Name of the Patient : Abc Xyzo Nilmn / M / 59 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to the LLE with paresthesias since 6 months.
H/O fall prior to this.
M.R.I of the dorso-lumbar spine was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and T2 Weighted axial images.
There is collapse with wedging of the D9 vertebral body. Also seen is anterior and central wedging of the D10 vertebral body.
There is retroplacement of the D9 and D10 vertebrae with resultant compression upon the cord. The cord over the D8 to D11 vertebral levels is hyperintense on the T2 Weighted images and this may represent cord edema/ischemia.
The D8, D9 and D10 vertebral bodies show a hypointense signal on the T1 Weighted images and which turns subtly hyperintense on the T2 Weighted images. The D8 and D9 pedicles are also involved as are the D8-D9 facet joints.
There is circumferential spread of the pathologic process at the D8 and D9 levels. The D8-D9 and D9-D10 costo-vertebral joints are also involved.
The visualized dorso-lumbar intervertebral discs show loss of water content.
- 2 - Scan-00004
A hemangioma with fat content (hyperintense on all pulse sequences) is seen within the D11 vertebral body.
The rest of the visualized dorso-lumbar vertebral bodies reveal normal signal intensity. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the L1 level.
The MRI features are suggestive of collapse of the D9 vertebral body and anterior and central wedging of the D10 vertebral body with cord compression and cord edema/ischemia/contusion as described.
The possibilities to be considered are,
2. Infective process like tuberculosis.
3. Neoplasia like secondaries or small cell tumors.