Back pain, previous MRI with disc protrusion and annular tear Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is mild retrolisthesis of L5 on S1 which was present on prior study. Alignment is otherwise maintained. Bone marrow signal is benign. There is edema involving the L5-S1 disc as well as the L5 and S1 vertebral bodies which is new since prior. There is moderate loss of disc height at this level, slightly worse in the interval. There is questionable mild surrounding edema. No discrete paraspinous or epidural collections. There is a small disc protrusion at this level which is not significantly changed since prior. Disc desiccation at the L4-L5 level is also noted and was also present previously. The conus medullaris is normal in position.Individual levels as below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis.L3-L4: No significant disc disease. No spinal canal or neural foraminal stenosis.L4-L5: Disc desiccation with minimal disc bulge with dorsal annular fissure as before. No spinal canal or neural foraminal stenosis. Mild facet arthropathy.L5-S1: Central disc protrusion as before. There has been worsening of disc height loss and increased signal abnormality in the disc and endplates as described above. Mild fluid in the facet joints as before. There is mild right worse than left neural foraminal stenosis which has progressed.
Compared to 9/6/2011, there has been progression of degenerative changes at the L5-S1 level with worsening of disc height loss. There is particular increase in edema involving the disc and adjacent endplates which may be on a progressive degenerative basis. Early discitis-osteomyelitis however cannot be excluded and if there is clinical suspicion for infection, short-term follow-up MRI with post gadolinium and diffusion-weighted sequences should be considered.