Clinical question: Evaluate for stenosis. Signs and symptoms: Low back pain and lumbar radiculopathy. Nonenhanced lumbar MRI:There is unremarkable signal intensity and normal anatomical alignment of the vertebral column.There is a slight generalized narrower than expected caliber of the lumbar spinal canal at L3 and L4 levels which is believed to represent a congenital anatomical variation.There is no appreciable degenerative disk disease and no evidence of disk protrusion/extrusion. Examination however demonstrate mild hypertrophic changes of the ligamentum flavum in a symmetrical fashion in the mid to lower lumber spine. Very mild facet degenerative changes and including minimal facet effusion is also suspected.There is no evidence of spinal stenosis or definitive neural foraminal compromise at any level.Partially visualized SI joints demonstrate no abnormality.The paraspinal musculature remains normal in signal intensity and morphology.
1.No evidence of spinal stenosis or definitive neural foraminal compromise.2.Mild hypertrophic changes of the ligamentum flavum and mild facet disease in the lower lumber spine is present3.Mild decreased caliber of the spinal canal at L3 and L4 levels likely representing a congenital anatomical variation.