Date : 00.00.00
Name of the Patient : Abc Xyz Almn / M / 62 yrs.
Referred by : Dr. Abc Xyzodak.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
C/O backache with paresthesias in BUE since 4-5 months.
M.R.I of the dorsal 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 evidence of destruction of the left sided pedicle, transverse process and the left lamina of the D5, D6 and D7 vertebrae. There is an ill-defined, hypointense signal on the T1 Weighted images involving the left postero-lateral segment of the D5, D6 and D7 vertebral bodies, the left pedicle, transverse process and lamina of these vertebrae and the head and neck of the left fifth, sixth and seventh ribs. These lesions appear hyperintense on the T2 Weighted images. There is an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the left paravertebral and left posterior paraspinal region extending over D5 to D7 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. There is extension of the soft tissue lesion into the posterior and left lateral epidural space over the D5 and D6 vertebral levels, with cord compression. The cord at the D5 and D6 levels shows a hyperintense signal on the T2 Weighted images which suggests cord edema/ischemia/myelitis. The soft tissue lesion is also seen to extend into the left neural foramen at the D5-D6 and D6-D7 levels.
Suspicious hypointense signal on the T1 Weighted images is seen in the D3 and D4 vertebral bodies.
The visualized dorsal intervertebral discs show loss of water content.
The rest of the visualized dorsal vertebral bodies reveal normal signal intensity.
Screening T2 Weighted sagittal images of the cervical spine reveal posterior peridiscal osteophytes in the cervical region.
Destruction of the left sided pedicle, transverse process and the left lamina of the D5, D6 and D7 vertebrae with altered signal of the D5, D6 and D7 vertebral bodies, their apendages on the left and the head and neck of the left fifth, sixth and seventh ribs with altered signal as described most likely represents osteitis, probably tuberculous in etiology. Paravertebral and posterior epidural soft tissue lesion over these levels would represent granulation tissue/abscess. There is resultant cord compression and cord signal alteration suggesting cord edema/ischemia/myelitis.
The possibility of this lesion representing a neoplasm like a small cell tumor cannot be entirely excluded.