Clinical question: Back pain. Signs and symptoms: Back pain. Nonenhanced lumbar MRI:There is normal anatomical alignment of vertebral column. No evidence of fracture.The signal intensity of vertebral column is abnormal with uniformly hypodense T1 and hypo-T2/T2 STIR signal likely due to systemic process. Correlate with history.Minimal degenerative disc disease at L4-L5 is noted and unremarkable at other levels.At L4-L5 there is mild degenerative disc disease and a small far lateral broad-based disc protrusion projecting into the right neural foramina and it is often mild compromise. No spinal stenosis and patent left neural foraminal.Mild hypertrophic changes of the ligamentum flavum at the L5-S1 is noted.Unremarkable images at other levels.Unremarkable perispinal soft tissues.
1.Uniformly hypointense T1 and hypointense T2 signal intensity of bone marrow of all visualized bony structures of region of exam suggestive of a systemic process. No fracture or malalignment.2.Mild degenerative disc disease at L4-L5 and a small right lateral disc protrusion with resultant mild compromise of right neural foraminal.3.Minimal degenerative changes of posterior elements in the lower lumbar spine.4.Unremarkable exam otherwise and without evidence of spinal canal or neural foraminal compromise at any level.