Lumbago with sciatica, right side [M54.41], Reason for Study: ^Reason: cause of low back pain with radicular distribution History: low back pain radiating down legs. For the purpose of this dictation, the lowest visualized intervertebral disc space is labeled L5-S1. The bone marrow of whole lumbar spine as well as bilateral iliac bone show low T1 signal intensity with patchy high signal intensity areas. This finding likely to be artifactual due to signal inhomogeneity, however, possibility of diffuse bone marrow infiltrative lesions cannot be completely excluded. Clinical correlation is recommended.In addition, there is subtle T2/STIR signal intensity with irregular enhancement of Bilateral S1 ala and S2 body. There is no evidence of associated soft tissue lesion on this scan. This may represent compression/stress fracture, bone infarctions or other bone marrow infiltrative lesions. There is normal lumbar lordosis. The spine alignment is anatomic. The vertebral body height is preserved. The signal of the visualized cord is normal. The conus medullaris terminates at the L1-L2 level.The paraspinal soft tissues are unremarkable.There is no evidence of abnormal enhancement, cord compression or mass. Degenerative changes are specified by the intervertebral level as follows: T12-L1: no neuroforaminal narrowing or spinal stenosis. L1-L2: no neuroforaminal narrowing or spinal stenosis. L2-L3: no neuroforaminal narrowing or spinal stenosis. L3-L4: no neuroforaminal narrowing or spinal stenosis. L4-L5: minimal bulging of disc, no neuroforaminal narrowing or spinal stenosis. L5-S1: minimal diffuse bulging of disc, no neuroforaminal narrowing or spinal stenosis.
1. Diffuse patchy low T1 signal intensity of lumbar and sacral vertebral bodies as well as bilateral iliac bones. Differential diagnosis include artifacts and diffuse bone marrow infiltrative lesions.2. Inhomogeneous enhancement with subtle T2/STIR high signal intensity lesions at S1 and S2 suggest possibility of compression/stress fracture, bone infarcts or bone marrow infiltrative lesion.3. Diffuse bulging of discs at the level of L45 and L5S1. Comment: Bony Pelvic CT can be considered for further imaging evaluation if clinically indicated.