Diagnosis: Lumbago with sciatica, left sideClinical question: r/i disc herniationSigns and Symptoms: progressive low back back with tingling down L leg 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 or neural foramina.At L4-5 there is is a right lateral recess broad-based disc protrusion which displaces the nerve roots of the right lateral recess and partially effaces the fat at the right lateral recess. Disc material extends into the inferior aspect of the right neural foramen at this level. The exiting nerve roots within the neural foramina are surrounded by fat. There are endplate reactive changes present at this level which are predominantly high signal on T2-weighted imaging and low signal on T1-weighted imaging which are located along the right half of the endplates of the L4-5 disc space.At L3-4 there is no significant compromise to spinal canal or neural foramina.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 is a right lateral recess disc protrusion present at L4-5 associated with some subacute inflammatory changes at the adjacent endplates which encroaches mildly on the nerve roots of the right lateral recess at this level. Please note that this does not match the reported history of left sided sciatica