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Name of the Patient : Abc XyzHlmn / F / 21 yrs.
Referred by : Dr. Abc Xyzshar.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

C/O purulent discharge from the right side of low back since 1 1/2 months.

EXAMINATION :

M.R.I of the dorso-lumbar spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

6 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is sacralization of the L5 vertebra and the D11 vertebral body is as marked on the film.

There is replacement of the normal marrow of the D9 and D10 vertebral bodies by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. There is a large right paravertebral soft tissue lesion which is hypointense to the fat on the T1 Weighted images and turns heterogeneously hyperintense on the T2 Weighted images. This lesion is seen to extend from the D8 to the D12 vertebral levels. The costo-vertebral and the costo-transverse joints at the D8-D9, D9-D10 and D10-D11 levels are involved by the pathology. There is encroachment into the D8-D9, D9-D10 and D10-D11 neural foramen on the right side with encasement of the corresponding exiting nerve roots. Anterior and right lateral epidural extension is also seen over the D8 to D11 vertebral levels with compression and displacement of the cord, posteriorly and to the left. The paraspinal muscles on the right side over the D8 to the D12 vertebral levels on the right side are also involved.
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- 2 - Scan-00007

The rest of the visualized dorso-lumbar vertebral bodies and intervertebral discs reveal normal signal intensity. The facet joints and the visualized prevertebral soft tissues are unremarkable.

The visualized lower dorsal spinal cord reveals normal signal intensity.

The conus medullaris terminates at the L1 level.

There is suggestion of a small opening in the subcutaneous region at the L2-L3 vertebral level.

IMPRESSION :

The MRI features are suggestive of a pathologic process involving the D9 and D10 vertebral bodies with soft tissue extensions and cord compression as described. This most likely represents an infective process like tuberculosis.

The possibility of this being a neoplastic process like a round cell tumor is less likely.


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