Diagnosis: Radiculopathy, lumbar regionClinical question: eval disk herniation 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 disc desiccation at this level as well as a disc bulge. There is partial effacement of the fat at the lateral recess bilaterally but worse on the right side when compared to the left with encroachment of the nerve roots at the right lateral recess.. There is bilateral facet hypertrophy at this level as well as some ligamentum flavum hypertrophy. These findings are stable and compared to the previous exam.At L4-5 there is no significant compromise to the neural foramina. There is loss of disc space height at this level associated with a disc bulge and disc desiccation as well as bilateral facet and ligamentum flavum hypertrophy. There is effacement of the fat at the left lateral recess at this level and encroachment of the nerve roots at the left lateral recess. There is partial effacement of the fat at the right lateral recess at this level. There is milder encroachment of the nerve roots of the right lateral recess at this level. These findings are stable and compared to the previous exam.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 are multiple cysts present along the kidneys. One along the left kidney measures approximately 30 mm in diameter. One along the right kidney measures approximately 23 mm in size. Another one along the left kidney is oblong and measures 17 x 45 mm in axial dimensions. These were also identified in the recent CT of the abdomen.
There is redemonstration of multilevel degenerative changes in the lumbar spine predominantly at L4-5 and L5-S1. There is encroachment of the nerve roots of the right lateral recess at L5-S1 (probably right S1 nerve roots) and the left lateral recess at L4-5 (probably left L5 nerve roots) related to combination of disc bulge and facet and ligamentum flavum hypertrophy. These findings are stable when compared to the prior exam from 2012.