55-year-old female with low back pain and left hip pain The density and the alignment the vertebral column remains within normal limits. No significant degenerative disk disease is identified. There is however mild degree of degenerative disease at L5 -- S1 level. No evidence of spinal stenosis at any level.No evidence of central spinal stenosis or neural foramina compromise from T12 -- L1 through L3 -- L4 level.L4 -- L5.Minimal degenerative disk disease and hypertrophic changes of posterior elements are noted. Minimal bulge of disk material is present. Laterally within the neural foramina and far laterally there is broad-based bulge of disk material and a more focal area of disk protrusion. This is highly suspected of a large herniated disk. This finding is best appreciated on axial image 57 and 58. Lateral to the disk a prominent soft tissue density (axial image 55) is identified. This finding may represent inflamed and swollen nerve root or a migrated disk fragment laterally. I recommend further evaluation with an MRI examination or a post infusion study to exclude possibility of a mass. There is only minimal compromise of the left neuroforamina secondary to above findings. The right neuroforamina is patent and no central spinal stenosis is detected.L5 -- S1.Moderate degree of degenerative disk disease with a sclerotic changes of endplates are noted. No central spinal stenosis or neural foramina compromise. Mild bulge of disk material is also present.
1.Suspected large herniated disk at L4 -- L5 laterally and far laterally as detailed.2.Prominent soft tissue density adjacent to the disk at this same location may be represent a swollen nerve root or a mass. Further evaluation with a dedicated post infused MRI or a post infusion CT to exclude presence of the mass is recommended.3.No evidence of central spinal stenosis or neural foramina compromise at any other level.