Name of the Patient : Abc Xyzvi A. Ylmn / F / 28 yrs.
Referred by : Dr. Abc Xyztel.
Examination : M.R.I. of the Cervical Spine.
CLINICAL PROFILE :
C/O neck pain radiating to the RUE with weakness of BUE and BLE (right more than left) since 15 days.
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.
There is near complete collapse of the C6 vertebral body with posterior displacement. The C5 vertebral body is decreased in height.
Areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted and Fast Scan (T2 *) images are seen to involve the C5, C6 and C7 vertebral bodies and pedicles.
There is extension of this pathologic process into the anterior epidural space over the C5 to C7 vertebral levels with resultant cord compression. The cord over these levels shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images (iso to hypointense to normal cord on the T1 Weighted images) which may represent cord edema/isclmn / Myelitis.
- 2 - Scan-00004
Also seen is extension into the pre and paravertebral soft tissues over the C2 to D2 levels. Bilateral, well-defined lesions which have a hypointense centre with a hyperintense rim on the T1 Weighted images and turn hyperintense, centrally with a hypointense rim on the Fast Scan (T2 *) images are noted in the paravertebral soft tissues over the C3-C4 to D1-D2 levels and would represent abscesses. The esophagus is compressed by the lesion over these levels.
The C5-C6 intervertebral disc is seen to be nearly obliterated with involvement by the pathologic process.
The rest of the cervical intervertebral discs show loss of water content.
The remaining cervical vertebral bodies show normal signal intensity.
The atlanto-axial region and the cervico-medullary junction are unremarkable.
The MRI features are suggestive of a pathologic process involving the C5, C6 and C7 vertebral bodies with cord compression, cord edema/ischemia/myelitis and soft tissue extensions as described. This most likely represents an infective process like tuberculosis.
The possibility of this representing a neoplastic process is less likely.