 The evaluation of the study for infection is limited due to the study performed without contrast.The vertebral bodies demonstrate stable mild anterior wedging of L1. Along the anterior superior endplate of L4 there is a small area of low T1 signal with high T2 signal, with no definite corresponding lesion on the previous CT although there is minimal marginal sclerosis noted. This may represent early degenerative changes or an atypical hemangioma. The neural foramina are normal and there is no spinal stenosis at any level of the lumbar spine. There is no evidence of nerve root thickening. There is no epidural fluid collection. No marrow signal abnormality is identified concerning for infection. There is no diffusion restricted "claw sign" to suggest discitis/osteomyelitis. The discs appear normal with no evidence of degenerative changes.The conus ends at the level of L1-L2. Incidentally a thin linear T1 weighted hyperintensity is seen along the dorsal aspect of the distal thecal sac at the level of S1 that represent an incidental fatty filum.There is a small round lesion of CSF signal along the left S2 foramen that measures 6 mm in diameter, and represents a Tarlov cyst.The common bile duct is prominent for age with a diameter of 8 mm. Atrophic kidneys are seen. There is a transplanted kidney that is seen in the right hemipelvis.
1. No evidence of spinal infection within limitations of noncontrast technique.2. Incidental fatty filum, most likely a normal variant but can be associated with tethered cord. Recommend clinical correlation. 3. Mild stable anterior wedging of L1.