Reason: concern for physical exam changes since last MRI. Disc herniation History: + straight leg and faber test in the setting of L back pain For the purposes of this exam, there are 5 nonrib-bearing lumbar-type vertebral bodies with the most inferior well-defined disc space labeled L5-S1 as before. Vertebral body heights are within normal limits. Alignment is within normal limits. Bone marrow signal is benign with small T1 hyperintense lesion at the S1 level compatible with focal fat or hemangioma. The conus medullaris is normal in position.Mild degenerative changes are seen, as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis.L3-L4: No significant disc disease. No spinal canal or neural foraminal stenosis.L4-L5: No significant disc disease. No spinal canal or neural foraminal stenosis.L5-S1: Bilateral L5 pars defects are again seen. There is disc desiccation as well as disc bulge with a more focal left-sided protrusion which slightly effaces the left lateral recess and mildly narrows the left-sided neural foramen similar to prior. There is an associated left-sided dorsal annular fissure which is more apparent than prior. No significant spinal canal stenosis or right neural foraminal stenosis. Bilateral facet effusions are again seen. Paraspinous soft tissues are within normal limits.
Overall no significant change since MRI from 8/9/2014. Bilateral L5 pars defects again seen. There is a left-sided disc protrusion at the L5-S1 level which is associated with mild narrowing of the left lateral recess as well as mild left neural foraminal narrowing, similar to prior. Spinal canal is patent. L5-S1 facet joint effusions again seen. Dynamic radiographs may be considered to assess for instability at this level.