Date : 00.00.00
Name of the Patient : Abc Xyzn Salmn / F / 11 yrs.
Referred by : Dr. Abc Xyzar.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache since 1 month.
M.R.I of the lumbo-sacral 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 left lateral wedging of the L4 vertebral body. Areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted images are seen to involve the L4 vertebral body and both pedicles.
There is extension of this pathologic process into the pre and paravertebral soft tissues over the L3 to L5 vertebral levels. Also seen is extension into the anterior epidural space over the L4 to L5 vertebral levels and encroachment into the L4-L5 neural foramina bilaterally.
There appears to be enlarged lymph nodes in the lumbar prevertebral region.
The L4-L5 intervertebral disc shows loss of water content.
The rest of the lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.
The conus medullaris terminates at the L1 level and the thecal sac terminates at the S2 level.
The MRI features are suggestive of a pathologic process involving the L4 vertebral body with extensions as described is not specific for a single diagnosis. The differential diagnosis would include :
1. Infective processes like tuberculosis.
2. Neoplastic processes like small cell tumors.