58-year-old man with history of osteomyelitis, now with low back pain and fever. Decreased T1 and increased T2 signal involving the inferior endplate of L4 and superior endplate of L5 with abnormal intermediate signal in the L4/L5 disc is again noted. Overall, the extent of the signal abnormality appears similar to the study from 3/31/2016. There is subcentimeter area of what may represent a heterogeneous fluid collection surrounded by edema in the right posterior paraspinal muscles. The vertebral body heights are within normal limits. The alignment is within normal limits. The conus medullaris is normal in position terminating at the T12 level. There is a disc bulge at L3/L4 with effacement of the anterior subarachnoid space and moderate bilateral neural foraminal narrowing.
1.Sequela of chronic osteomyelitis and discitis involving L4/5, although assessment is limited due to the lack of intravenous contrast.2.Probable residual fluid collection and surrounding edema in the right paraspinal musculature which may represent a small persistent abscess, although assessment is limited due to the lack of intravenous contrast.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.