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Name of the Patient : Abc Xyz P. Vakchlmn / M / 22 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O weakness of BUE (left more than right) and the LLE since 1 1/2 years with inability to lift the RUE since 8 months.

EXAMINATION :

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.

OBSERVATION :

There is loss of water content of the cervical intervertebral discs.

There is scoliosis of the cervical spine with convexity to the right. Resultant anti-clockwise rotational anomaly of the cervical vertebrae is noted.

There is partial occipitalization of the atlas with the atlanto-dens interval measuring approximately 4.0 mm in the neutral position.

There is probable congenital block C2/C3 vertebra with fusion of the posterior elements and the C4 vertebra is as marked on the film.

There is continuous ossification of the posterior longitudinal ligament over the C3-C4 to the C5-C6 disc levels.
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Small posterior disc herniations are noted at the C3-C4, C4-C5 and the C5-C6 levels indenting the cervical spinal cord anteriorly. A small, right postero-lateral disc herniation is also noted at the C3-C4 level with right neural foraminal narrowing.

The cervical spinal cord over the C3 to C6 vertebral levels appears smaller in calibre and shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images suggesting myelomalacic changes.

The pedicles of the cervical vertebrae appear congenitally short in their antero-posterior dimensions. The facet joints in the cervical region appear hypertrophied.

The cervical vertebral bodies show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.

The cervico-medullary junction is unremarkable.

Screening, T2 Weighted sagittal images of the dorsal spine do not reveal any significant feature of note.

IMPRESSION :

1. Scoliosis of the cervical spine with convexity to the right with resultant anti-clockwise rotational anomaly of the cervical vertebrae.

2. Partial occipitalization of the atlas with the atlanto-dens interval measuring approximately 4.0 mm in the neutral position.

3. Probable congenital block C2/C3 vertebra.

4. Continuous ossification of the posterior longitudinal ligament over the C3-C4 to the C5-C6 disc levels.
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5. Small posterior disc herniations at the C3-C4, C4-C5 and the C5-C6 levels.

6. A small, right postero-lateral disc herniation at the C3-C4 level with right neural foraminal narrowing.

7. Atrophy of the cervical spinal cord over the C3 to C6 vertebral levels with altered signal which suggests myelomalacic changes.

8. Congenitally short pedicles of the cervical vertebrae in their antero-posterior dimensions.

9. Facetal hypertrophy in the cervical region.




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