Clinical question: Evaluate disc for herniation. Signs and symptoms: Right thoracic pain. Nonenhanced thoracic MRI:There is normal anatomical morphology and alignment of the vertebral column.There is normal signal intensity and caliber of the thoracic cord.There is no evidence of spinal stenosis at any level.Mild degenerative changes at T10-T11 level results in moderate to severe right neural foraminal compromise (sagittal T2 series 501 image 12 and axial T2 series 801 image 11). No evidence of neural foraminal compromise at any other level.Unremarkable perispinal soft tissues.Nonenhanced lumbar MRI:There is normal anatomical development, morphology and alignment of vertebral column.Degenerative changes are noted only in the lower lumbar spine at L4-L5 and L5-S1 levels are noted and unremarkable at other levels.At L4-L5 there is mild disc disease and loss of disc height, mild facet and ligamentum flavum hypertrophy without spinal or neural foraminal compromise. There is a linear T2/T2 STIR hyperintense lesion in the annulus of the disc in the midline consistent with an annular fissure.L5-S1 demonstrate advanced disc disease and loss of disc height, mild bilateral facet and ligamentum flavum hypertrophy with resultant mild left neural foraminal compromise and unremarkable otherwise.
1.Nonenhanced thoracic MRI demonstrate mild degenerative changes at T10-T11 with resultant moderate to severe right neural foraminal compromise and unremarkable exam otherwise as detailed.2.Nonenhanced MRI of lumbar spine demonstrate moderate to advanced disc disease at L5-S1 and mild degenerative changes at L4-L5 levels only. There is resultant mild left neural foraminal compromise at L5-S1 and unremarkable exam otherwise