Female, 73 years old, with right hip and low back pain radiating down the posterior right leg. Bone marrow signal intensity is diffusely low on all sequences including T2 and STIR. Superimposed are small areas of bright T2 signal within the left aspect of the L1 and L3 vertebral bodies though this signal does suppress partially on STIR images.A grade 1 anterolisthesis of L4 relative to L5 is seen. Vertebral body alignment is otherwise unremarkable. Vertebral body heights are preserved.The visualized spinal cord, conus and nerve roots of the cauda equina are unremarkable.Loss of disc height and disc T2 signal is seen at L4-5 and L5-S1. Additional level specific findings are as follows:T12-L1: Mild bulging disc. No significant spinal canal or foraminal stenosis.L1-2: Unremarkable. L2-3: Facet hypertrophy. Minimal laterally bulging disc. No significant spinal canal or foraminal stenosis. L3-4: Facet hypertrophy with small facet effusions. Minimal laterally bulging disc. No significant spinal canal or foraminal stenosis. L4-5: Facet hypertrophy and ligamentum flavum thickening. Disc bulging and disc uncovering. Moderate spinal canal narrowing. Mild bilateral foraminal narrowing. L5-S1: Facet hypertrophy. Bulging disc. No significant spinal canal stenosis. Mild right foraminal narrowing.
1.Diffusely abnormal low marrow signal intensity is seen which would be compatible with anemia, excess iron deposition perhaps from blood transfusions, or other marrow infiltrative processes.2.Focal areas of bright T2 signal which suppresses on STIR images in L1 and L3 probably reflect either hemangiomas or focal fatty sparing.3.Relatively mild degenerative findings are seen. These are most notable at the L4-5 level where spondylolisthesis, disc bulging and posterior element hypertrophy contribute to produce a moderate spinal canal stenosis.