65 year old female with persistent back pain. The right sacroiliac joint is slightly wider than that on the left with slight irregularity and more sclerotic margins, as seen on the patient's CT examination from 2010. This may reflect the sequela of previous inflammation or be degenerative in etiology, but we see no enhancement on postcontrast sequences to suggest active sacroiliitis. Please note that this study was not protocoled for detailed evaluation of the lumbar spine. Severe degenerative disc disease affects the level of L4/L5 with signal abnormality and enhancement of the adjacent vertebrae and paravertebral soft tissues on the right. There is a diffuse disc bulge as well as ligamentum flavum hypertrophy with associated moderate spinal canal stenosis at this level. Mild degenerative disc disease affects the levels of L3/L4 and L5/S1. There is facet joint osteoarthritis at the levels of L4/L5 and L5/S1. There are also inflammatory changes in the paravertebral soft tissues at the level of L5/S1, right greater than left, with associated posterior synovial cyst formation.
1. Mild widening and articular surface irregularity along the inferior aspect of the right sacroiliac joint, which may represent previous inflammation or degenerative changes. We see no findings to suggest active sacroiliitis.2. Degenerative disc disease and facet joint osteoarthritis of the lower lumbar spine as described above.