Vague lower back pain with SI joint symptoms of unknown etiology. There is mild loss of lumbar lordosis. The vertebral body and disc space heights are preserved. There are scattered vertebral body hemangiomas as well as patchy areas of increased T1 and T2 signal within the sacrum and vertebrae, compatible with fatty marrow. The spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable. At T12-L1, L1-2, and L2-3, there is mild facet arthropathy without significant compromise to spinal canal or neural foramina. At L3-4, there is mild disc bulging and facet arthropathy causing mild bilateral neural foraminal stenosis, but no significant spinal canal stenosis. At L4-5, there is facet arthropathy, ligamentum flavum thickening, and a left paracentral disc protrusion causing moderate left neural foraminal stenosis without significant spinal canal stenosis. At L5-S1, there is no significant narrowing of spinal canal or neural foramina. However, there is a subcentimeter posterior right synovial cyst at this level.
1. Mild multilevel spondylosis with a left paracentral disc protrusion causing moderate left neural foraminal stenosis at L4-5.2. No evidence of inflammatory changes involving the sacroiliac joints.3. Scattered areas of fatty bone marrow in the imaged axial skeleton, which may indicate incipient osteopenia.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.