hs/sb/nl/rg.
Name of the Patient : Abc Xyzamlmn / M / 15 yrs.
Referred by : Dr. Abc Xyzar.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
C/O backache with radiation of pain to BLE.
O/E swelling over the mid and lower back.
H/O fever. Patient is on AKT since 15 days.
EXAMINATION :
M.R.I of the dorso-lumbar spine was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
10 mm thick T1 Weighted and T2 Weighted axial images.
The lumbar and cervical spines was screened with 4 mm thick T2 Weighted sagittal images.
OBSERVATION :
Areas of hyperintensity on the T2 Weighted images are seen to involve the L2 and L3 vertebral bodies and the L2-L3 intervertebral disc. This pathologic process is seen to extend into the pre and paravertebral soft tissues over the D12 to atleast the L3 vertebral levels with involvement of the psoas muscles (left more than right). This lesion is hypointense on the T1 Weighted images and turns hyperintense on the T2 Weighted images and would represent an abscess. This lesion is seen to extend into the left paraspinal region and into the subcutaneous soft tissues over the back on the left side. This subcutaneous lesion is seen to extend from the L2 upto the D5 vertebral levels.
The visualized dorsal vertebral bodies and intervertebral discs reveal normal signal intensity.
The conus medullaris terminates at the L2 level.
No cord compression or cord signal alteration is noted on this study.
IMPRESSION :
The MRI features are suggestive of a pathologic process involving the L2 and L3 vertebrae and the L2-L3 intervertebral disc with a large abscess in the posterior left subcutaneous soft tissues over the L2 to D5 vertebral levels. This most likely represents an infective process like tuberculosis.