Reason: r/o osteomyelitis History: fever, back pain MRI thoracic spine:At T10-T11 there is loss of vertebral body height, irregularity of the endplates and heterogeneous signal within the disk space as well as marrow replacement within the vertebral bodies and posterior elements. There is epidural extension of disk material associated with the compression of the thecal sac and mild compression of the spinal cord. There is a CT of the abdomen study from 7/16/14 which indicates that the endplates were intact at that time. There is a peri-vertebral infiltration present.The thoracic vertebral bodies are appropriate in the overall alignment. The thoracic spinal cord has normal signal characteristics and overall morphology. There is no compromise of thoracic spinal canal or exiting nerve roots. No abnormal enhancing lesions are appreciated in the thoracic spine.Lumbar spine:Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact.No abnormal enhancing lesions are appreciated in the lumbar spine.At L5-S1 there is no significant compromise to spinal canal or neural foramina.At L4-5 there is no significant compromise to spinal canal or neural foramina.At L3-4 there is no significant compromise to spinal canal or neural foramina.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.
1.Findings are compatible with diskitis and osteomyelitis at T10-T11 associated with epidural extension and some mild compression of the spinal cord. There is both the anterior and posterior element involvement associated with compression deformities of T10 and T11. Post-contrast imaging of the thoracic spine may help further assess the extent of involvement.2.Exam is somewhat limited due to inability on for the patient to tolerate the exam.3.Findings were discussed with Dr Pulimi at the time of this interpretation at approximately 9:40 a.m.