History of discitis osteomyelitis with antibiotic treatment for 8 weeks. There is diffuse edema and enhancement involving the T7 and T8 vertebral bodies. The vertebral body heights are preserved. There is enhancement of the surrounding paraspinal soft tissues as well as a small amount of enhancement extending into the epidural space, improved since prior examination. The T7-8 intervertebral disc demonstrates mild postcontrast enhancement however edema within the disc space has improved. The thoracic spinal cord demonstrates normal signal and morphology.The thoracic kyphosis is preserved. The vertebral body heights are maintained. There is mild extrusion of the T7-8 intervertebral disc resulting in mild effacement of the ventral thecal sac and mild right neuroforaminal stenosis. There is a small T8-9 disc protrusion without significant spinal or neuroforaminal stenosis.Scout views of the lumbar spine demonstrate large superior endplate Schmorl's nodes are visualized in the thoracolumbar spine. There is an approximately 50% chronic appearing compression deformity of the L4 vertebral body seen only on scout views. There is mild anterolisthesis of L5 over S1. Multilevel disc herniations are visualized throughout the lumbar spine. There is a probable hemangioma in the L1 vertebral body.
1.Findings consistent with T7-8 osteomyelitis. There has been improvement of paraspinal and epidural enhancement consistent with treatment related change. The T7-8 intervertebral disc demonstrates only mild enhancement with improved edema which was only mild on the original examination. With this constellation of imaging features tuberculous osteomyelitis is included within the infectious differential diagnosis for discitis/osteomyelitis.2.There is an approximately 50% chronic appearing compression deformity of the L4 vertebral body seen only on scout views. Multiple large Schmorl's nodes are visualized in the thoracolumbar spine. There are multilevel degenerative changes throughout the lumbar spine which can be further evaluated with dedicated lumbar spine MRI.