Low back pain [M54.5], Reason for Study: ^Reason: work related back injury ? History: severe low back pain, unresponsive to one year of physical therapy. For the purpose of this dictation, the lowest visualized intervertebral disc space is labeled L5-S1. There are localized high signal intensities of L4 and L5 vertebral body on T2 images adjacent to Schmorl's nodes. On Gad enhanced scan, there are localized enhancement around the Schmorl's nodes. The L45 disc shows diffuse bulging of disc which is extending toward left side neural foramen which abuts the left L4 root.Other intervertebral discs from T12-L1 to L5S1 appear to be normal.There is normal lumbar lordosis. The spine alignment is anatomic. The vertebral body height is preserved. The bone marrow and end plates demonstrate a normal MR appearance. The signal of the visualized cord is normal. The epidural space, thecal sac, and spinal cord are preserved with no evidence of spinal canal/neural foraminal narrowing. The conus medullaris terminates at the L1-L2 level. The paraspinal soft tissues are unremarkable.
1. Diffuse bulging of disc with slight extension toward left side neural foramen at the level of L45 which abuts left L4 root as described above.2. Schmorl's nodes with enhancements at the inferior endplate of the L4 and superior endplate of the L5 vertebral bodies.3. Otherwise unremarkable.