Reason: r/o radiculopathy, back and R hip pain, history of RCC History: back and R hip pain Mild levoscoliosis of the lumbar spine. Vertebral body heights are intact. There is mild anterolisthesis of L4 relative to L5 with uncovering of the disc. There is minimal anterolisthesis of L3 on L4. The canal is mildly narrowed at all levels, likely congenital. There is multilevel disc desiccation with disc height loss at L4-L5 and L5-S1. There are degenerative endplate marrow signal changes at L4-L5. There is a lesion in the L2 vertebral body which is hyperintense on T1 and T2 images, likely focal fat. There is a lesion in the L5 vertebral body measuring 1.7 x 2.0 cm which is hyperintense on T2 images and isointense on T1 images. There appears to be a corresponding subtle hemangioma on prior CT, with probable atypical MR appearance. No abnormal signal within the distal cord or conus which ends at L1.T12-L2: Right para median annular fissure. Right facet arthropathy. Mild ligamentum flavum thickening. No spinal canal or neural foraminal stenosis.L1-L2: No significant disc disease. Mild ligamentum flavum thickening. Mild facet arthropathy. No spinal canal or neural foraminal stenosis.L2-L3: Diffuse disc bulge. Mild ligamentum flavum thickening and facet arthropathy. Small cyst along the posterior aspect of the left facet joint. Mild to moderate spinal canal narrowing. Mild to moderate bilateral neural foraminal narrowingL3-L4: Diffuse disc bulge superimposed left neural foraminal protrusion. Moderate ligamentum flavum thickening and facet arthropathy. Moderate spinal canal stenosis. Mild bilateral neural foraminal stenosis.L4-L5: Uncovering of the disc. Diffuse disc bulge with superimposed left neural foraminal protrusion. Narrowing of the lateral recess stenoses bilaterally. Moderate facet arthropathy and ligamentum flavum thickening. Moderate to severe spinal canal stenosis. Moderate bilateral neural foraminal stenosis.L5-S1: Uncovering of the disc, with diffuse disc bulge. Mild facet arthropathy and ligamentum flavum thickening. No significant spinal canal stenosis. Moderate to severe left and mild right neural foraminal stenosis.Right upper pole renal cyst.
1.Multilevel spondylosis, most severe at L4-L5 where there is anterolisthesis, degenerative disc disease, moderate to severe spinal canal stenosis and moderate bilateral neural foraminal stenosis.2.Additional spinal canal stenosis and neural foraminal stenosis at L2-L3, L3-L4 and L5-S1 as above.3.Lesion in the L5 vertebral body may represent a atypical hemangioma.