76 yo F w/ back pain; prior XR shows degeneration vs discitisSigns and Symptoms: back pain Five lumbar type vertebral bodies are presumed to be present. The conus medullaris on sagittal imaging is grossly intact. At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is mild loss of disk space height at this level associated with endplate reactive change (bright on T1) and a mild disk bulge.At L4-5 there is a diffuse disk bulge present associated with bilateral facet and ligamentum flavum hypertrophy. There is effacement of fat at the lateral recess bilaterally at this level. Overall there is moderate spinal stenosis at this level. The exiting nerve roots are surrounded by fat within the neural foramina.At L3-4 there is loss of disk space height and end plate reactive change with high T1 signal . There is a diffuse disk bulge present associated with bilateral facet and ligamentum flavum hypertrophy. There is effacement of fat at the lateral recess bilaterally at this level. Overall there is moderate spinal stenosis at this level. There is mild encroachment of the exiting nerve roots at this level. There is T2 signal hyperintensity within the disk at this level.At L2-3 there is loss of disk space height and end plate reactive change with low T1 and low T2 signal and irregular endplates. There is a diffuse disk bulge present associated with bilateral facet and ligamentum flavum hypertrophy. There is effacement of fat at the lateral recess bilaterally at this level. Overall there is moderate to severe spinal stenosis at this level. There is encroachment of the exiting nerve roots at this level. There is T2 signal hyperintensity within the disk at this level.At L1-2 there is no significant compromise to spinal canal or neural foramina.
1.There are multilevel degenerative changes present in the lumbar spine with moderate spinal stenosis at L4-5 and L3-4 and moderate to severe spinal stenosis at L2-3. There is also bilateral encroachment of exiting nerve roots at L2-3 and to a lesser degree L3-4.2.There are inflammatory changes at L2-3 with suggested endplate sclerotic change. This could represent old diskitis possibly with some superimposed acute inflammation. Alternatively it could represent marked degenerative change. Comparison to any prior exams or a contrast enhanced follow-up exam may be helpful to further evaluate this.