Clinical question: 43-year-old male with history of scoliosis, pes cavus, family history of RA with 4 months seen near back pain without improvement with physical therapy. Concern for radiculopathy on exam. Evaluate for degenerative disk disease and stenosis. Signs and symptoms: Lumbar/thoracic back pain, positive straight leg raise. Non-enhanced thoracic MRI:There are no coronal images available for evaluation of scoliosis.There is normal anatomical alignment the vertebral column and with normal signal intensity. There is no evidence of any appreciable significant degenerative disease of the spine. There is no evidence of spinal canal compromise or stenosis at any level.There is no evidence of neural foraminal compromise at any level.There is normal signal intensity and caliber of thoracic cord.Nonenhanced MRI:There are no coronal images available for assessment of scoliosis.There is normal anatomical development of the vertebral column and with normal signal intensity. There is normal anatomical alignment of the common however with straightening of lumbar lordosis.Mild degenerative disk disease at L5 -- S1 and a shallow broad-based bulging disk is noted. There is however no evidence of neural foraminal or spinal canal compromise or stenosis at any level. No detectable perispinal soft tissue abnormalities.There is normal termination of the cord at L1 level.The signal intensity of the conus and cauda equina is unremarkable.
1.Nonenhanced MRI of thoracic spine is unremarkable.2.Nonenhanced MRI of lumbar spine demonstrate mild degenerative disk disease at L5 -- S1 and unremarkable otherwise. No evidence of tethered cord. No evidence of spinal canal or neural foraminal compromise or stenosis at any level.