Reason: 70 yo with bacteremia, h/o DDD with reported low back pain with onset of rigors. Please eval for any discitis/osteo History: had previous c/o low back pain Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is minimal retrolisthesis of L3 on L4. Alignment is otherwise maintained. Bone marrow signal is benign. Small scattered foci of T1 hyperintensity, relatively more prominent involving the posterior superior aspect of the L1 vertebral body, are compatible with hemangiomas or foci of fat. The conus medullaris is normal in position.Lack of contrast somewhat limits evaluation for infection. There is however no edema involving the disc or endplates to suggest discitis osteomyelitis. There are also no epidural or paraspinous fluid collections to suggest abscess.There is disc desiccation involving the discs throughout the lumbar spine, worst at the L5-S1 level where there is also moderate to severe loss of disc height with vacuum phenomena. Additional details regarding multilevel degenerative changes as described below: T12-L1: There is linear abnormal signal along the posterior aspect of the mid T12 to the mid L1 vertebral bodies likely representing a small right paracentral disc extrusion with cranial and caudal migration. There is no associated spinal canal or neural foraminal stenosis.L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: Minimal disc bulge. No spinal canal or neural foraminal stenosis.L3-L4: There is a disc bulge and mild bilateral facet arthropathy without significant spinal canal stenosis. There is mild left neural foraminal stenosis. No significant right neural foraminal narrowing. There is small amount of fluid in the facet joints which is likely on a degenerative basis.L4-L5: There is disc bulge eccentric to the left, ligamentum flavum thickening, and bilateral facet arthropathy. There is mild effacement of the lateral recesses but no significant central spinal canal stenosis. There is mild left neural foraminal stenosis. No significant right neural foraminal narrowing. There is small amount of fluid in the facet joints which is likely on a degenerative basis.L5-S1: Moderate to severe disc height loss with disc bulge and a small central protrusion. There is no significant spinal canal stenosis. There is mild to moderate left neural foraminal stenosis and mild right neural foraminal stenosis.Paraspinous soft tissues demonstrate mild fatty atrophic changes involving the paraspinous musculature but are otherwise unremarkable.
1. There is no evidence of infection involving the lumbar spine within the mild limitations of noncontrast imaging.2. Mild to moderate degenerative changes in the lumbar spine as detailed above without significant spinal canal stenosis at any level. Please see additional details above.