Male, 60 years old, history of L1-2 diskitis with bilateral psoas abscesses. Assess for improvement on IV antibiotics. Redemonstrated is destruction and replacement of the L1-2 disk space with T2 hyperintense signal along with destruction of the adjacent endplates and significant collapse of the L1 vertebral body. Moderate retropulsion of the L1 vertebral body continues to result in narrowing of the spinal canal this level. Findings are not changed since prior. Extension of inflammation into the ventral epidural space at L2 casuses tenting of the dura and some narrowing of the thecal sac, also unchanged.Additional patchy areas of largely T1 hyperintense marrow signal are stable in the remaining vertebral bodies. No new or concerning marrow space lesions are seen.Extensive edema persists within the bilateral psoas musculature. Loculated collections within the right psoas are definitely smaller than on the prior examination. Loculated collections within the left psoas muscle are also probably slightly smaller but the change is less dramatic than on the right.The kidneys are atrophic and contain numerous cysts compatible with renal failure.T12-L1: Mild facet hypertrophy and ligamentum flavum thickening. No significant spinal canal stenosis. No significant neuroforaminal narrowing. No significant interval changes.L1-2: Moderate facet hypertrophy and ligamentum flavum thickening. Disk destruction and vertebral body retropulsion result in a moderate generalized canal stenosis with crowding of the cauda equina. The neural foramina are mildly narrowed as well. No significant interval changes. L2-3: Mild facet hypertrophy and ligamentum flavum thickening. Mild bulging disk. Prominence of the epidural fat and ventral epidural inflammation as above. Mild thecal sac narrowing. No significant foraminal narrowing. No significant interval changes.L3-4: Mild facet hypertrophy and ligamentum flavum thickening. Mild bulging disk. Prominence of the epidural fat. Mild thecal sac narrowing. No significant neuroforaminal narrowing. No significant interval changes.L4-5: Moderate facet hypertrophy and ligamentum flavum thickening. Mild bulging disk. Prominence of the epidural fat. Mild thecal sac narrowing. No significant neuroforaminal narrowing. No significant interval changes.L5-S1: Mild facet hypertrophy and ligamentum flavum thickening. Mild bulging disk. No significant generalized spinal canal stenosis. No significant neuroforaminal narrowing. No significant interval changes.
1. Findings of osteomyelitis diskitis at L1-2 show no significant interval change. This includes destruction of the disk and adjacent endplates with significant collapse of the L1 vertebral body. The overall process results in narrowing of the spinal canal at the L1 and L2 levels which is also unchanged.2. Significant edema persists within the bilateral psoas musculature. However, loculated collections compatible with abscess have significantly improved on the right, with probable mild improvement on the left.