Type 2 diabetes mellitus, bacteremia with MRSA. For the purpose of this dictation, the lowest visualized intervertebral disc space is labeled L5-S1. There are multiple areas of abnormal fatty marrow replacement including T12, L1, L2 and L3. Especially L2 and L1 vertebral body were most extensive. There is minimal less than 5% compression fracture of L3 vertebral body.On contrast enhancement, those areas of low signal intensity on T1-weighted images show diffuse enhancement. On axial scan, post gadolinium enhancement images show ill-defined enhancement of soft tissues mesial aspect of bilateral psoas muscles and prevertebral space with some foci of non enhancing areas. Especially at the level of L2 vertebral body, the anterior epidural space shows slightly thicker enhancement than other level but does not particularly show mass formation. This finding could suggest possible inflammatory extension toward anterior epidural space but could also be engorged basivertebral vein due to surrounding inflammation.These findings are suggestive for multilevel vertebral osteomyelitis extends toward paravertebral space. The paravertebral space lesions are likely represent phlegmon type of lesion with some internal small abscess formation.There is no evidence of epidural abscess formation or hemorrhage.There is about 22.2 mm sized right renal cyst and 12.8 mm sized left renal cyst.On the right side external to back muscle group fascia, there is well circumscribed fat containing lesion within the subcutaneous tissue likely represent lipoma. The entire lesion was not imaged with this scan, thus if indicated, consider abdominal CT scan.There is normal lumbar lordosis. The spine alignment is anatomic. The signal of the visualized cord is normal. The epidural space, thecal sac, and spinal cord are preserved with no evidence of spinal canal/neural foraminal narrowing. The conus medullaris terminates at the L1 level.Degenerative changes are specified by the intervertebral level as follows: T12-L1: no neuroforaminal narrowing or spinal stenosis. L1-L2: no neuroforaminal narrowing or spinal stenosis. L2-L3: no neuroforaminal narrowing or spinal stenosis. L3-L4: no neuroforaminal narrowing or spinal stenosis. L4-L5: no neuroforaminal narrowing or spinal stenosis. L5-S1: disc dessication. no neuroforaminal narrowing or spinal stenosis.
1. Osteomyelitis involving T12, L1, L2 and L3 with main focus on the L2 and L1. Minimal compression fracture of L2 as described above.2. Evidence of paravertebral and pre vertebral inflammation with possible phlegmon with some internal abscess formation around L1 and L2 vertebral body level.3. Spinal canal and spinal cord appear to be normal.4. Disc dessication at the level of L5S1.