Name of the Patient : Abc Xyznath Salmn / M / 18 yrs.
Referred by : Dr. Abc Xyzar.
Examination : M.R.I. of the Cervical Spine.
CLINICAL PROFILE :
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 T2 Weighted axial images.
5 mm thick T1 Weighted coronal images.
Areas which are hyperintense to normal muscle but hypointense to fat on the T1 Weighted images are seen to involve the anterior arch and lateral mass of the C1 vertebra, the right lateral mass, body and odontoid process of the C2 vertebra and both occipital condyles. These are hyperintense on the T2 Weighted images.
The odontoid process is displaced to the right, with the periodontoid space also being involved. The atlanto-dens interval is seen to measure approximately 2.5 mms.
There is extension of this pathologic process into the prevertebral soft tissues over the C1 to C4 vertebral levels and paravertebral soft tissues over the C1 to C2-C3 levels. There is also extension into the anterior and right lateral epidural space over the C1 and C2 levels.
The clivus appears to be involved and inflammatory changes are seen within the sphenoid sinus.
A small psotero-central disc herniation is noted at the C5-C6 level.
The C3-C4, C4-C5 and C5-C6 intervertebral discs show loss of water content.
Enlarged cervical lymph nodes are also noted.
The rest of the cervical vertebral bodies and the remaining intervertebral discs show normal signal intensity. The joints of Luschka are unremarkable.
The cervical spinal cord reveals normal signal intensity.
The cervico-medullary junction is unremarkable.
The MRI features are suggestive of a pathologic process involving the atlanto-axial region with soft tissue extension as described. This most likely represents an infective process like tuberculosis. The possibility of this being a neoplastic process is less likely.