Date : 00.00.00
Name of the Patient : Abc XyzMlmn / M / 32 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache radiating to the RLE since 1 month.
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 appears to be sacralization of the L5 vertebra and it is as marked on the film. Please correlate with plain radiographs.
There is mild forward translation of the L5 vertebra over the S1 vertebra. The L5-S1 intervertebral disc shows loss of water content.
A posterior disc bulge with small peridiscal osteophytes is noted at the L5-S1 level. There is a posterior disc bulge at the L4-L5 level.
There appears to be spina bifida at the L5 level.
The lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the D12 level and the thecal sac terminates at the S1 level.
- 2 - Scan-00009
The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
17.0 mm at L1-L2
17.0 mm at L2-L3
16.0 mm at L3-L4
14.0 mm at L4-L5
13.0 mm at L5-S1.
The sacro-iliac joints were screened with 5 mm thick STIR coronal images. Hyperintense signal is seen within the bones adjacent to the right sacro-iliac joint with involvement of the joint per se.
The MRI features are suggestive of :
1. Sacralization of the L5 vertebra and it is as marked on the film. Please correlate with plain radiographs.
2. Posterior disc bulges at the L4-L5 and L5-S1 levels
with small peridiscal osteophytes at the L5-S1 level.
3. Altered signal within the bones adjacent to the right sacro-iliac joint with involvement of the joint per se most likely represents sacro-ilitis. A dedicated study of the sacro-iliac joint may be worthwhile.