Clinical question: Rule out spinal pathology for pain. Signs and symptoms: Severe low back pain. Nonenhanced lumbar MRI:Examination is incomplete and degraded due to patient's severe pain and inability to continue.There is normal anatomical alignment of the vertebral column.There is unremarkable signal intensity of vertebral column.Lower most visualized thoracic spine and thoracic cord is unremarkable.There is no evidence of spinal stenosis at any level.Examination at T11-T12 through L1-L2 is unremarkable.L2-L3 straight mild hypertrophic changes of posterior elements and unremarkable otherwise.L3-L4 demonstrate mild hypertrophic changes of the ligamentum flavum and the right greater than left facet hypertrophy without spinal stenosis or neural foraminal compromise.L4-L5 demonstrate mild hypertrophic changes of posterior elements and unremarkable otherwise.L5-S1 demonstrate no spinal stenosis or neural foraminal compromise. Moderate disc disease and loss of disc height is noted.Incidental note is made of extensive varying size bilateral renal cysts which are partially visualized. Correlate with history and consider dedicated imaging.
1.There is no evidence of an acute finding on this suboptimal study.2.Mild bilateral facet degenerative changes in the lower lumbar spine and including mild facet effusion is present.3.There is no evidence of a spinal canal or neural foraminal compromise.4.There is no detectable acute finding in the perispinal soft tissues.5.Extensive varying sized bilateral renal cysts are noted.