Date : 00.00.00
Name of the Patient : Abc Xyzmesh Jalmn / M / 17 yrs.
Referred by : Dr. Abc Xyzhtekar.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
H/O tuberculous spine. On AKT since 3 months.
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 is replacement of the normal marrow of the L2 and L3 vertebrae by hypointnese areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. The cortical endplates adjacent to the L2-L3 intervertebral disc are breached with involvement of the L2-L3 disc. There is minimal bilateral paravertebral soft tissue extension at the L2 and L3 levels with involvement of the left psoas muscle over the L2 to L4 vertebral levels. The left posas muscle shows a subtle hyperintense signal on the T1 Weighted images which turns heterogeneously hyperintense on the T2 Weighted images and would represent abscess/granulation tissue.
The rest of the lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.
The conus medullaris terminates at the D12 level and the thecal sac terminates at the S1 level.
Similar altered signal intensity lesion is seen in the D11 vertebral body with prevertebral soft tissue extension.
The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
12.0 mm at L1-L2
14.0 mm at L2-L3
11.0 mm at L3-L4
9.0 mm at L4-L5
8.0 mm at L5-S1.
In a known C/O tuberculous spine, the MRI features of altered signal in the D11, L2 and L3 vertebral bodies and L2-L3 intervertebral disc with extensions as described suggests osteities with discitis with paravertebral abscess/granulation tissue.