65 years Male (DOB:5/6/1951)Reason: History of metastatic RCC with new weakness and not able to ambulate. Please r/o cord compression as cause History: back pain, LE weakness, numbness/tinglingPROVIDER/ATTENDING NAME: ANITA KALLEPALLI MRI limited complete spine for cord compression:There are multiple foci of marrow replacement throughout the patient's spine. There is a compression fracture and present at L1 associated with obliteration of the right neural foramen of L1-2. There is mild narrowing of the spinal canal at that level.. There is narrowing of the spinal canal at the T9 and T10 levels due to an epidural based lesion.There are degenerative changes present in the cervical spine.The patient status post abdominal aortic aneurysm repair.MRI thoracic spine:There is an epidural-based lesion present at the T9 and T10 levels which encircles the spinal cord and obliterates spinal fluid surrounding the spinal cord. There is extension of this epidural based lesion through the neural foramina right T9-10 and T10-11 neural foramina to a lesser degree left T10-T11 neural foramen. There is marrow replacement within the T10 vertebral body.There is a T1 hyperintense well-circumscribed lesion present within the subcutaneous tissues behind the thoracic spine measuring 38 x 11 mm sagittal dimensions it is to the left of midline behind the left perivertebral musculature extends from the T6 level to the T8 level. This represents a subcutaneous lipoma.There is a right-sided pleural effusion present.
1.There is an epidural lesion present which circumferentially encases the spinal cord at the T9 andT10 levels which extends through the right T9-10 and T10-11 neural foramina and a left and T10-11 neural foramen.2.There is an L1 compression fracture present associated with some encroachment of the exiting nerve roots within the L1-2 neural foramina worse on the right side when compared to the left.3.There are multiple foci of marrow replacement throughout the visualized spine compatible with metastatic disease.4.There is a right pleural effusion present.5.At the time of dictation an alphanumeric page was sent to pager 9100 Dr Desai Parin and the findings were discussed.