Diagnosis: Sciatica, right side Radiculopathy, site unspecifiedClinical question: assess for causes of radicular back painSigns and Symptoms: back pain with radiculopathy Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall height. 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 disc desiccation present at this level.At L4-5 there is loss of disc space height, diffuse disc bulge and endplate reactive changes associated with facet and ligamentum flavum hypertrophy. The endplate reactive changes are high signal on T2 and low signal on T1. The endplates are irregular. The loss of disc space height appears to be worse than a plain film exam of 3/24/2015. There is crowding of the nerve roots within the thecal sac at this level with near effacement of the spinal fluid surrounding the nerve roots. Overall there is a moderate degree of spinal stenosis present at this level. There is effacement of the fat at the lateral recess bilaterally at this level. There is narrowing of the neural foramina at this level associated with encroachment of the exiting nerve roots within the neural foramina.At L3-4 there is no significant compromise to spinal canal or neural foramina. There is a minor disc bulge at this level. At L2-3 there is no significant compromise to spinal canal or neural foramina. There is a Schmorl's node at this levelAt L1-2 there is no significant compromise to spinal canal or neural foramina.The kidneys appear relatively small.
1.There are degenerative changes present in the lumbar spine which are worse at L4-5 where there is moderate spinal stenosis and bilateral neural foramen encroachment due to degenerative change. The degenerative changes appear to have progressed significantly since the prior CT of the abdomen from 9/9/2014. There are acute endplate reactive changes at this level which are likely inflammatory in nature. Please correlate with clinical history.2.The kidneys appear atrophic.