Female, 57 years old, with low back pain, and right leg pain. L5 radiculopathy. History of discitis. A grade 1 anterolisthesis of L5 relative to S1 is seen. Sagittal alignment is otherwise unremarkable.Vertebral body heights are preserved. Severe endplate degenerative signal alteration is seen at L5-S1, with moderate endplate signal alteration at L3-4. Edema is evident within the L5 pedicles and surrounding the right L4-5 facet joint. Apart from degenerative endplate enhancement, no concerning or worrisome marrow enhancement is seen.The visualized distal spinal cord, conus and nerve roots of cauda equina are unremarkable. No epidural abnormalities are suspected. No intradural or extradural enhancing lesions are seen.The left kidney is large and contains several cystic lesions. A normal right kidney is not visualized, though in the right renal bed there is an oval enhancing structure which may represent dysplastic somewhat featureless renal parenchyma. A subcentimeter liver cyst is incidentally noted. Mild enhancement is seen on the sacral side of the sacroiliac joints bilaterally.L1-2: No significant spinal canal stenosis or neuroforaminal narrowing. L2-3: Mild facet arthropathy. No significant spinal canal or foraminal stenosis. L3-4: Moderate facet arthropathy and ligamentum flavum thickening. Severe loss of disc height and endplate irregularity. Minimal disc bulging. No significant spinal canal stenosis. Mild bilateral foraminal narrowing. L4-5: Moderate facet arthropathy and ligament flavum thickening with a facet effusion on the right. Mild disc bulging. No significant spinal canal or foraminal stenosis. L5-S1: Marked facet arthropathy and ligamentum flavum thickening. Disc bulging and disc uncovering. No significant spinal canal stenosis. Moderate to severe bilateral foraminal narrowing.
1.Severe degenerative disc disease is seen at L3-4 and L5-S1 with complete or near complete loss of disc height and endplate irregularity at these levels. There is no significant spinal canal stenosis. However, the neural foramina at L5-S1 are significantly narrowed.2.Facet arthropathy is evident most notably at L4-5 and L5-S1.3.Enhancement along the sacral portion of the sacroiliac joints may represent sacroiliitis.4.It appears that the right kidney is dysmorphic and somewhat featureless. Dedicated abdominal imaging can be considered to further evaluate if clinically warranted.