Date : 00.00.00
Name of the Patient : Abc Xyzbegum Shlmn / F / 50 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to BLE and paresthesias.
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.
The L4 vertebral body is decreased in height and is seen to bulge posteriorly with indentation upon the thecal sac. It shows areas of hypointensity on the T1 Weighted images, a few of which turn mildly hyperintense on the T2 Weighted images. Few linear hypointensities on all the pulse sequences are also seen within this vertebral body and these may represent compressed trabeculae. There is erosion of the inferior cortical endplate with involvement of the L4-L5 intervertebral disc. The intranuclear cleft is not clearly identified. Few areas with similar signal characteristics are seen to involve the L5 vertebral body.
There is extension of this pathologic process into the anterior epidural space and paravertebral soft tissues over the L3-L4 to L4-L5 levels. Also seen is encroachment into the L4-L5 neural foramina with encasement of the exiting L4 nerve roots bilaterally.
The L4-L5 facet joints show degenerative changes.
The rest of the lumbar intervertebral discs show loss of water content.
The rest of the lumbar vertebral bodies reveal normal signal intensity. The remaining facet joints and the visualized prevertebral soft tissues are unremarkable.
The conus medullaris terminates at the L1 level and the thecal sac terminates at the S1-S2 level.
Screening of the dorsal spine reveals no significant feature of note.
The MRI features are suggestive of a pathologic process involving the L4 and L5 vertebrae and the L4-L5 intervertebral disc as described. This may represent an infective process like tuberculosis.
The possibility of this being a neoplastic process seems less likely.