Female, 65 years old, with hip pain, back pain, suspicion for metastatic cancer. Straightening of the lumbar lordosis is seen. Alignment is otherwise unremarkable. Patchy T1/T2 hyperintensity is seen through the vertebral body marrow. Most of these area suppress on fat suppressed images, and only one small lesion in L3 shows mild central enhancement. A band of strikingly low signal on all sequences is seen in the posterior superior right L2 vertebral body and pedicle. No worrisome spinal or paraspinal enhancement is seen.The visualized spinal cord and conus and cauda equina are unremarkable. L1-2: Unremarkable. L2-3: Mild loss of disk height and mild disk bulging. No significant spinal canal or neuroforaminal stenosis. L3-4: Mild facet hypertrophy. Mild bulging disc. No significant generalized spinal canal stenosis. No significant neuroforaminal narrowing. L4-5: Mild facet hypertrophy. Mild bulging disc with central annular fissuring and perhaps a tiny right paracentral protrusion. No significant generalized spinal canal stenosis. No significant neuroforaminal narrowing. L5-S1: Mild facet hypertrophy. Mild bulging disc with a small left paracentral protrusion. No significant generalized spinal canal stenosis. No significant neuroforaminal narrowing. Small renal cysts are seen.
1.No evidence of active neoplastic disease in the lumbar spine.2.Patchy areas of marrow T1/T2 hyperintensity most likely represent inhomogeneous fat and/or hemangiomas, including one small lesion with mild enhancement.3.Signal in the right L2 vertebral body and pedicle suggestive of dense sclerosis.