Shoulder pain and sciatica. Cervical spine:There are degenerative changes in the cervical spine, with level-specific findings as follows:C2-C3: There is mild disk-osteophyte complex, degenerative changes of uncovertebral joints and facet joints. Spinal canal and neuroforamina remain patent.C3-C4: There is mild disk-osteophyte complex, degenerative changes of uncovertebral joints and facet joints. Spinal canal remains patent. There is minimal left neuroforaminal narrowing.C4-C5: There is mild disk-osteophyte complex, degenerative changes of uncovertebral joints and facet joints. There is mild narrowing at the left lateral recess and left neuroforamen. C5-C6: There is mild disk-osteophyte complex, degenerative changes of uncovertebral joints and facet joints. There is mild narrowing at the spinal canal. Moderate bilateral neuroforaminal narrowing is also seen.C6-C7: There is moderate disk-osteophyte complex, degenerative changes of uncovertebral joints and facet joints. There is mild to moderate narrowing at the spinal canal. Moderate bilateral neuroforaminal narrowing is also seen.C7-T1: Spinal canal and neuroforamina are patent.Lumbar spine:For the purpose of labeling, 5 lumbar vertebral bodies are assumed to be present, with the most superior intervertebral level on the sagittal images assumed to be T12 - L1.Degenerative disease is seen in the lumbar spine. The degenerative changes at individual levels are as follows:T12-L1: There is central disk protrusion, with calcification. There is indentation of thecal sac. Neural foramina at this levels are patentL1-L2: Vacuum disk phenomenon is seen. There is disk bulging. Spinal canal and neural foramina remain patent.L2-L3: Vacuum disk phenomenon is seen. There is disk bulging, facet arthropathy changes and ligamentum flavum hypertrophy. Spinal canal and neural foramina remain patent.L3-L4: There is mild grade 1 anterolisthesis of L3 over L4, with disk bulging, facet arthropathy changes and ligamentum flavum hypertrophy, resulting in spinal canal stenosis and neural foraminal narrowing. L4-L5: There is disk bulging with calcification, facet arthropathy changes and ligamentum flavum hypertrophy, resulting in spinal canal. There is stenosis of the lateral recess with probably mild L5 nerve impingement bilaterally. There is neural foraminal stenosis greater on the left, with likely impingement of exiting left L4 nerve. L5-S1: There is disk bulging, posterior osteophytes, facet arthropathy changes and ligamentum flavum hypertrophy, resulting in spinal canal stenosis. There is latera recess and neural foraminal stenosis, with likely impingement of the S1 nerves at the lateral recesses.In the right iliac wing, there is a 14 mm lesion with fine internal matrix. Its imaging characteristics are of indeterminate significance. At a similar location, there is a subtle lesion seen on T1 weighted images on prior MRI of 12/07/07, suggesting this is likely a chronic lesion.There are fine calcifications in the left kidney with punctate calcification in the lower pole suggesting calculus.
1. Degenerative disease of the cervical and lumbar spine resulting in multilevel spinal canal and neuroforaminal stenosis as described above. There is likely multi-level nerve impingement. Further correlation with MRI will be helpful.2. Left renal calculus.3. Nonspecific lesion at right iliac wing, of indeterminate significance. Continued follow-up is recommended to confirm its stability.