Osteomyelitis, unspecified [M86.9], Reason for Study: ^Reason: evaluation of back pain and weakness in the setting of osteo History: pain and weakness of LE For the purpose of this dictation, the lowest visualized intervertebral disc space is labeled L5-S1.  There is new enhancing lesions on the right side of L45 transverse process which extends toward right side paraspinal muscle. The lesion extends around the level of the right side posterior SI joint level. Comparing to prior scan especially CT guided biopsy, the lesions is matching with the needle path. Thus, this new lesion is likely an extension of discitis infection through the biopsy needle path. A simple bit exaggerated inflammatory reaction through the needle track is another possibility but less likely.Enhancing lesions on both L45 and L5S1 as well as L4 and L5 vertebral bodies with bone marrow edema indicating discitis and osteomyelitis are again seen, unchanged since prior scan.Mild to moderate spinal canal stenosis with bilateral mild to moderate neuroforaminal stenosis at the level of L34, and L45, unchanged since prior scan.Spinal cord signal intensity is normal.Lumbar spine alignment is normal.The vertebral body height is preserved. The conus medullaris terminates at the T12-L1 level.
1. Interval development of right paraspinal muscle enhancing lesion at the level of L45 which likely represent infection extension through prior post CT guided disc biopsy needle track. 2. Otherwise unchanged MR findings of L45 and L5S1 discitis and osteomyelitis.3. Unchanged multilevel spinal stenosis and neuroforaminal stenosis.