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Name of the Patient : Abc Xyzkumar Almn / M / 65 yrs.
Referred by : Dr. Abc Xyzavsar.
Examination : M.R.I. of the Dorso-lumbar Spine.

CLINICAL PROFILE :

Alleged H/O fall 2 months ago with pain in the back since then.

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.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

The D9 and the superior half of the D10 vertebral bodies appear hypointense on the T1 Weighted images and heterogeneously hyperintense on the T2 Weighted images. The left pedicle of D10 and both the pedicles of the D9 vertebra show similar signal intensity changes. The D9-D10 intervertebral disc shows loss of water content. No obvious break in the cortical endplates adjacent to the D9-D10 disc is noted (marginal osteophytes are noted adjacent to the D9-D10 disc anteriorly).

There is a generalized bulge of the D9 and D10 vertebral bodies. Hypertrophic facetal arthropathy is noted at the D9-D10 level, more pronounced in the right facet joint. Right sided facet joint effusion is also noted. Suspicious fracture of the left sided transverse process of the D10 vertebra is noted.

Fusion of the posterior margin of the D11 and D12 vertebral bodies, to the right of the midline is noted, with involvement of the D11-D12 intervertebral disc, which is reduced in height.
Scan-00004


The rest of the visualized dorso-lumbar vertebral bodies show spotty fatty marrow changes. The visualized dorso-lumbar intervertebral discs show loss of water content. The remaining facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The visualized lower dorsal spinal cord reveals normal signal intensity.

The conus medullaris terminates at the L1 level.

Screening, T1 Weighted sagittal images of the lumbo-sacral spine reveals hypertrophic facetal hypertrophy at the L4-L5 level, bilaterally.

IMPRESSION :

1. Altered signal in the D9 and D10 vertebral bodies is not specific for a single etiology. This most likely is post-traumatic in etiology, superimposed on osteoporotic vertebrae. The possibility of an infective or a neoplastic etiology seems less likely.

2. Hypertrophic facetal arthropathy at the D9-D10 level, more pronounced in the right facet joint with right sided facet joint effusion.

3. Suspicious fracture of the left sided transverse process of the D10 vertebra.

4. Fusion of the posterior margin of the D11 and D12 vertebral bodies, to the right of the midline is noted, with involvement of the D11-D12 intervertebral disc, is either due to previous trauma or the sequelae of previous osteitis with discitis.