85-year-old female with severe back and leg pain for one month with new fever and chills since 9/10/2015, elevated inflammatory markers. There is diffuse areas of fat signal in the lumbar and sacral vertebrae, but no evidence of edema or abnormal enhancement to suggest acute osteomyelitis. There is enhancement within the L4-5 disc space centrally, where there is associated herniation into the L4 vertebral body (Schmorl node). There is also enhancement in the L3-4 disc space centrally. The vertebral column alignment is within normal limits. There are multilevel mild endplate concavities. There is mild multilevel degenerative spondylosis, but no significant spinal canal or neural foraminal stenosis. The spinal cord displays normal signal and morphology. The facet joints show no excessive fluid or gross erosive change. The paravertebral soft tissues are unremarkable. However, there are small left renal cysts and the infrarenal aorta is mildly enlarged, measuring between 25 and 30 mm in width.
1. No evidence of lumbosacral osteomyelitis.2. Nonspecific enhancement in the L3-4 disc space may be degenerative in nature, as is the case at the L4-5 level, where there is an associated Schmorl node. 3. Diffuse fatty marrow signal may be indicative of osteopenia.4. No evidence of epidural collections or significant spinal canal stenosis.5. The infrarenal aorta is mildly enlarged, measuring between 25 and 30 mm in width.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.