Diagnosis: Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema Other symptoms and signs involving the musculoskeletal systemClinical question: r/o lumbosacral disc diseaseSigns and Symptoms: right leg weakness Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact.At L5-S1 there is no significant compromise to spinal canal. There is disc desiccation and diffuse disc bulge at this level associated with bilateral facet and ligamentum flavum hypertrophy. Fluid is identified within the facet joints. There is partial effacement of the fat at the lateral recess bilaterally at this level with mild encroachment of the nerve roots of the lateral recess. There is narrowing of the neural foramina bilaterally with effacement of the fat surrounding the left-sided exiting nerve roots and partial effacement of the fat surrounding the right-sided exiting nerve roots.At L4-5 there is no significant compromise to spinal canal or neural foramina. There is loss of disc space height this desiccation and diffuse disc bulge at this level associated with ligamentum flavum hypertrophy and partial effacement of the fat at the lateral recess bilaterally. The exiting nerve roots of the neural foramina are surrounded by fat.At L3-4 there is no significant compromise to spinal canal or neural foramina. There is disc desiccation, diffuse disc bulge and endplate reactive change at this level associated with mild ligamentum flavum hypertrophy. There is mild narrowing of the neural foramina at this level. The endplate reactive changes are predominantly high signal on T1 with a mixture of T2 signal hyperintensity.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.
There are multilevel degenerative changes present lumbar spine with encroachment of the nerve roots within the left neural foramen at L5-S1.