Female, 69 years old, with low back and hip pain. Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits. No evidence of pathologic marrow replacement is seen. Mild superior endplate edema is seen at L4 which is new from prior.Significant degeneration of the L4-5 facet joints is seen with edema in the joint spaces and in the surrounding soft tissues. There may be mild edema within the right aspect of the partially visualized sacrum. The SI joints also appear to be sclerotic. The visualized distal spinal cord, conus and nerve roots of the cauda equina are within normal limits. No epidural abnormalities are suspected.L1-2: No significant spinal canal stenosis or neuroforaminal narrowing. L2-3: Mild facet arthropathy. No significant spinal canal or neuroforaminal stenosis. No interval changes. L3-4: Moderate facet arthropathy. Minimal disc bulging. Mild generalized spinal canal narrowing. No significant foraminal stenosis. No interval changes. L4-5: Advanced facet arthropathy and ligamentum flavum thickening. Mild disc bulging. Mild spinal canal narrowing. Mild bilateral foraminal narrowing. No interval changes. L5-S1: Advanced facet arthropathy. No significant spinal canal or foraminal narrowing. No interval changes.
Multilevel facet arthropathy is seen, most severely affecting the L4-5 and L5-S1 levels. In particular, there is edema associated with the L4-5 facets which could indicate an inflammatory component.Relatively mild disc degeneration is redemonstrated without areas of high-grade spinal canal stenosis and without significant interval change.Sclerosis of the SI joints and possible right sacral edema are partially evaluated on this examination.