Back pain, fever. Evaluate for compression. Examination is limited to sagittal sequences per cord compression protocol. There are postsurgical changes related to recent revision of spinal fusion with hardware extending from L4 to S1 with iliac screws. Mild L5-S1 anterolisthesis. There is a small fluid collection involving the posterior paraspinous soft tissues which given recent surgery may represent a seroma or perhaps a pseudomeningocele. Superimposed infection is not excluded. Degenerative changes are seen in the cervical spine particularly at C5-C6 and C6-C7 with mild kyphotic angulation. Minimal T2 hyperintensity at the C6-C7 disc is likely on a degenerative basis. STIR hyperintensity involving the posterior elements at the C7-T1 level is also nonspecific and may represent a mild interspinous bursitis.
1. No evidence of cord compression or high-grade stenosis within the cervical, thoracic, or lumbar spine. No obvious epidural collection.2. Postoperative changes of recent hardware revision with fluid collection involving the posterior paraspinous soft tissues dorsal to the L4-S1 levels. Given recent surgery, this fluid collection can be expected and may represent a seroma or pseudomeningocele, although infection cannot be excluded.3. Due to the screening nature of this protocol details are not as evident on imaging as dedicated protocols of the spine. If there is high suspicion for spinous/paraspinous infection, consider complete study with gadolinium.