Date : 00.00.00
Name of the Patient : Abc XyzWaghalmn / M / 53 yrs.
Referred by : Dr. Abc Xyzhari.
Examination : M.R.I. of the Cervical Spine.
CLINICAL PROFILE :
C/O neckpain with pain radiating to all four extremities with paresthesias since 4 months.
H/O fall from a bicycle 4 months back.
M.R.I of the cervical spine was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.
The cervical intervertebral discs show loss of water content.
There is a suspicious hyperintense signal on the T2 Weighted images in the cervical spinal cord on the T2 Weighted sagittal images posterior to the C4 vertebra which probably represents a contusion/edema.
A postero-central disc protrusion is seen at the C6-C7 level with anterior indentation of thecal sac.
There are small posterior disc bulges with peridiscal osteophytes at the C3-C4 and C4-C5 levels with anterior indentation of the thecal sac.
The C3-C4 facet joint on the right side and the C4-C5 and C5-C6 facet joints bilaterally show degenerative changes.
The cervical vertebral bodies show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.
The atlanto-axial region and the cervico-medullary junction are unremarkable.
1. Probable signal alteration within the spinal cord at the C4 level which may represent a cord contusion/edema, in the given clinical setting.
2. A postero-central disc protrusion at the C6-C7 level.
3. Small posterior disc bulges with peridiscal osteophytes at the C3-C4 and C4-C5 levels.
4. Facetal arthropathy at the C3-C4 facet joint on the right side and bilaterally at the C4-C5 and C5-C6 levels.