Diagnosis: Radiculopathy, lumbar regionClinical question: eval for L-spine pathologySigns and Symptoms: LBP/ RLE pain Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall height. The conus medullaris on sagittal imaging is grossly intact. There is a levocurvature to the lumbar spine. There is multilevel disc desiccation presentAt L5-S1 there is no significant compromise to spinal canal or neural foramina. There is bilateral facet hypertrophy present at this level associated with disc desiccation and a minor disc bulge.At L4-5 there is a diffuse disc bulge present associated with moderate to severe bilateral facet hypertrophy. The facet hypertrophy is worse on the left compared to the right side. There is fluid within the facet joints which can be visualized on this exam. The fat located the lateral recesses is effaced bilaterally at this level. There is a partial effacement of the fat surrounding the exiting nerve roots within the neural foramen at this level. Overall there is a moderate degree of spinal stenosis present at this level.At L3-4 there is a diffuse disc bulge present associated with disc desiccation and loss of disc space height as well as a mild to moderate degree of bilateral facet and ligamentum flavum hypertrophy. The facet hypertrophy is worse on the right than the left side. There is mild (2-3 mm) left lateral translation of L3 on L4. There is effacement of the fat at the lateral recesses bilaterally (right worse than left) and effacement of spinal fluid within the thecal sac at this level. There is effacement of the fat surrounding the right exiting nerve root at this level. Overall there is a moderate to severe degree of spinal stenosis at this level.At L2-3 there is no significant compromise to spinal canal or neural foramina. There is mild facet and ligamentum flavum hypertrophy present at this level associated with a minor disc bulge.At L1-2 there is no significant compromise to spinal canal or neural foramina. There is a mild disc bulge present at this level.There is a large cyst present along the right kidney measuring 4 cm x 3.5 cm in coronal dimensions. This cortically based and at the midportion of the right kidney.
1.There are multilevel degenerative changes present in the lower lumbar spine with moderate-to-severe spinal stenosis at L3-4 and moderate spinal stenosis at L4-5 as well as encroachment of exiting nerve roots within the neural foramina bilaterally at L4-5 and on the right side at L3-4.2.There is a rotatory levocurvature to the lumbar spine centered at approximately L3-4 there is a mild degree of left lateral translation of L3 on L4.3.There is a large cyst present along the right kidney measuring 4 cm in size