ke/hs/rg.
Date : 00.00.00
Name of the Patient : Abc Xyzar Mohd. Slmn / M / 5 yrs.
Referred by : Dr. Abc Xyzdi.
Examination : M.R.I. of the Cervical Spine.
CLINICAL PROFILE :
C/O stiffness of the neck since 6 weeks.
Alleged H/O fall prior to this.
EXAMINATION :
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.
4 mm thick T1 Weighted and Fast Scan (T2 *) coronal images.
OBSERVATION :
There is replacement of the normal marrow of the anterior arch and both the lateral masses of the atlas, odontoid process and the C2 vertebral body 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 soft tissue extension of this lesion over the C1 to the C4 vertebral levels. This is slightly hyperintense to normal muscle on the T1 Weighted images and turns more hyperintense on the T2 Weighted and Fast Scan images and may represent abscess formation. Minimal lateral epidural extension on the right side is noted at the C2 level.
The rest of the cervical vertebral bodies and the intervertebral discs show normal signal intensity.
The cervical spinal cord reveals normal signal intensity.
The cervico-medullary junction is unremarkable.
Incidental note is made of enlarged deep cervical group of lympnodes bilaterally.
IMPRESSION :
The MRI features are suggestive of a pathologic process involving the C1 and C2 vertebrae with extensions as described. This most likely represents a granulomatous infective process (? tuberculosis).
The possibility of this being a neoplastic process like a round cell tumor is less likely.