Name of the Patient : Abc Xyzi Ganglmn / F / 70 yrs.
Referred by : Dr. Abc Xyzhashur.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
Known C/O sarcoidosis with backache
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 loss of water content of the lumbar intervertebral discs and reduction in height of the L1-L2, L2-L3 and L3-L4 discs. Evidence of a vacuum phenomena/calcium is noted in the L1-L2 to L4-L5 intervertebral discs.
There is Grade I spondylolisthesis of the L4 over the L5 vertebra without obvious spondylolysis.
There is a posteriorly herniated disc at the L4-L5 level with bilateral neural foraminal narrowing.
A right far lateral disc herniation is noted at the L5-S1 level indenting the extraforaminal segment of the right L5 nerve root.
A right paracentral protruded disc with peridiscal osteophytes is seen at the L3-L4 level with right neural foraminal narrowing.
Left and right lateral postero-lateral disc bulges with peridiscal osteophytes are noted at the L1-L2 and L2-L3 levels.
Hypertrophic facetal arthropathy is seen at the L5-S1 level on the right and at the L4-L5 and L3-L4 levels bilaterally. Ligamentum flavum hypertrophy is noted at the L3-L4 and L4 levels.
The L4 vertebral body is slightly wedged anteriorly and shows an ill-defined hypointense signal on the T1 Weighted images in its right half. This lesion appears hyperintense on the T2 Weighted images. Herniation of the L3-L4 intervertebral disc into the body of the L4 vertebra is noted.
The L5 vertebral body shows spotty fatty marrow changes. Type II degenerative marrow changes are noted adjacent to the L2-L3 disc.
The rest of the lumbar vertebral bodies reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the L1 level and the thecal sac terminates at the S2 level.
The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
13.0 mm at L1-L2
13.0 mm at L2-L3
8.0 mm at L3-L4
11.0 mm at L4-L5
12.0 mm at L5-S1.
The T1 Weighted sagittal images of the dorsal spine do not reveal any significant feature of note.
- 3 - Scan-00006
1. Grade I spondylolisthesis of the L4 over the L5 vertebra without obvious spondylolysis.
2. A posteriorly herniated disc at the L4-L5 level.
3. A right far lateral disc herniation at the L5-S1 level indenting the extraforaminal segment of the right L5 nerve root.
4. A right paracentral protruded disc with peridiscal osteophytes at the L3-L4 level.
5. Left and right lateral postero-lateral disc bulges with peridiscal osteophytes at the L1-L2 and L2-L3 levels.
6. Hypertrophic facetal arthropathy at the L5-S1 level on the right and L4-L5 and L3-L4 levels bilaterally with ligamentum flavum hypertrophy at the L3-L4 and L4 levels.
7. Slight anterior wedging of the L4 vertebral body with altered signal as described is not specific for a single etiology. These changes may represent Type I degenerative marrow changes or may represent a ? infective, ?? neoplastic lesion (considering the age of the patient), or may be post-traumatic in etiology.
8. Lumbar canal stenosis at the L2-L3, L3-L4 and L4-L5 levels.