Male, 94 years old, with gait impairment. Evaluate for spinal stenosis, metastatic disease. Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits. Marrow signal characteristics are somewhat heterogeneous but overall benign. Mild endplate edema is seen at the inferior L3 endplate with an associated Schmorl's node deformity. A small focus of STIR hyperintensity within the S2 vertebral body is nonspecific.The visualized distal spinal cord, conus and cauda equina are within normal limits. No epidural abnormalities are suspected.Note is made of severe hydronephrosis and hydroureter on the right. In addition, there are a number of enlarged retroperitoneal lymph nodes. A masslike lesion is partially visualized in the right pelvis.L1-2: Mild facet arthropathy and ligamentum flavum thickening. No significant spinal canal or foraminal stenosis. L2-3: Facet arthropathy and ligamentum flavum thickening. Mild disc bulging. No significant spinal canal stenosis. Mild bilateral foraminal narrowing. L3-4: Moderate facet arthropathy and ligamentum flavum thickening. Moderate disc bulging. Mild spinal canal stenosis. Mild bilateral foraminal narrowing. L4-5: Moderate facet arthropathy and ligamentum flavum thickening. Mild bulging disc. No significant spinal canal stenosis. Mild bilateral foraminal narrowing. L5-S1: Moderate facet arthropathy. No significant spinal canal or foraminal stenosis.
1.Relatively mild degenerative disease of the lumbar spine with no areas of high-grade spinal canal or foraminal stenosis.2.Severe hydronephrosis and hydroureter is evident on the right, in the context of retroperitoneal adenopathy and a probable right pelvic mass which is only partially visualized. Further evaluation with dedicated pelvic imaging is recommended. Findings were discussed with Dr. Campbell at 1:00 PM on 08/03/16.3.No definite osseous metastases are seen. A small focus of signal abnormality in the S2 vertebral body is nonspecific. If concern for osseous metastases persists, further evaluation with a nuclear medicine bone scan may provide additional information.