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Name of the Patient : Abc Xyzhalfan Al-Slmn / M / 60 yrs
Referred by : Dr. Abc Xyzmani.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain with radicular pain in BLE with quadriparesis since 6 months.
H/O tuberculosis in the cervical region, detected in August 0000. No AKT taken.
H/O fall 5 months back.

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 mild basilar invagination with atlanto-dens subluxation. The atlanto-dens distance measures approximately 9.0 mms. The tip of the odontoid process is seen to indent the cervico-medullary junction which is reduced in its antero-posterior dimension. The cervico-medullary junction and the cervical spinal cord at the C2 vertebral level shows a hyperintense signal on the T2 Weighted images which is isointense to the normal cord on the T1 Weighted images suggestive of cord edema/ischemia/myelomalacia.

There is fusion of the C3 and C4 vertebral bodies with fatty marrow changes.

Small postero-central disc herniations are noted at the C2-C3, C4-C5, C5-C6, C6-C7 and C7-D1 levels with posterior peridiscal osteophytes indenting the anterior aspect of the thecal sac and mild bilateral neural foraminal narrowing.
..2/.




- 2 - Scan-00009


Ligamentum flavum hypertrophy is noted in the cervical region, with a tight canal.

Intermediate signal intensity is seen in the lateral masses of the atlas and the paravertebral/periodontoidal soft tissues on the T1 Weighted images which are seen to turn heterogeneously hyperintense on the T2 Weighted images and may represent residual inflammatory chlmn / Fibrous tissue.

There is wedging of the C5, C6 and C7 vertebral bodies and the remaining cervical vertebral boides show fatty changes.

The cervical intervertebral discs show loss of water content.

The joints of Luschka at the C4-C5, C5-C6 and C6-C7 levels show degenerative changes.

IMPRESSION :

The MRI features are suggestive of :

1. Mild basilar invagination with atlanto-dens subluxation
with the atlanto-dens distance measuring approximately 9.0 mms.

2. Altered signal in the cervico-medullary junction and the cervical spinal cord at the C2 vertebral level suggestive of cord edema/ischemia/myelomalacia.

3. Small postero-central disc herniations at the C2-C3, C4-C5, C5-C6, C6-C7 and C7-D1 levels with posterior peridiscal osteophytes.

4. Altered signal in the lateral masses of the atlas and the paravertebral/periodontoidal soft tissues may represent residual inflammatory changes/fibrous tissue.

5. Wedging of the C5, C6 and C7 vertebral bodies with fatty changes in the cervical vertebral bodies suggestive of osteoporosis.




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