78 years Female (DOB:9/23/1937)Reason: Evaluate for stenosis History: EMG shows multi-level lumbar radiculopathyReferring Attending: NAOUM P ISSA L5 appears to be a transitional vertebra and is partially sacralized there are 5 nonrib-bearing vertebrae present. Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall height. There is mild anterior subluxation of L4 and L5. The conus medullaris on sagittal imaging is grossly intact. At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is a disc bulge present this level. There is right-sided facet hypertrophy present and to lesser degree left-sided facet hypertrophy.At L4-5 there is some loss of disc space height, disc desiccation and a diffuse disc bulge associated with ligamentum flavum hypertrophy and crowding of the nerve roots within the thecal sac. Overall there is a mild to moderate degree of spinal stenosis present at this level. Although the neural foraminal are narrowed, within the neural foramina the exiting nerve roots are surrounded by fat.At L3-4 there is disc desiccation, loss of disc space height and a disc bulge associated with ligamentum flavum hypertrophy. There is crowding of the nerve roots at this level and overall a mild to moderate degree of spinal stenosis the fat at the lateral recesses is effaced bilaterally at this levelAt L2-3 there is no significant compromise to spinal canal or neural foramina. There is mild ligamentum flavum hypertrophy at this level.At L1-2 there is no significant compromise to spinal canal or neural foramina. There is infiltration of the pelvic fat planes associated with some pelvic fluid. This could represent a site is or inflammatory process. Correlating to a CT from 6/15/2016 and appears that a similar appearance was present.
1.There is infiltration of the pelvic fat planes associated with some pelvic fluid. This could represent a site is or inflammatory process or related to the patient's neoplasm. This is similar appearance to the CT of the abdomen from 6/15/2016. Please correlate with patient's clinical symptoms.2.No obvious lesions appreciated in the lumbar plexus. Please note however the sensitivity of MRI of the lumbar plexus without contrast is significantly lower than that with contrast for detection of carcinomatosis. As a result carcinomatosis cannot be adequately excluded.3.There are degenerative changes present in the lower lumbar spine with a mild to moderate spinal stenosis at L4-5 and L3-4.4.Please note that there is a transitional vertebra present with partial sacralization of L5.