Clinical question: Evaluate for lumbar disc disease. Reported the disc bulging on prior imaging at OSH years ago. Signs and symptoms: Some radiculopathic pain down right lower extremity. High doses of hydrocodone. Nonenhanced lumbar MRI:Examination demonstrates normal signal intensity and alignment of vertebral column and without detectable fracture.There is no evidence of a spinal stenosis in the lumbar spine at any level. There is no detectable neural foraminal compromise at any level. Mild degenerative disc disease and hypertrophic changes of posterior elements of present. There is no detectable abnormal bulge of disc, disc protrusion or extrusion at any level.Partially visualized lower thoracic spine at T11-T12 demonstrate advanced disc disease and loss of disc height as well as mild degree of central spinal stenosis secondary to degenerative disease. Neural foraminal at this level are fully visualized and cannot be assessed. The signal intensity of lower most visualized thoracic cord, conus and cauda equina is within normal.
1.Nonenhanced MRI of the lumbar spine demonstrate no spinal stenosis or neural foraminal compromise.2.Mild degenerative changes are noted. Partially visualized T11-T12 disc level demonstrates moderate disc disease and loss of disc height and suspected mild central spinal stenosis.3.Normal signal intensity and caliber of lower most visualized thoracic cord, conus and the cauda equina.4.Partially visualized right lower thoracic cavity demonstrate pleural effusion symmetrically 17 mm in thickness. Review of prior CT of chest from 8-31-14 demonstrated right-sided pleural effusion as well. Correlate with clinical symptoms and consider follow-up with dedicated imaging.