Name of the Patient : Abc Xyzli S. Glmn / F / 20 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorsal Spine.
CLINICAL PROFILE :
H/O fever with backache since 2 months.
C/O weakness of BLE with paresthesias since 8 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.
6 mm thick T1 Weighted coronal images.
The D6, D7 and D8 vertebral bodies appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. The D6-D7 intervertebral disc also seems to be involved by the pathology.
There is seen a right paravertebral, intermediate signal intensity soft tissue lesion on the T1 Weighted images extending over the D5 to the D8 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. The right sided costo-vertebral joints are involved at these levels. There is also extension of the soft tissue lesion into the anterior and right lateral epidural space over the D5 to D9 vertebral levels with resultant significant compression and displacement of the dorsal spinal cord posterior and to the left of the midline. The dorsal spinal cord over these levels shows a hyperintense signal on the T2 Weighted images suggesting cord edema/ischemia.
The rest of the visualized dorsal vertebral bodies reveal normal signal intensity. The D12-L1 intervertebral disc shows loss of water content whereas the remaining intervertebral discs show normal signal intensity. The facet joints are unremarkable.
The conus medullaris terminates at the L1-L2 level.
A right sided pleural effusion is noted.
Screening, T1 Weighted sagittal images of the lumbar spine reveal a hypointense signal in the L1 vertebral body postero-inferiorly and to the left of the midline.
Incidentally noted is splenomegaly.
Altered signal of the D6, D7 and D8 vertebral bodies and the D6-D7 intervertebral disc represents osteitis with discitis, most likely tuberculous in etiology. Right paravertebral and anterior epidural soft tissue lesion as described would represent granulation tissue/abscess. There is resultant significant cord compression over the D5 to D9 vertebral levels with cord signal alteration suggesting cord edema/ischemia.
The possibility of this lesion representing a neoplasm seems less likely.