Clinical question: SLE patient with severe pain in the left parasacral area radiating bilaterally across her back. Signs of symptoms: As above. Nonenhanced lumbar MRI:There is normal anatomical alignment of sarcoma.There is unremarkable signal intensity of which.Lowermost visualized thoracic spine and thoracic cord from T2 inferiorly are unremarkable.T12 -- L1 demonstrate mild degenerative disk disease and with moderate left and mild right ligamentum flavum hypertrophy. There is no central spinal stenosis or neural foraminal compromise.L1 -- L2 demonstrate minimal degenerative changes and unremarkable otherwise.L2 -- L3 is unremarkable.L3 -- L4 demonstrate minute degenerative changes and unremarkable otherwise.L4 -- L5 demonstrate a small central and right paramedian disk herniation with minimal migration superiorly behind the body of L4 (axial T2 series 601 images 14 and 15, sagittal T2 stir series 401 images 7 and 8). This finding results in very subtle indentation of thecal sac and without spinal stenosis or neuroforaminal compromise. Minimal degenerative disk disease and ligamentum flavum hypertrophy is also noted. L5 -- S1 demonstrate minimal degenerative changes and unremarkable otherwise.
1.Small central and rightward disk herniation with minute superior migration at L4 -- L5 without resultant spinal canal or neural foraminal compromise.2.Unremarkable nonenhanced lumbar MRI otherwise with the exception of minute degenerative changes as detailed level.