Patient with past medical history of SLE, presenting with bilateral lower extremity, left greater than the right weakness and decreased sensation below umbilicus. Alignment is anatomic. There is multilevel loss of T2 signal of the intervertebral discs. Conus medullaris terminates at the level of L1-L2. Vertebral body heights are preserved. A hemangioma is noted in the L5 vertebral body.At L1-L2, there is mild bulging of the disc and mild bilateral neural foraminal narrowing. At L2-L3, there is hypertrophy of the ligamentum flavum and facet joint arthropathy with mild disc bulge, resulting in mild spinal canal stenosis and bilateral mild neural foraminal narrowing. At L3-L4, there is facet joint arthropathy and a diffuse disc bulge resulting in effacement of the thecal sac and moderate narrowing of the spinal canal, along with moderate left and mild right neural foraminal stenosis. At L4-L5, there is facet joint arthropathy, small facet effusions, and a diffuse disc bulge resulting in moderate to severe spinal canal stenosis and severe right and moderate left neural foraminal stenosis. Epidural fat appears to contribute to the narrowing of the spinal canal at this level. There is mild loss of intervertebral disc space at this level. At L5-S1, there is facet joint arthropathy and mild disc bulge with no significant spinal canal stenosis. Moderate bilateral neural foraminal narrowing is noted at this level.Large probable fibroid uterus is present. Otherwise the visualized soft tissues are unremarkable.
1.Multilevel degenerative changes of the lumbar spine, with severe spinal canal and right neural foraminal stenoses at the L4-L5 level.2.Large probable fibroid uterus.