62 years Female (DOB:1/2/1954)Reason: L2 blastic lesion likely 2/2 breast cancer mets History: lumbar radiculopathyPatient History: Pt. states low back pain - worse to Right side // no known injury or trauma to spine // Pt had Hx. of pain radiating into Right leg - symptoms have improved drastically recentlyPROVIDER/ATTENDING NAME: RICHARD W KANG STEVEN J. CHMURA Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact. There is sclerotic lesion present within the L2 vertebral body is low signal on all pulse sequences and has some mild signal heterogeneity within it. In general the marrow has a somewhat heterogeneous appearance which is nonspecific.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is loss of disc space height, disc desiccation and diffuse disc bulge at this level associated with mild narrowing of the spinal canal. There are some mild ligamentum flavum hypertrophy at this level.At L4-5 there is no significant compromise to spinal canal or neural foramina. There is loss of disc space height, disc desiccation and a mild disc bulge at this level associated with some ligamentum flavum hypertrophy and mild narrowing of the spinal canal.At L3-4 there is no significant compromise to spinal canal or neural foramina.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.There is a cystic type lesion in the left kidney which is not entirely included on this exam. There is a tiny cortically based lesion along the left kidney measuring 5 mm at the inferior pole most likely representing a simple cyst. Within the liver there is a low signal focus on the scout views which is not entirely included or evaluated on this exam.
1.There is a sclerotic lesion within the L2 vertebral body. Additionally the marrow has a somewhat heterogeneous appearance to it. Metastasis cannot be excluded on the basis of this exam. Please refer to bone scan of the same date for further comments. CT may also be of further benefit in evaluating this.2.There are some incidental findings present including an apparent lesion in the liver and another one in the left kidney. The current lumbar MR imaging is not adequate to further characterize these lesions. A CT of the abdomen may be of further benefit in evaluating this. Alternatively ultrasound may help evaluate these.3.There are some mild degenerative changes present in the lower lumbar spine without significant compromise spinal canal or neural foramina.4.Findings were discussed with Dr. Kang at the time of this interpretation