hs/bv/nl/rg.
Date : 00.00.00
Name of the Patient : Abc Xyza M. Golmn / F / 86 yrs.
Referred by : Dr. Abc Xyzngsarkar.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache.
EXAMINATION :
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.
OBSERVATION :
There is probable sacralization of the L5 vertebra and the D11 vertebra is as marked on the film. Please correlate with plain radiographs.
Areas of hypointensity on the T1 Weighted images which turn heterogeneously hyperintense on the T2 Weighted images are seen to involve the L1 and L2 vertebral bodies and pedicles. The L1 vertebral body is decreased in height. The L1-L2 intervertebral disc is also involved with erosion of the adjacent cortical endplates. There is extension of this pathologic process into the anterior epidural space with thecal sac compression and into the pre and paravertebral soft tissues at the L1 and L2 vertebral levels. Also seen is encroachment into the L1-L2 neural foramina bilaterally and involvement of the psoas muscles at the L1 and L2 levels.
Areas with similar signal characteristics are seen to involve the L4 and L5 vertebral bodies on the right side and anteriorly with irregularity of the cortical end plate.
There is mild forward placement of the L4 vertebra over the L5 vertebra. A mild posterior disc bulge is noted at the L4-L5 level. The L4-L5 facet joints show degenerative changes. Also seen is ligamentum flavum hypertrophy at this level.
Mild facetal hypertrophy is noted at the L3-L4 level.
The rest of the lumbar intervertebral discs show loss of water content.
The visualized psoas and paraspinal muscles are atrophic.
The remaining facet joints are unremarkable.
The conus medullaris terminates at the D12-L1 level and the thecal sac terminates at the S2 level.
The cervico-dorsal spine was screened with 4 mm thick T1 Weighted sagittal images and does not show any significant feature of note.
IMPRESSION :
The MRI features are suggestive of a pathologic process involving the L1, L2, L4 and L5 vertebrae and the L1-L2 intervertebral disc with soft tissue extensions as described. This most likely represents an infective process like tuberculosis (less likely to represent a neoplastic process).
There appears to be sacralization of the L5 vertebra. Please correlate with plain radiographs.