sb/ke/rg/nl

Name of the Patient : Abc Xyzda Patwarlmn / F / 61 yrs.
Referred by : Dr. Abc Xyzahane.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE with difficulty in walking and sitting.

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 an ill-defined, hypointense signal on the T1 Weighted images in the L2 and L3 vertebral bodies adjacent to the L2-L3 disc. This signal remains predominantly hypointense on the T2 Weighted images. Irregularity of the cortical endplate adjacent to the L2-L3 disc is noted. The L2-L3 intervertebral disc shows loss of water content.

There is a posteriorly bulging disc with posterior peridiscal osteophytes at the L2-L3 level indenting the dural theca anteriorly. Right paravertebral soft tissue lesion is noted at the L2 and L3 vertebral levels which is of intermediate signal on the T1 Weighted images and hyperintense on the T2 Weighted images.

A small, right postero-lateral protruded disc with peridiscal osteophytes is noted at the L5-S1 level.


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A posterior and right postero-lateral disc bulge with peridiscal osteophytes is noted at the L4-L5 level with right neural foraminal narrowing.

Slight facetal hypertrophy is seen at the L4-L5 and L5-S1 levels.

The rest of the lumbar vertebral bodies show spotty fatty marrow changes.

The remaining intervertebral discs reveal loss of water content. The rest of the facet joints and the visualized prevertebral soft tissues are unremarkable.

The conus medullaris terminates at the L1 level and the thecal sac terminates at the S1 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
10.0 mm at L2-L3
17.0 mm at L3-L4
14.0 mm at L4-L5
9.0 mm at L5-S1.

IMPRESSION :

1. Altered signal in the L2 and L3 vertebral bodies adjacent to the L2-L3 disc most likely represent osteitis. Right paravertebral soft tissue lesion at that level may represent granulation tissue/abscess. A tuberculous etiology may be considered.

2. A small, right postero-lateral protruded disc with peridiscal osteophytes at the L5-S1 level.
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3. A posterior and right postero-lateral disc bulge with peridiscal osteophytes at the L4-L5 level with right neural foraminal narrowing.

4. A posteriorly bulging disc with posterior peridiscal osteophytes at the L2-L3 level.

5. Slight facetal hypertrophy at the L4-L5 and L5-S1 levels.