 There has been no significant interval change in the abnormal fatty bone marrow and endplate irregularity involving the L4 and L5 vertebrae related to previous discitis-osteomyelitis. Likewise, the there is persistent mild loss of vertebral body height at L4 and L5. Enhancement involving the right L3-L4 foramen and posterior to the right L3-L4 facet extending along the spinous process is unchanged, but there is no discrete abnormal signal or pathological enhancement within the facet joint. Degenerative spondylosis at L4-L5 and L5-S1 appears similar as before, with mild to moderate narrowing of the lower lumbar neural foramina, except for moderate severe narrowing of the left L5-S1 foramen, with nerve root impingement. There is no significant central spinal canal stenosis. There is redemonstration irregularity and abnormal marrow signal within the left sacrum and iliac bone, with predominantly fatty marrow characteristics. There is again significant irregularity of the left sacroiliac joint consistent with prior sacroiliitis. The lumbar spine is in normal alignment, with a normal lumbar lordosis. The distal spinal cord appears unremarkable.
1. Redemonstration of sequela of prior discitis-osteomyelitis at L4-L5 with vertebral body height loss and endplate irregularity, but no evidence of epidural abscess. 2. Degenerative spondylosis in the lower lumbar spine with left neural foraminal narrowing and nerve root impingement at L5-S1. In addition, persistent mild enhancement along the posterior aspect of the right L3-L4 facet may be be degenerative in nature.3. Redemonstration of sequela of previous left sacroiliitis.