Date : 00.00.00
Name of the Patient : Abc Xyzumar S. Badilmn / M / 45 yrs.
Referred by : Dr. Abc Xyzrnad.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
H/O fall on 00.00.00 with weakness of BLE with bladder/bowel involvement for 2-3 days.
M.R.I of the dorsal spine was performed using the following parameters :
4 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 D3, D4 and D5 vertebral bodies by hypointense areas on the T1 Weighted images which are seen to turn heterogeneously hyperintense on the T2 Weighted images. The left pedicle of these vertebral bodies and the right pedicle of the D4 and D5 vertebral bodies are involved. There is pre and left paravertebral soft tissue extension over the D2-D3 to the D7 levels with involvement of the costo-vertebral and costo-transverse joints at the D4-D5 and D5-D6 levels. Left lateral epidural extension is seen over the D3 to D6 vertebral levels.
The rest of the visualized dorsal vertebral bodies and intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.
The visualized dorsal spinal cord reveals a subtle hyperintense signal on the T2 Weighted images over the D4 to D6 vertebral levels, suggesting cord edema/ischemia.
The conus medullaris terminates at the L2 level.
The lower dorsal spine and the lumbo-sacral spine show altered signal in the L5 vertebral body and an intermediate signal intensity lesion is noted in the right paravertebral soft tissue at the D10 level.
The MRI features are suggestive of altered signal of the D3, D4 and D5 vertebral bodies with pre and paravertebral and epidural soft tissue extensions as described. This most probably is due to a granulomatous infective process like tuberculosis.
The possibility of this being a neoplastic process like a round cell tumor or metastasis may be considered as differential diagnosis.
Altered cord signal over the D4 to D6 vertebral levels would suggest cord edema/ischemia.