Name of the Patient : Abc XyzHlmn / F / 21 yrs.
Referred by : Dr. Abc Xyzshar / Dr. Abc Xyzgarwala.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
H/O purulent discharge from the right side of low back since December 0000. Detected to have tuberculosis of the spine in the lower dorsal region.
Now C/O weakness of BLE since 4 days.
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.
The D7 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. Similar signal intensity changes are noted in the D8 vertebral body on the right and in the D11 vertebral body posteriorly and to the right of the midline. There is a large right paravertebral soft tissue lesion which is hypointense to 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 foramina 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.
- 2 - Scan-00008
The visualized dorsal spinal cord over the D8 to D10 vertebral levels shows a subtle hyperintense signal on the T2 Weighted images which suggests cord edema/ischemia/myelitis.
The rest of the visualized dorso-lumbar vertebral bodies and intervertebral discs reveal normal signal intensity.
The conus medullaris terminates at the L1 level.
There is a suggestion of a small opening in the subcutaneous region at the D12-L1 vertebral level on the right.
Altered signal in the D8 to D11 vertebral bodies with right paravertebral and epidural soft tissue lesion as described most likely represents osteitis, probably tuberculous osteitis. There is resultant cord compression over the D8 to D11 vertebral levels with cord signal alteration over the D8 to D10 vertebral levels suggesting cord edema/ischemia/myelitis.
As compared to the previous MRI (scan no:00007) dated 00.00.0000, there is involvement of the D8 and D11 vertebrae on the present study. There is slight increase in the anterior and right lateral epidural soft tissue lesion and slight increase in the degree of cord compression on the present study. Subtle cord signal alteration is noted over the D8 to D10 vertebral levels.