ke/sb/rg.

Name of the Patient : Abc XyzTulmn / M / 75 yrs.
Referred by : Dr. Abc XyzK. Jariwala.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O severe backache with pain radiating to BLE.
Alleged H/O fall.

EXAMINATION :

M.R.I of the lumbo-sacral 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.

OBSERVATION :

There is anterior wedging of the D12 vertebral body which shows hypointense areas replacing the normal marrow on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted images. A linear hypointense signal is seen along the superior cortical endplate on all the pulse sequences and would represent compressed trabeculae. There is posterior bulging of the D12 vertebral body with anterior indentation of the thecal sac. Slight bulging in the paravertebral soft tissues is also noted.

Small posterior disc bulges with peridiscal osteophytes are noted at the L3-L4 and L4-L5 levels. A right postero-lateral and far lateral disc herniation is noted at the L2-L3 level.

A small postero-central disc bulge is seen at the L5-S1 level.

Small posterior peridiscal osteophytes are noted at the L1-L2 and L2-L3 levels with anterior indentation of the thecal sac.

The L1-L2 and the L5-S1 intervertebral discs show loss of water content.
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There is anterior wedging of the L2, L3 and the L4 vertebra and the central wedging of the L5 vertebral body with fatty changes, probably osteoporotic in etiology.

The rest of the lumbar vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints in the lumbar region appear slightly hypertrophied.
The visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the L1 level and the thecal sac terminates at the S2 level.

The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

15.0 mm at L1-L2
15.0 mm at L2-L3
14.0 mm at L3-L4
16.0 mm at L4-L5
13.0 mm at L5-S1.

The dorsal spine was screened with the help of 5 mm thick T1 Weighted sagittal images which does not reveal any diagnostic feature of note.

IMPRESSION :

The MRI features are suggestive of :

1. Compression fracture of the D12 vertebral body as described, probably osteoporotic in etiology.

2. Small posterior disc bulges with peridiscal osteophytes at the L3-L4 and L4-L5 levels.

3. A right postero-lateral and far lateral disc herniation at the L2-L3 level.
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4. A small postero-central disc bulge at the L5-S1 level.

5. Small posterior peridiscal osteophytes at the L1-L2 and L2-L3 levels.

6. Anterior wedging of the L2, L3 and the L4 vertebra and the central wedging of the L5 vertebral body with fatty changes, are probably osteoporotic in etiology.