Clinical question: Evaluate osteo-. Signs and symptoms: Back pain. Nonenhanced lumbar MRI:Examination redemonstrated diffuse marrow signal changes all vertebral bodies of L3 and L4 consistent with edema. There is also redemonstration of increased T2 signal intensity in the severely degenerated disc space at L4-L5. Although the extent of the findings appears similar to prior exam the signal changes appear slightly less conspicuous on T2 STIR sequence which may be technical or could represent subtle interval improvement of edema. Although the T2/T2 STIR signal of disc space at this level remains similar to prior exam there is suggestion of subtle interval decreased height of disc space which conceivably could represent decreased effusion in the disc space and with resultant decreased disc height. Ventral epidural defects of degenerative cause and with resultant central spinal stenosis demonstrate no change.Degenerative changes at L2-L3 and a prominent degenerative ventral epidural defect with resultant moderate central spinal stenosis demonstrate no change.Marrow signal changes suggestive of edema at T11 and T12 vertebral bodies and the intervertebral disc space is again identified and as well suggestive of inflammatory changes/discitis osteomyelitis. Compared to prior exam the signal changes at this level is less conspicuous which again can be technique related or indicate subtle interval improvement. There is no evidence of a spinal stenosis at this level.Significant bilateral neural foraminal compromise secondary to degenerative disease at L3-L4 and L4-L5 levels are again noted. Bilateral neural foraminal compromise at T11-T12 also remains stable and similar to prior exam.There is no evidence of any perispinal or epidural abnormal soft tissue thickening or collection on this non-infused exam.
1.Redemonstration of L3-L4 disc and vertebral body signal changes suggestive of inflammation/infectious process appears slightly less conspicuous on T2 STIR compared to prior exam which could be technique related or may represent subtle interval improvement.2.Redemonstration of disc space and adjacent vertebral body signal changes at T11-T12 highly suggestive of an inflammatory/infectious process also appears slightly less conspicuous on sagittal T2 STIR which may be technique related or represent subtle interval improvement since prior study.3.Central spinal stenosis secondary to degenerative disease at L4-L5 and L3-L4 levels remains stable since prior exam.4.Significant bilateral neural foraminal compromise at T11-T12, L3-L4 and L4-L5 levels secondary to degenerative disease remains similar to prior exam.5.No detectable perispinal or epidural soft tissue abnormality or collection on this nonenhanced study.