Congenital talipes equinovarus. Evaluate for cord tethering, syrinx or Chiari malformation. Brain:The cerebral white-matter appears decreased in volume, especially centrally. There is asymmetric expansion of the posterior left lateral ventricle, which may reflect more pronounced white-matter volume loss or might be in part relate to normal variation. Anterior subarachnoid space prominence and ventricular prominence also in part likely relate to benign enlargement of subarachnoid spaces of infancy. Myelination is delayed for age. Otherwise, there is no definite parenchymal signal abnormality but there is diffuse thinning of the corpus callosum. There is no Chiari malformation. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.Complete spine: The study is limited by motion artifact. Mild broad-based rightward convex spinal curvature might be positional. Sagittal alignment is preserved. Note, the S1 is partially lumbarized which is a common variation. The vertebral bodies and intervertebral discs are unremarkable there is no significant narrowing of the spinal canal or the neural foramina. The spinal cord is of normal shape and signal, without a syrinx. The conus medullaris is normal in morphology and its tip lies at L2-L3 level which is normal. In prone positioning, there is appropriate ventral displacement of the nerve roots. Focal T2-hypointensity projecting anterior to the tip of the conus medullaris on axial T2-weighted imaging (image #14 of series #2801) with no definite abnormality on sagittal imaging or the other sequences is likely artifactual. There is no fat signal intensity in the distal thecal sac.The vitamin E capsule marker overlies the intergluteal cleft at S1-S2 level with no definite underlying soft tissue abnormality or posterior osseous defect. While the right testicle is in the scrotum, the left one is not, and might be undescended.
1.Cerebral white-matter volume is decreased along with findings of delayed myelination or hypomyelination, which are nonspecific findings.2.No Chiari malformation.3.Spine imaging shows no abnormality but is limited by motion artifact. There is no MR suggestion of cord tethering. Of note, S1 is partially lumbarized; if surgery is to be contemplated, correlation with imaging of the entire spine is recommended.4.Suggestion of undescended left testicle. Correlation with scrotal ultrasound is recommended.