Name of the Patient : Abc Xyz Plmn / F / 27 yrs.
Referred by : Dr. Abc Xyzhta Trust.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
C/O backache with fever.
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 partial collapse of the D9 vertebral body. The D9 and D10 vertebral bodies and pedicles appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. The D9-D10 intervertebral disc is reduced in height and appears slightly more hyperintense as compared to normal. Similar signal intensity change is noted in the antero-superior quadrant of the D11 vertebral body.
There is an intermediate signal intensity, soft tissue lesion on the T1 Weighted images in the prevertebral, paravertebral and anterior epidural region at the D9 and D10 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. Resultant mild indentation on the dorsal spinal cord at the D9-D10 level is noted.
The D12 vertebral body is slightly wedged, anteriorly with fatty marrow changes. The D11-D12 intervertebral disc shows slight loss of water content.
The rest of the visualized dorso-lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The right sided facet joint at the D10-D11 level is slightly hypertrophied.
The conus medullaris terminates at the L1-L2 level and the thecal sac terminates at the S2 level.
Screening, T1 Weighted sagittal images of the lumbar spine reveal a small postero-central disc protrusion at the L4-L5 level with slight facetal hypertrophy at that level.
1. Partial collapse of the D9 vertebral body with altered signal of the D9, D10 and D11 vertebrae and the D9-D10 intervertebral disc most likely suggests osteitis with discitis, probably tuberculous in etiology. Prevertebral, paravertebral and anterior epidural soft tissue lesion would represent granulation tissue/abscess.
The possibility of this lesion representing a neoplasm seems less likely.
2. Slight anterior wedging of the D12 vertebral body with subtle fatty marrow changes may either be the sequelae of previous trauma or may be the result of an old infection.