Date : 00.00.00 Name of the Patient : Abc Xyz lmn / F / 26 yrs.Referred by : Dr. Abc Xyzmpat. Examination : M.R.I. of the Cervical Spine.CLINICAL PROFILE : H/O pulmonary kochs in September 0000. AKT taken irregularly for 1 year. Developed cervical lymphadenopathy in October 0000. Cervical lymphadenectomy done. Subsequently developed headaches and abnormal behaviour in March 0000. For follow-up.EXAMINATION :
M.R.I. of the cervical spine was performed using the following parameters :5 mm thick T1 Weighted and T2 Weighted sagittal images.5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.
4 mm thick T1 Weighted sagittal images were obtained in flexion and extension.
There is atlanto-dens subluxation with the atlanto-dens interval measuring 5.0 mms in the neutral position. The peridental fat shows a subtle ill-defined, hypointense signal on the T1 Weighted images which turns hyperintense on the T2 Weighted and Fast Scan (T2 *) images. On the flexion images, the atlanto-dens interval measures approximately 5.0 mms and on the extension images the atlanto-dens interval is approximately 1.0 mm. Minimal posterior disc bulge is noted at the C3-C4 level and a postero-central disc herniation is seen at the C4-C5 level.
The upper cervical intervertebral discs show loss of water content.
The cervical vertebral bodies and remaining intervertebral discs reveal normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.The cervical spinal cord reveals normal signal intensity. There is no cord compression.The cervico-medullary junction is unremarkable.IMPRESSION :
1. Mobile atlanto-dens subluxation.
2. Altered signal in the peridental soft tissue may represent granulation tissue/fibrous tissue.
As compared to the previous MRI (study no:00007) dated 00.00.00, there is near complete resolution of the soft tissue lesion in the atlanto-axial region and a postero-central disc herniation is seen at the C4-C5 level.