Date : 00.00.00
Name of the Patient : Abc Xyz V. Dilmn / M / 16 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache since 2-3 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 L1 and the L2 vertebral bodies by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. The cortical endplates adjacent to the L1-L2 intervertebral disc are breached with involvement of the L1-L2 disc also. There is minimal pre and paravertebral soft tissue extension at the L1 and L2 levels.
A sliver of anterior epidural extension is noted at the L2 level.
A small postero-central disc protrusion is seen at the L5-S1 level. This disc shows loss of water content.
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 L1 level and the thecal sac terminates at the S1 level.
The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
18.0 mm at L1-L2
17.0 mm at L2-L3
18.0 mm at L3-L4
16.0 mm at L4-L5
14.0 mm at L5-S1.
The MRI features are suggestive of altered signal of the L1 and L2 vertebral bodies and the L1-L2 intervertebral disc with minimal soft tissue extension as described. This most likely represents osteitis with discitis, most likely tuberculous in etiology.
The possibility of this being a neoplastic process like a round cell tumor is considered less likely.