Reason: h/o discitis with vertebral osteo. please look for improvement History: back pain improved. Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment. The conus medullaris on sagittal imaging is grossly intact. There is mild loss of virtual body height at L4.At L5-S1 there is no significant compromise to spinal canal or neural foramina.At L4-5 there is no significant compromise to spinal canal or neural foramina. There is a disk bulge present at this level with narrowing of the neural foramina bilaterally (left worse than right) and encroachment of the left-sided exiting nerve roots. At L3-4 there is T2 signal hyperintensity within the disk associated with endplate irregularity. There is associated signal changes within the adjacent virtual bodies. There is associated signal change in the surrounding perivertebral musculature and effacement of surrounding fat planes. No epidural fluid collection is clearly appreciated.At L2-3 there is loss of the space height, disk desiccation and a diffuse disk bulge which was also present on the prior exam. It is associated with partial effacement of the fat of the right lateral recess and encroachment of the right-sided exiting nerve roots within the neural foramen. Overall there is no significant change in compared to prior exam.At L1-2 there is no significant compromise to spinal canal or neural foramina.At T11-T12 there is redemonstration of loss of disk space height as well as signal hyperintensity within the right half of the disk and endplate irregularity. There is some mild loss of height of the right half of the T12 vertebral body which was also present on the prior exam.
1.The patient was unable to continue with examination for axial imaging. As a result this is a limited study. If clinically appropriate and the patient is able to tolerate the exam and the renal function is appropriate, MRI of the lumbar spine with gadolinium may be of benefit to further evaluate the extent of the disease.2.Findings are suggestive of diskitis osteomyelitis at L3-4. Since the prior exam there is been some regression of the signal abnormalities at the adjacent vertebral bodies suggesting evolution but not significant progression.3.Since the prior exam there is been some mild compression of the L4 vertebral body.4.There is redemonstration of findings suggestive of chronic inflammatory reaction at the T11-T12 vertebra.5.There is redemonstration of encroachment of the nerve roots right neural foramen and right lateral recess at L2-3 associated with mild spinal stenosis.6.There is redemonstration of encroachment on the left-sided exiting nerve root at L4-5 related to disk disease.