Male, 73 years old, with left-sided back pain and left lower extremity radiculopathy. T1 hypointensity and heterogeneous T2 hyperintensity are seen affecting the superior aspect of the L4 vertebral body. These findings correlate with sclerosis and cystic changes demonstrated on prior CT from 2013. Only slight loss of vertebral body height is seen at this level which may reflect endplate degeneration and/or Schmorl's node formation. The remaining vertebral bodies are free of significant marrow signal abnormality and demonstrate preservation of height. Spinal alignment is anatomic. The distal spinal cord, conus and nerve roots of the cauda equina are unremarkable. No epidural abnormalities are suspected.A large left renal cystic lesion is partially visualized.L1-2: Unremarkable. L2-3: Mild facet arthropathy. Mild disc bulging. No spinal canal or foraminal stenosis. L3-4: Moderate facet arthropathy and ligamentum flavum thickening. Bulging disc. Mild spinal canal narrowing. Mild bilateral foraminal narrowing. L4-5: Advanced facet arthropathy. Ligamentum flavum thickening. Disc bulging with perhaps a small superimposed right paracentral/foraminal protrusion. No significant spinal canal stenosis. Moderate right and mild left foraminal narrowing. L5-S1: Moderate facet arthropathy. Ligamentum flavum thickening. Bulging disc. No significant spinal canal stenosis. Mild bilateral foraminal narrowing.
1.Findings are seen compatible with sclerosis and endplate degeneration or Schmorl's node formation at L4. Accounting for differences in technique, this abnormality does not appear to have changed significantly when compared to a prior CT examination from 2013.2.No other definite acute vertebral body abnormalities are seen.3.Multilevel disc and posterior element degeneration are seen. At most, the spinal canal is mildly narrowed. Moderate right foraminal narrowing is seen at L4-5.