This patient presented with progressive weakness of the legs and tingling sensation. This was attributed to his long-standing diabetes.
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Evidence of extensive epidural fat infiltration which is hyperintense on both T1W and T2W. There is also associated fatty atrophy of back muscles. The cord and cauda equina are compressed anteriorly by the epidural lipomatosis, with complete effacement of CSF. There are mild posterior disc herniations at several levels which may be contributing to the compressive myelopathy.
Case credit: Dr Abhijit Datir.