round cell tumor seems less likely.