ke/hs/rg.
Name of the Patient : Abc Xyzhai lmn / M / 66 yrs.
Referred by : Dr. Abc Xyz Jhaveri.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
Alleged H/O fall 15 days back.
C/O backache with weakness of the BLE and retention of urine (3 episodes) since 15 days.
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 and central wedging with a comminuted fracture of the L2 vertebral body. Hypointense areas on T1 Weighted images which are seen to turn heterogeneously hyperintense on the T2 Weighted images are seen in the L2 vertebral body and pedicles and would represent bone bruise/edema. The superior and inferior cortical endplates of the L2 vertebral body show a break. The L1-L2 and L2-L3 intervertebral discs appear slightly hyperintense on the T2 Weighted images and may represent edema. There is slight circumferential bulging of the L2 vertebral body.
Anterior wedging of the L1 vertebral body is also noted with fatty changes. Schmorls nodes are noted at its superior aspect.
Small posterior disc herniations are seen at the L4-L5 and L5-S1 levels.
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- 2 - Scan-00001
A left postero-lateral disc herniation is noted at the L3-L4 level.
Bilateral far lateral disc bulges are noted at the L3-L4 and L5-S1 levels.
A left paracentral disc herniation with peridiscal osteophytes is seen to indent the thecal sac at the D12-L1
level. Also seen is a posterior disc bulge with peridiscal osteophytes at the L1-L2 level.
The D12-L1, L3-L4, L4-L5 and L5-S1 intervertebral discs show loss of water content.
The L3-L4, L4-L5 and L5-S1 facet joints show mild degenerative changes. Ligamentum flavum hypertrophy is noted at the L4-L5 and L5 vertebral levels.
The lumbar vertebral bodies show areas of fatty replacement of normal marrow.
The visualized lower dorsal spinal cord and the conus show normal signal intensity
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 :
16.0 mm at L1-L2
17.0 mm at L2-L3
13.0 mm at L3-L4
14.0 mm at L4-L5
13.0 mm at L5-S1.
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- 3 - Scan-00001
IMPRESSION :
In known a C/O trauma, the MRI features are suggestive of :
1. Anterior and central wedging with a comminuted fracture of the L2 vertebral body with bone bruise/edema as described (The possibility of this being superimposed upon a pathologic process cannot be entirely excluded).
2. Small posterior disc herniations at the L4-L5 and L5-S1 levels.
3. A left paracentral disc herniation with peridiscal osteophytes at the D12-L1 level.
4. A left postero-lateral disc herniation at the L3-L4 level.
5. Mild facetal arthropathy at the L3-L4, L4-L5 and L5-S1
levels with ligamentum flavum hypertrophy at the L4-L5 and L5 vertebral levels.