58 years Male (DOB:6/14/1957)Reason: pt with persistent bacteremia endorsing back pain, r/o osteomyelitis vs. Abscess History: back painPROVIDER/ATTENDING NAME: KIRK T SPENCER KIRK T SPENCER Cervical spine:Exam is degraded by patient motion artifact.The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. There is mild reversal of the normal cervical curvature.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there is no significant compromise to the spinal canal or neural foramina. There is T2 signal hyperintensity and T1 signal hyperintensity present within the C5 and C6 vertebral bodies adjacent to the C5-6 disc. This is stable compared to prior exam.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.Incidental note is made of a Thornwaldt cyst.MRI thoracic spine:Exam is degraded by patient motion artifact.The thoracic vertebral bodies are appropriate in the overall alignment and height. The thoracic spinal cord has normal signal characteristics and overall morphology. There is no compromise of thoracic spinal canal or exiting nerve roots. There is T2 signal hyperintensity within the vertebral bodies along the anterior and lateral aspects (left more than right) adjacent to the T6-7 disc space. The endplates are partially preserved. There is T2 signal hyperintensity within the intervening disc. This is new since the prior exam.Findings suggest loculated pleural effusions.Lumbar spine:Exam is degraded by patient motion artifact.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.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is a mild disc bulge present at this level.At L4-5 there is no significant compromise to spinal canal or neural foramina. There is mild ligamentum flavum hypertrophy at this level. There is a disc bulge at this level. There is effacement of the fat at the lateral recess bilaterally at this level and overall mild to moderate degree of spinal stenosis. This is stable compared to prior exam.At L3-4 there is no significant compromise to spinal canal or neural foramina. There is mild ligamentum flavum hypertrophy at this level. There is a disc bulge at this level. There is partial effacement of the fat at the left lateral recess and effacement of the fat at the right lateral recess at this level and overall mild to moderate degree of spinal stenosis. This is stable compared to prior exam.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 are small cysts along the left kidney
1.There is abnormal signal within the T6-7 disc associated with some endplate reactive change. This has progressed since the prior exam at which time it did not appear to involve the disc. The possibility of discitis cannot be excluded. Other possibilities include repetitive injury and renal spondylarthropathy.2.There are degenerative changes in the lumbar spine with mild to moderate degrees of spinal stenosis at L4-5 and L3-4 as detailed above. This is stable compared to prior exam.3.There are degenerative changes present in the cervical spine without significant compromise to spinal canal or exiting nerve roots. This is stable compared to prior exam.4.Exam is degraded by patient motion artifact which will obscure more subtle abnormalities.5.There are loculated pleural effusions present. These are new compared to the prior exam.