Female, 69 years old, with left lower extremity radiculopathy. Alignment is anatomic. Vertebral body height and morphology are within normal limits. Marrow signal characteristics are heterogeneous but no concerning areas of marrow replacement or marrow edema are detected. The visualized distal spinal cord, conus and nerve roots of the cauda equina are within normal limits. No epidural abnormalities are suspected.Facet arthropathy develops at lower lumbar levels, most notably at L4-5 and L5-S1. At L4-5, severe disc degeneration is seen with loss of disc height and chronic fatty endplate signal change. An inferiorly directed disc protrusion is also evident on the left at this level where it effaces the lateral recess likely impinging upon the transiting left L5 nerve root. The spinal canal is generally mildly narrowed. The neural foramina are moderately narrowed.At L5-S1, there is minimal disc bulging but no significant spinal canal or foraminal stenosis.
Severe disc degeneration is seen at L4-5 with loss of disc height and a disc herniation projecting into the left lateral recess likely impinging the transiting left L5 nerve root.