44M uncontrolled IDDM with recent dog scratch now presents with sepsis presumed secondary to infection of left upper due to left subscapular abscess seen on imaging status post left shoulder open anterior I&D and posterior arthroscopic I&D. Back pain. Evaluate for infection in the spine. There is mild dextro thoracic and mild levo lumbar curvature. There is straightening of the lumbar lordosis in the sagittal plane. The vertebral body heights are preserved. There is mild loss of height of the L4-L5 disc space with endplate degenerative changes. There is diffuse low signal of the bone marrow. There is no significant spinal canal stenosis. The spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable.T12-L1: No significant disc bulge, spinal canal or foraminal stenosis. L1-L2: No significant disc bulge, spinal canal or foraminal stenosis.L2-L3: Mild bilateral facet degeneration. No significant disc bulge, spinal canal or foraminal stenosis. L3-L4: Mild bilateral facet degeneration. No significant disc bulge, spinal canal or foraminal stenosis. L4-L5: Disc bulge with superimposed large central/right paracentral disc extrusion with cranial and caudal migration and measuring approximately 20 mm, contributing to moderate spinal canal stenosis and possible impingement of the descending nerve roots, and mild bilateral foraminal stenosis. Mild bilateral facet degeneration. L5-S1: Mild bilateral facet degeneration. No significant disc bulge, spinal canal or foraminal stenosis.
1. Central/right paracentral disc extrusion at L4-L5 with cranial and caudal migration and measuring approximately 20 mm in length. There is resulting moderate central canal stenosis as well as and right lateral recess stenosis. 2. No evidence of discitis-osteomyelitis, inflammatory changes, or fluid collections in the lumbar spine to suggest infection.3. Diffusely low marrow signal, which is nonspecific but can be seen in conditions such as chronic anemia or marrow proliferative disorders. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.