Date : 00.00.00
Name of the Patient : Abc Xyzkumar Jailmn / M / 15 yrs.
Referred by : Dr. Abc Xyzilotri.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to BLE since 6-7 months.
M.R.I of the dorso-lumbar 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 is collapse of the D12 and L4 vertebral bodies which shows hypointense signal on the T1 Weighted images and turns heterogeneously hyperintense on the T2 Weighted images.
The spinous process of the L4 and L5 vertebrae appear destroyed and show intermediate signal intensity to muscle on the T1 Weighted images and are heterogeneously hyperintense on the T2 Weighted images. There is extension into the paraspinal soft tissue over the L3 to S1 levels. There is slight extension into the posterior epidural region over the L3 to the L5 levels with anterior displacement and compression of the thecal sac. There is minimal left paravertebral soft tissue extension at the L3-L4 and L4 levels.
Hyperintense signal in the L2 vertebral body on the T2 Weighted images may represent a hemangioma.
The visualized lower dorsal spinal cord reveals normal signal intensity.
The conus medullaris terminates at the L1 level and the thecal sac terminates at the S1 level.
The cervico-dorsal spine was screened with 4 mm thick T1 Weighted sagittal images which shows collapse of the D1 and D3 vertebral bodies with slight anterior wedging of the D9 vertebral body. These are hypointense on the T1 Weighted images. The right D9 pedicle is also involved.
Altered signal of the D1, D3, D9, D12, L4 and L5 vertebrae with soft tissue extensions as described is not specific for a single etiology.
The differential diagnosis would include :
1. Small cell tumors.
2. Multiple metastases.
3. Multifocal tuberculosis though less likely cannot be excluded.