Clinical question: Back pain, radiculopathy? Stenosis or disc herniation? Signs and symptoms: Back pain, leg, thigh pain, unsteady standing-new onset. Nonenhanced lumbar MRI:The signal intensity of vertebral column is unremarkable and maintained normal anatomical alignment.Lower most visualized thoracic spine and thoracic cord is unremarkable.T12-L1 is unremarkable.L1-L2 is unremarkable.L2-L3 is unremarkable.L3-L4 demonstrate mild disc desiccation, mild bilateral ligamentum flavum hypertrophy without spinal stenosis or neural foraminal compromise.L4-L5 demonstrate mild ligamentum flavum hypertrophy and unremarkable otherwise without spinal stenosis or neural foraminal compromise.L5-S1 demonstrate mild disc disease and loss of disc height, mild bilateral facet and ligamentum flavum degenerative changes. No spinal stenosis or neural foraminal compromise.No detectable paraspinal soft tissue abnormalities.Limited view of the SI joints demonstrate no abnormality.Normal signal intensity and caliber of the lower thoracic cord, conus and the cauda equina.
Unremarkable nonenhanced MRI of the lumbar spine other than minimal degenerative changes as detailed above.