Name of the Patient : Abc Xyzn Plmn / F / 83 yrs.
Referred by : Dr. Abc Xyzauhan.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O radicular pain in the LLE with tingling since 3 days.
Alleged H/O fall 20 days back.
M.R.I of the lumbo-sacral spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted sagittal images.
The sacrum was studied with 5 mm thick T1 Weighted and STIR coronal images and 5 mm thick T1 Weighted and T2 Weighted axial images.
There is loss of water content of the lumbar intervertebral discs. There is slight forward translation of the L4 over the L5 vertebra.
There is a small posterior disc herniation at the L4-L5 level with anterior indentation of the thecal sac, bilateral neural foraminal narrowing, facetal hypertrophy and tight lumbar canal.
Posterior disc bulges are seen at the L3-L4 and L5-S1 levels.
The sacrum appears hypointense on the T1 Weighted images and shows a hyperintense signal on the T2 Weighted and STIR images. There is no evidence of pre and paravertebral soft tissues at this level. Both the sacro-iliac joints are spared by the pathology. A hypointense area is seen in the right iliac bone, posteriorly (Scans 105.8 & 106.8), which turns hyperintense on the T2 Weighted images. There is slight angular kyphus at the S2-S3 level.
The lumbar vertebral bodies reveal normal signal intensity. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the L1 level and the thecal sac terminates at the L5-S1 level.
The MRI features are suggestive of :
1. Slight forward translation of the L4 over the L5 vertebra.
2. A small posterior disc herniation at the L4-L5 level with bilateral neural foraminal narrowing, facetal hypertrophy and tight lumbar canal at this level.
3. Altered signal within the sacrum and right iliac bone, posteriorly, represents bone bruise, the result of previous trauma.
The possibility of an inflammatory or a neoplastic lesion is less likely.