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Name of the Patient : Abc Xyzen Plmn / F / 65 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neckpain radiating to BUE (left more than right) with paresthesias.

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.

3 mm thick T1 Weighted and T2 Weighted (with fat saturation) coronal images.

OBSERVATION :

There is reduction in height and loss of water content of the cervical intervertebral discs.

There is partial occipitalization of the posterior arch of the atlas. Slight lateral subluxation of the C1 vertebra over the C2 vertebra is noted with the tip of the odontoid process slightly more to the left of the midline. The anterior arch of C1 is not fused in the midline.

There is an ill-defined, hyperintense signal on the T1 Weighted images in the left lateral mass of the C1 and C2 vertebrae. This signal appears hypointense when compared to normal marrow on the T1 Weighted images. Minimal fluid is noted in the left sided atlanto-axial joint at the C1-C2 level. Marginal osteophytosis is also noted in this region. There is no pre or paravertebral soft tissue lesion identified. The periodontal soft tissues on the right show a subtle hyperintense signal on the Fast Scan (T2 *) images.
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Posterior disc bulges with posterior peridiscal osteophytes are noted at all the cervical disc levels (C2-C3 to C6-C7 levels), maximum at the C3-C4 and C6-C7 levels. Slight ligamentum flavum hypertrophy is noted at these levels.

Degenerative changes of the joints of Luschka are noted at the C3-C4, C4-C5, C5-C6 and C6-C7 levels, bilaterally.

Slight facetal hypertrophy is noted at the C3-C4 level on the left and at the C4-C5 level on the right.

The rest of the cervical vertebral bodies show spotty fatty marrow changes. The visualized pre and paravertebral soft tissues are unremarkable.

The cervical spinal cord reveals normal signal intensity.

The cervico-medullary junction is unremarkable.

IMPRESSION :

1. Partial occipitalization of the posterior arch of the atlas with slight lateral subluxation of the C1 vertebra over the C2 vertebra.

2. Altered signal in the left lateral mass of the C1 and C2 vertebrae with minimal fluid in the left sided joint at the C1-C2 level and marginal osteophytosis in this region may be due to degenerative changes. The possibility of a low grade osteitis cannot be entirely excluded, though less likely.

3. Posterior disc bulges with posterior peridiscal osteophytes at all the cervical disc levels (C2-C3 to C6-C7 levels), maximum at the C3-C4 and C6-C7 levels.

4. Degenerative changes of the joints of Luschka at the C3-C4, C4-C5, C5-C6 and C6-C7 levels, bilaterally with slight facetal hypertrophy at the C3-C4 level on the left and at the C4-C5 level on the right.




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