Lower back pain and right foot drop. There are five lumbar type vertebral bodies. There is a normal lumbar lordosis. Stable 4 mm of anterolisthesis of L4 on L5. The vertebral body and disk heights are well-maintained. The conus medullaris terminates at L1/L2. The paraspinal soft tissues are unremarkable.Within the posterior aspect of L1 vertebral body there is a small focus of abnormal signal that is intermediate on T1 and bright on T2 and STIR, with peripheral T1 hyperintensity. At L3 there is ill-defined signal abnormality superiorly and posteriorly, it is hypointense on T1 and T2-weighted images with no STIR abnormality and corresponds to an ill-defined lucency on the recent CT, where it has a benign appearance. Additionally, there is a benign-appearing heterogeneous T1, T2 hyperintense lesion in the right ischium as well as a focus of sclerosis in the left ischium, similar in appearance compared to the recent CT.T12-L1: There is no significant compromise to spinal canal or neural foramina.L1-L2: There is mild to moderate facet joint hypertrophy, ligamentum flavum thickening and a very shallow left foraminal disc protrusion but no significant compromise to spinal canal or neural foramina.L2-L3: There is moderate facet joint hypertrophy and ligamentum flavum thickening. There is bilateral, right greater than left shallow disc protrusion but no significant compromise to spinal canal or neural foramina.L3-L4: There is moderate facet hypertrophy and ligamentum flavum thickening with mild narrowing of the spinal canal. There are bilateral foraminal disc protrusions resulting in mild to moderate narrowing of the left neural foramen and very mild narrowing of the right neural foramen.L4-5: There is moderate facet joint hypertrophy with facet joint effusions and ligamentum flavum thickening. There is a prominent central disc protrusion with an annular fissure. These findings result in moderate narrowing of the spinal canal as well as moderate to severe left and moderate right neural foraminal narrowing and narrowing of the lateral recesses bilaterally.L5-S1: There is moderate facet joint hypertrophy with facet joint effusions. There is a disc bulge and superimposed right foraminal disc protrusion resulting in severe neural foraminal narrowing. Disc material abuts the descending right S1 nerve root and displaces it minimally posteriorly. There is moderate narrowing of the left foramen. The lateral recesses are narrowed, greater on the right.Probable right renal cyst is similar in size compared to the.
1.Disc bulge with superimposed right foraminal protrusion at L5-S1 severely narrows the right neural foramen. The disc material abuts and posteriorly displaces the right S1 nerve root.2.Prominent central disc protrusion with annular fissure at L4-5 results in moderate central spinal stenosis, moderate to severe left and moderate right neural foraminal narrowing.3.Bone marrow signal abnormalities in the L1 and L3 vertebral bodies are nonspecific with only subtle CT correlating abnormality. The L3 lesion may represent an atypical hemangioma. These findings could be further evaluated with bone scan if there is concern for infection or metastatic disease.