Clinical question: Please perform Dr.Javed's MS protocol. Signs and symptoms: Multiple sclerosis with acute lumbar radiculopathy, evaluate for myelitis or disc etiology. Pre and postcontrast enhanced lumbar MRI:There is normal anatomical alignment of vertebral column. There is however mild straightening of lumbar lordosis without significant change since prior exam.There is normal signal intensity over lowermost visualized thoracic cord and the cauda equina without abnormal enhancement.T11-T12 is unremarkable.T12-L1 is unremarkable.L1-L2 is unremarkable.L2-L3 demonstrate minimal disc desiccation and mild hypertrophy of ligamentum flavum without spinal stenosis or neural foraminal compromise.L3-L4 demonstrate a broad based shallow left lateral and far lateral disc protrusion at this level without significant change since prior exam from 2010. There is no spinal stenosis or neural foraminal compromise at this level. L4-L5 demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise.L5-S1 is unremarkable.Postenhanced images demonstrate no abnormal enhancement of the vertebral column, the discs or the epidural spaces.
1.Normal signal intensity and caliber of the lower most visualized thoracic cord, conus and cauda equina without abnormal enhancement.2.Mild degenerative changes of lumbar spine without spinal stenosis or neural foraminal compromise at any level. Findings remain similar to prior exam. There is a shallow broad-based disc protrusion laterally and far laterally at L3-L4 without significant change since prior exam. Please see above comments.