Name of the Patient : Abc Xyzlmn / F / 10 yrs.
Referred by : Dr. Abc Xyzarmar.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to BLE with weakness since 10 days.
H/O ? pus aspiration from the right elbow and right side of back.
M.R.I of the lumbo-sacral spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and T2 Weighted axial images.
There are ill-defined hypointense areas in the erector spinae group of muscles on the right side extending over the L3 to the S2 verteral levels on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. Few small hypointense areas are seen within this lesion on the T1 Weighted images which turn hyperintense on the T2 Weighted images and would represent abscess formation (? cold abscess).
The left lamina of the S1 and the spinous process show a hypointense signal on the T1 Weighted images which turn hyperintense on the T2 Weighted images.
A small posterior epidural collection is identified extending from the L1 to the L3 levels, L4-L5 disc level and L5 vertebral levels.
The remaining lumbar vertebral bodies, appendages and the intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the L1-L2 level and the thecal sac terminates at the S2 level.
The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
15.0 mm at L1-L2
14.0 mm at L2-L3
11.0 mm at L3-L4
12.0 mm at L4-L5
10.0 mm at L5-S1.
Altered signal in the left lamina and spinous process of S1, with small posterior epidural collection as described and small abscesses in the erector spinae muscle on the right side extending over the L3 to the S2 verteral levels is infective in etiology (probably tuberculous in origin).