ke/hs/rg.
Date : 00.00.00
Name of the Patient : Abc Xyz I. Khalmn / F / 40 yrs.
Referred by : Dr. Abc Xyzni / Dr. Abc Xyzhijwala.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to the LLE since 1 year.
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 a posterior disc herniation, more to the right of the midline at the L5-S1 level with anterior indentation of the thecal sac and slight right neural foraminal narrowing. Slight inferior migration of the disc is noted with indentation upon the traversing right S1 nerve root. This disc shows loss of water content. The L5-S1 facet joints show mild degenerative changes.
Type II degenerative changes are noted in the lumbar vertebral bodies. There is a suggestion of hemangioma in the L2 vertebral body (hyperintense on all the pulse sequences).
The remaining intervertebral discs reveal normal signal intensity. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the L2 level and the thecal sac terminates at the S3 level.
Scan-00001
The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
15.0 mm at L1-L2
16.0 mm at L2-L3
12.0 mm at L3-L4
11.0 mm at L4-L5
18.0 mm at L5-S1.
IMPRESSION :
The MRI features are suggestive of a posterior disc herniation, more to the right of the midline at the L5-S1 level with slight inferior migration of the disc and indentation upon the traversing right S1 nerve root.