Pain and abnormal sclerotic lesion on L2 per x-ray. There is a non-enhancing low T1 and T2 focus that measures up to 14 mm in right aspect of the L2 vertebral body. There is an intravertebral disc herniation in the inferior endplate of the L3 vertebral body with associated enhancement. There is a disc bulge at L2-3 with mild bilateral neural foraminal narrowing. There is an eccentric right disc bulge at L3-4 and ligamentum flavum thickening with mild to moderate right and slight left neural foraminal narrowing, as well as spinal canal narrowing, with impingement upon the descending nerve roots in the right lateral recess. There is a disc bulge, facet hypertrophy, and ligamentum flavum thickening at L4-5, with moderate right and moderate to severe left neural foraminal narrowing and narrowing of the spinal canal with apparent impingement upon the descending nerve roots in the bilateral lateral recesses. There is no significant neural foraminal or spinal canal stenosis at T12-L1, L1-2, or L5-S1. The vertebral column alignment is within normal limits. There is no significant spinal canal stenosis. The spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable.
1. A non-enhancing low T1 and T2 focus that measures up to 14 mm in the L2 vertebral body may represent an enostosis, versus less likely a metastasis. 2. Multilevel degenerative spondylosis of the lumbar spine with variable degrees of neural foraminal and spinal canal narrowing, which is most pronounced at the L3-4 level.