Low back pain [M54.5], Reason for Study: ^Reason: assess for cause of urinary retention and back pain History: urinary retention and back pain For the purpose of this dictation, the lowest visualized intervertebral disc space is labeled L5-S1. There are evidence of subtle linear enhancement on both superior endplate of L1 and inferior endplate of L2 with surrounding soft tissue enhancement especially on the left side. In addition, there is a small nodular enhancement of the L2 vertebral body left posterior superior aspect adjacent to the L12 disc space. The L12 disc demonstrates high signal intensity on T2. However, there is no definitive enhancement of the L12 disc.Constellation of above findings indicate the possible diagnosis of degenerative changes but cannot exclude possibility of discitis.In addition, there is T1 high signal intensity lesion within the thecal sac especially conus area indicating subacute blood products which most likely represent redistribution of acute SAH. There is normal lumbar lordosis. The spine alignment is anatomic. The vertebral body height is preserved. The bone marrow demonstrates a normal MR appearance. The signal of the visualized cord is normal. The conus medullaris terminates at the T12-L1 level. The paraspinal soft tissues are unremarkable.Degenerative changes are specified by the intervertebral level as follows: T12-L1: Disc desiccation, no neuroforaminal narrowing or spinal stenosis. L1-L2: Subtle enhancement of inferior endplate of L1 and superior endplate of L2 vertebral body with surrounding soft tissue. This indicates possible degenerative change related enhancement however possibility of associated discitis cannot be completely excluded. No neuroforaminal narrowing or spinal stenosis. L2-L3: Disc desiccation. No neuroforaminal narrowing or spinal stenosis. L3-L4: Disc desiccation. No neuroforaminal narrowing or spinal stenosis. L4-L5: Disc desiccation. Diffuse bulging of disc. No neuroforaminal narrowing or spinal stenosis. Bilateral facet joints show subchondral sclerosis with subchondral cyst formation especially on the left side indicating minimal to mild facet arthritis.L5-S1: Diffuse bulging of disc with bilateral ligamentum flavum thickening results minimal spinal canal stenosis. Otherwise unremarkable..
1. Subtle enhancement of endplates around L12 disc space likely represents degenerative changes related findings but associated early discitis cannot be completely excluded.2. Intrathecal especially sacral area subacute blood products indicate redistribution of acute SAH.3. Minimal degenerative changes of lumbar spine.