 Previous scoliosis x-ray demonstrated levoscoliosis of the lower thoracic spine with a Cobb angle measuring 50 degrees as well as a compensatory dextroscoliosis at the thoracolumbar junction with a Cobb angle measuring 61 degrees.The patient's scoliosis is redemonstrated, as better demonstrated on the previous x-ray.There appear to be 13 rib bearing segmental units. Thus, C7 is presumed to be the upper-most level containing cervical ribs, and utilizing this nomenclature there are 6 lumbar type vertebral bodies. However, the presence of hemivertebrae as described below magnum are difficult. If a spinal procedure is contemplated, CT may be of benefit for better osseous interpretation.Multiple osseous dysplasias are present including:Narrowed vertebral bodies with partial fusion across C4, C5, C6, and C7.A large anterior bridging osteophyte at C7/T1.A very small left-sided hemivertebra at T2/3.Right lateral wedge deformity of T10.A small right-sided hemivertebra of L2.Foraminal stenoses are as follows:Moderate left neural foraminal stenosis at C4/5.Mild right neural foraminal stenosis at T2/3.The spinal cord is normal in signal throughout. The conus terminates at L2/3.There is a tiny focus of T1 hyperintensity in the region of the presumed filum (although the axial T1 is motion degraded)(best seen series 2801, image 25). This same region on axial T2 demonstrates a small hypointense focus with an inferiorly located linear hyperintense periphery, suggestive of chemical shift artifact, which can be seen from fat (best seen series 2401, image 25). Lastly, the same focus appears to be present on the sagittal T1 (series 2901, image 8, although this sequences also motion degraded). The constellation of these features are suggestive of a tiny portion of fatty filum.There are no fractures. The marrow signal is benign. The cervicomedullary junction is normal. The cerebellar tonsils are in normal position. The visualized paraspinal contents are unremarkable.
1.Scoliosis with osseous dysplasias including vertebral body fusion and hemivertebrae as described in detail above.2.Moderate left neural foraminal stenosis at C4/5, and mild right neural foraminal stenosis at T2/3.3.The spinal cord is normal in signal throughout.4.There is a tiny focus of T1 hyperintensity in the region of the presumed filum (although the axial T1 is motion degraded). This same region on axial T2 demonstrates a small hypointense focus with an inferiorly located linear hyperintense periphery, suggestive of chemical shift artifact, which can be seen from fat. Lastly, the same focus appears to be present on the sagittal T1 (although this sequences also motion degraded). The constellation of these features are suggestive of a tiny portion of fatty filum.