Severe low back pain, concern for infection/osteo, persistent E. faecalis bacteremia Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. Alignment is within normal limits. Bone marrow signal is benign. The conus medullaris is normal in position. There is edema involving the T11-T12 and L2-L3 intervertebral disc spaces as well as the adjacent endplates. There is enhancement involving the endplates at these levels. Mild bilateral paraspinous soft tissue enhancement is also noted at the L2-L3 level. Edema involving the right lateral paraspinous T11-T12 level is also questioned on the sagittal STIR sequences; axial images do not extend to this level for confirmation. No discrete fluid collections are evident. No epidural enhancement or evidence of epidural abscess. Multilevel degenerative changes are seen with mild multilevel disc desiccation as well as Schmorl's nodes involving the L2 and L3 inferior endplates. There is also multilevel ligamentum flavum thickening and mild bilateral facet arthropathy. There is no disc herniation or significant spinal canal or neural foraminal stenosis at any level.
Edematous changes involving the T11-T12 and L2-L3 intervertebral discs and adjacent endplates. While these may be on a degenerative basis, discitis-osteomyelitis at these levels cannot be excluded. The L2-L3 level is particularly suspicious for infection given the mild paraspinous soft tissue enhancement at this level. There may also be edema involving the right paraspinous T11-T12 level as seen on the sagittal STIR sequence, but is not imaged on the axial lumbar sequences for better assessment. No discrete fluid collections or evidence of epidural abscess.