Name of the Patient : Abc Xyzh Palmn / M / 74 yrs.
Referred by : Dr. Abc Xyz. Patil.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
C/O backache since 1 year.
M.R.I of the dorso-lumbar 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 is slight anterior wedging of the D12 vertebral body.
The D12, L1 and L2 vertebral bodies appear hypointense on the T1 Weighted images and show a subtle hyperintense signal on the T2 Weighted images. The D12-L1 intervertebral disc is reduced in height and also appears hyperintense on the T2 Weighted images which would be suggestive of its involvement.
There is a fairly large, prevertebral and paravertebral intermediate signal intensity soft tissue lesion on the T1 Weighted images extending over the D12 to L3 vertebral levels and involving the psoas muscles bilaterally. This lesion appears hyperintense on the T2 Weighted images. There is extension of this soft tissue lesion into the neural foramina at the D12-L1 level bilaterally with encasement of the exiting nerve roots. Minimal extension of the soft tissue into the anterior epidural space is noted at the D12 and D12-L1 levels.
The rest of the visualized dorso-lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.
The visualized lower dorsal spinal cord reveals normal signal intensity.
The conus medullaris terminates at the L1 level.
Slight anterior wedging of the D12 vertebral body with altered signal of the D12, L1 and L2 vertebral bodies and the D12-L1 intervertebral disc as described most likely represents osteitis with discitis, probably tuberculous in etiology. Prevertebral and paravertebral soft tissue lesion over the D12 to L3 vertebral levels would represent abscesses (multiloculated).
The possibility of this being a neoplastic process is less likely.