Lumbar radiculopathy. Evaluate for lumbar stenosis. There are 5 rib-less, lumbar-type vertebrae. The last well-formed disc is at L5-S1. Alignment is notable for straightening which may reflect patient position. The vertebral bodies are preserved in height. Focal signal abnormalities involving the T11 and T10 vertebral bodies, which contain fat are most compatible with hemangiomas. The marrow otherwise shows no suspicious lesion. There is mild loss of disc T2-signal and height at L3-L4 through L5-S1, associated with small posterior bulges as detailed below. The tip of the conus medullaris is at the upper L2 level. The conus medullaris and the included lower spinal cord show normal signal and morphology. The right kidney is laterally rotated. Subcentimeter T1-hypointense, T2-hyperintense lesions in the kidneys and liver may represent cysts but are not completely assessed on this examination. T12-L1, L1-L2 and L2-L3: There is no significant disc herniation. There is no spinal canal or foraminal stenosis. There is mild facet arthropathy.L3-L4: Minimal disc bulge is present along with mild ligamenta flava thickening and mild facet arthropathy. There is no significant spinal canal or foraminal stenosis.L4-L5: Mild disc bulge only flattens the ventral thecal sac. There is mild ligamenta flava thickening and mild-to-moderate facet arthropathy. There is mild-to-moderate left neural foraminal stenosis. There is no spinal canal or right foraminal stenosis.L5-S1: Minimal disc bulge is associated with moderate to severe, left worse than right facet arthropathy. There is also mild ligamenta flava thickening. There is no significant spinal canal stenosis. There is mild bilateral foraminal stenosis.
1.Mild lower lumbar degenerative spondylosis results in no significant spinal canal stenosis and only mild left L4-L5 and bilateral L5-S1 neural foraminal stenoses.2.Facet arthropathy is significant in the lower lumbar spine and might be contributing to back pain, especially the left L5-S1 facet.3.Subcentimetric liver and kidney lesions are not completely assessed but may represent cysts.