Diagnosis: Malignant neoplasm of liver, primary, unspecified as to typeClinical question: eval for metastatic diseaseSigns and Symptoms: back pain, hcc Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact. No abnormal enhancing lesions are appreciated in the lumbar spine. A T1 signal hyperintense lesion measuring 1 cm located within the L4 vertebral body most likely represents a hemangioma.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is loss of disc space height, disc desiccation and endplate reactive change present at this level is associated with mild narrowing of the neural foramina bilaterally. There is mild facet hypertrophy at this level.At L4-5 there is no significant compromise to spinal canal or neural foramina. There is mild facet hypertrophy present at this level.At L3-4 there is no significant compromise to spinal canal or neural foramina.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.There is a nonenhancing focus of signal abnormality present within the right kidney with a wedgelike configuration. Measuring approximately 22 mm in size .
1.Some degenerative changes are present in the lumbar spine without compromise to lumbar spinal canal or neural foramina.2.There is a lesion within the right kidney. It is suspected to represent possibly an infarction but is nonspecific. If clinically appropriate additional imaging of the kidneys with help further evaluate this.