Prostate cancer. Abnormal bone scan findings. The images and the official report of the whole body bone scan performed at outside hospital are not available. The clinical note indicates bone scan shows questionable abnormalities in the lower spine and also a pelvic node measuring 2cm in size.The study quality is mildly degraded by motion.CERVICAL SPINE:Alignment is anatomic accounting for straightening. Vertebral bodies are preserved in height. Marrow signal is notable for mild degenerative change subjacent to the endplates, most pronounced at C5-C6 through C7-T1 which is also associated with mild-to-moderate disc height loss. There is also edema like marrow signal involving the left sided articulating pillars at L2-L3 which is probably related to facet arthropathy. There is no suspicious marrow lesion. The cervical spinal cord shows normal signal and only very minimal ventral flattening by the C4-C5 degenerative disc-osteophyte complex. There is hyperostosis/enthesopathy at the occipital attachment of the ligamentum nuchae.C2-C3: Minimal disc-osteophyte complex and moderate left and mild right facet arthropathy, causing minimal left neuroforaminal stenosis. Left facet arthropathy is associated with marrow edema in the corresponding left articulating pillars. No significant spinal canal or right foraminal stenosis.C3-C4: Minimal disc-osteophyte complex and mild uncovertebral and facet arthropathy. No significant spinal canal or foraminal stenosis.C4-C5: Disc-osteophyte complexes associated with a narrow based central disc protrusion/spurring minimally indenting the ventral aspect of the spinal cord without abnormal cord signal. Mild facet arthropathy with no significant foraminal stenosis.C5-C6 and C6-C7: Disc-osteophyte complex is eccentric to the right but no significant spinal canal stenosis. Mild-to-moderate facet and uncovertebral arthropathy contribute to mild bilateral foraminal stenosis.T7-T1: No significant spinal canal or foraminal stenosis.THORACIC SPINE:Alignment is anatomic. Vertebral bodies are preserved in height and there is no suspicious marrow abnormality. Areas mild disc height loss in the mid thoracic spine associated with a small disc-osteophyte complexes as described below. The spinal canal is otherwise fairly preserved. The thoracic spinal cord shows normal signal and shape. Focal T2-hyperintensity and contrast enhancement just adjacent to the left spinolaminar junction at T3-T4 level on sagittal imaging (image #18) is related to a vessel. A 9 mm well-circumscribed, T2-hyperintense, mildly T1-hyperintense lesion within the skin and T8-T9 level to the left of midline is most likely a sebaceous cyst.T1-T2: Minimal disc-osteophyte but no spinal canal or foraminal stenosis.T2-T3: No spinal canal or foraminal stenosis.T3-T4 and T4-T5: Minimal disc-osteophyte but no spinal canal or foraminal stenosis.T5-T6: Broad-based left paracentral disc protrusion but no significant spinal canal or foraminal stenosis.T6-T7: No spinal canal or foraminal stenosis.T7-T8: Narrow based central disc protrusion mildly narrows the spinal canal. No foraminal stenosis.T8-T9, T9-T10, T10-T11 and T11-T12: No significant disc herniation. No spinal canal or foraminal stenosis.LUMBAR SPINE:Alignment is notable for 7 mm of anterior subluxation of L5 relative to S1 associated with bilateral chronic appearing pars interarticularis defects. There is also lumbar straightening which may relate to patient positioning. The vertebral bodies are preserved in height. Marrow signal shows no suspicious focality. Mild degenerative marrow change is present subjacent to the L2-L3 and, to a lesser extent, L1-L2 endplates anteriorly. There is also edema like signal involving the marrow of the left L4 articulating pillar, which is probably reactive to facet arthropathy. Small Schmorl node is present along the inferior endplate of L2 also with minimal associated subjacent marrow change. Moderate size anterior osteophytes are present at L2-L3. The tip of the conus medullaris is at the upper most L2 level. The conus medullaris and included coronal part of the spinal cord show normal signal and shape.T12-L1: No disc herniation. Mild facet arthropathy. No spinal canal or foraminal stenosis.L1-L2 and L2-L3: Minimal disc bulge but no spinal canal or foraminal stenosis.L3-L4: Disc bulge flattens the ventral aspect of the thecal sac. Moderate facet arthropathy and mild ligamenta flava thickening. There is mild narrowing of the subarticular recesses but no nerve displacement and no central spinal canal stenosis. No significant foraminal stenosis.L4-L5: Disc bulge and severe bilateral facet arthropathy (with a small synovial cyst arising from the dorsal aspect of the left facet) cause no significant spinal canal stenosis but mild-to-moderate left and mild right foraminal stenoses. Edema like signal involving the marrow of the left articulating pillar is probably reactive to facet arthropathy. L5-S1: Spondylolisthesis and anterior subluxation are associated with anteroposterior elongation of the spinal canal. Severe facet arthropathy, associated with minimal effusion, results in moderate transverse spinal canal stenosis and moderate biforaminal stenosis. In addition to disc and covering by the subluxation, there is a tiny right paracentral disc protrusion with coronal migration which abuts the traversing right S1 nerve root.
1.The study is mildly motion degraded.2.There is no definite, destructive spinal osseous metastasis. Foci of edema-like marrow signal abnormality subjacent to the endplates, as described above, are most likely degenerative in nature. Also, similar signal abnormality involving the left L4 as well as the left C2-C3 articulating pillars is probably reactive to facet arthropathy.3.L5-S1 spondylosis and anterior subluxation along with severe facet arthropathy are associated with moderate transverse spinal canal and biforaminal stenoses. Tiny right paracentral L5-S1 disc protrusion abuts the right S1 nerve root. Please correlate with right S1 radiculopathy.4.There is no spinal cord signal abnormality.