Name of the Patient : Abc Xyz Glmn / F / 30 yrs.
Referred by : Dr. Abc Xyzrikh.
Examination : M.R.I. of the Cervical Spine.
CLINICAL PROFILE :
C/O neck pain since 20 days.
H/O left Ca breast 2 years back. Being operated for the same and received Radiotherapy and Chemotherapy.
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 coronal images.
Areas of intermediate signal intensity on the T1 Weighted images which turn mildly hyperintense on the T2 Weighted and Fast Scan (T2 *) images are seen to involve the left lateral mass of the C1 and C2 vertebrae, the left occipital condyle and the odontoid process and the body of the C2 vertebra. Subtle involvement is also seen in the C3 and C4 vertebral bodies.
There is extension of this pathologic process into the periodontoid space and into the pre and paravertebral soft tissues over the C1 to C3 levels. There is encasement of the left vertebral artery over these levels. There is mild extension into the anterior epidural space over the C1 to C3 levels with resulant indentation upon the thecal sac.
The cervical intervertebral discs show mild loss of water content.
Small posterior disc bulges with peridiscal osteophytes are noted at the C4-C5, C5-C6 and C6-C7 levels.
The rest of the cervical vertebral bodies show normal signal intensity. The joints of Luschka are unremarkable.
The MRI features are suggestive of a pathologic process involving the atlanto-axial region and the C3 and C4 vertebral bodies as described. This is not specific for a single etiology. The possibility to be considered are,
1. Infective process like tuberculosis.
2. Neoplasia like secondaries, especially in the given clinical setting.