sb/bv/nl/rg.
Name of the Patient : Abc Xyz Khedalmn / F / 45 yrs.
Referred by : Dr. Abc Xyzapadia.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
C/O backache with loss of appetite and weight and fever.
EXAMINATION :
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.
OBSERVATION :
There is partial collapse of the D12 vertebral body which shows a pathological fracture. The D11, D12 and L1 vertebral bodies appear hypointense on the T1 Weighted images and heterogeneously hyperintense on the T2 Weighted images. The D11-D12 and D12-L1 intervertebral discs also appear more hyperintense on the T2 Weighted images. There appears to be destruction of the cortical endplates of the D12, inferior endplate of D11 and superior cortical endplate of L1.
There is seen an intermediate signal intensity mass lesion on the T1 Weighted images in the prevertebral and paravertebral regions, extending over the D11 to L4 vertebral levels. This lesion appears hyperintense on the T2 Weighted images. The psoas muscles are involved by this lesion, bilaterally. There is extension of the soft tissue lesion into the anterior epidural space over the D11 to L1 vertebral levels, with thecal sac compression and indentation of the conus medullaris. Involvement of the pedicles of the D11, D12 and L1 vertebrae is also noted.
The lower dorsal spinal cord, however, shows normal signal intensity.
The L2, L3 and L5 vertebral bodies and the right iliac bone also show similar signal intensity changes.
The conus medullaris terminates at the D12 level.
Incidentally noted is a mild hepatosplenomegaly.
IMPRESSION :
Partial collapse of the D12 vertebral body (with fracture) with altered signal of the D11, D12 and L1 vertebral bodies and the D11-D12 and D12-L1 intervertebral discs most likely represents osteitis with discitis, probably tuberculous in etiology. Pre and paravertebral and anterior epidural soft tissue lesion would represent an abscess. There is resultant mild indentation of the conus medullaris without change in signal intensity.
Altered signal is also noted in the L2, L3 and L5 vertebral bodies and right iliac bone.
The possibility of the above described lesions representing a neoplasm is less likely.