Diagnosis: Amyotrophic lateral sclerosisClinical question: r/o stenosis, radiculopathySigns and Symptoms: BL shooting leg pain Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is a mild disc bulge and some disc desiccation at this level.At L4-5 there is loss of disc space height as well as diffuse disc bulge associated bilateral ligamentum flavum hypertrophy. The disc is T2 signal hyperintense. Some disc material extends behind the adjacent L4 inferior endplates and L5 superior endplates. The endplates appear fairly well-preserved. There are endplate reactive changes which are high signal on T1 and low signal on STIR T2 TSE imaging. Disc material extends into the neural foramina bilaterally. There is partial effacement of the fat surrounding the right-sided exiting nerve root at this level there is milder encroachment in the left neural foramen. There is triangulation of the thecal sac at this level. There is effacement of the fat at the left lateral recess and to a lesser degree there is effacement of the fat at the right lateral recess. Overall there is mild to moderate spinal stenosis at this level.At L3-4 there is no significant compromise to spinal canal or neural foramina. There is ligamentum flavum hypertrophy present at this level.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.There are parapelvic renal cysts present.There are some endplate reactive changes at T10-T11.
1.There are degenerative changes present in the lumbar spine which are worse at L4-5 where there is a mild to moderate degree of spinal stenosis as well as some encroachment of the right-sided exiting nerve roots within the neural foramina.