Name of the Patient : Abc Xylmn / M / 13 yrs.
Referred by : Dr. Abc Xyzmat / Dr. Abc Xyzshi.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
C/O swelling over the dorso-lumbar region since childhood with backache and pain radiating to the RLE since 15 days.
M.R.I of the dorso-lumbar spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted (with and without fat saturation) sagittal images.
5 mm thick T1 Weighted and T2 Weighted axial images.
Vitamin E capsules were placed as markers at the site of swelling.
There is destruction of the spinous process of the L1 vertebra. In place, there is seen an approximately 3.2 x 2.0 cms sized intermediate signal intensity lesion on the T1 Weighted images in the posterior soft tissues in the midline at the L1 vertebral level, which appears hyperintense on the T2 Weighted images. Multiple, loculated, similar signal intensity lesions are noted in the subcutaneous tissues over the L1 to S1 vertebral levels, more to the left of the midline. There is no extension of these lesions into the spinal canal.
The visualized dorso-lumbar vertebral bodies and intervertebral discs reveal normal signal intensity. The facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
The visualized lower dorsal spinal cord reveals normal signal intensity.
The conus medullaris terminates at the L1-L2 level and thecal sac terminates at the S2-S3 level.
The MRI features are suggestive of a multiloculated lesion within the subcutaneous soft tissues over the L1 to S1 vertebral levels with destruction of the L1 spinous process. In view of the history, this may represent a hemangioma. However, similar features may also be seen with infective processes like tuberculosis.