Female, 76 years old, with rigors, positive blood cultures, presenting with neck and shoulder pain on the left. Cervical:The cervical lordosis is mildly straightened, but sagittal alignment is otherwise unremarkable.Significant disc degeneration and endplate irregularity are seen at C4-5 through C7-T1. Fatty degenerative endplate signal change is seen at C5-6. Relatively low marrow signal is evident at C7 and T1. No evidence of significant marrow edema or other findings are seen to suggest an active infectious process.The visualized spinal cord demonstrates normal signal throughout. Scattered areas of cord impingement are seen and will be discussed by level below. No evidence of any epidural fluid collection is seen.C2-3: Unremarkable. C3-4: Facet arthropathy. Ligamentum flavum thickening. Disc osteophyte complex with a large central protrusion which moderately deforms the ventral cord. Mild generalized canal stenosis. Mild foraminal narrowing. C4-5: Facet arthropathy. Loss of disc height with posterior disc-osteophyte complex formation. Mild deformation of the ventral cord. Mild to moderate generalized canal stenosis. Moderate left foraminal narrowing. C5-6: Facet arthropathy. Loss of disc height with posterior disc-osteophyte complex formation. Minimal deformation of the ventral cord. Mild generalized canal stenosis. Severe right foraminal narrowing. C6-7: Facet arthropathy. Mild posterior disc-osteophyte complex formation. No significant spinal canal or foraminal stenosis. C7-T1: Mild posterior disc-osteophyte complex formation. No significant spinal canal stenosis. Mild foraminal narrowing. Thoracic:A mild scoliotic curvature is seen along with exaggeration of the thoracic kyphosis. Sagittal alignment is otherwise unremarkable.Fatty degenerative endplate signal change is seen at T11-T12. Otherwise, marrow signal characteristics are unremarkable.The visualized spinal cord demonstrates normal signal intensity and morphology throughout. No evidence of any epidural fluid collection is seen.At T11-12, facet hypertrophy and a diffusely bulging disc contribute to cause a moderately severe spinal canal stenosis with slight deformation of the cord contour. The neural foramina are also severely narrowed at this level.The other thoracic levels are free of significant degenerative disc disease, spinal canal and foraminal stenosis.A multicystic lesion is partially visualized in the left renal fossa, perhaps related to ESRD.
1.No imaging findings are seen to suggest osteomyelitis or epidural abscess.2.Degenerative disease in the cervical spine results in mild to moderate spinal canal stenoses and mild cord impingement at mid cervical levels.3.Degenerative disease at T11-12 results in a moderate spinal canal stenosis and severe bilateral foraminal narrowing.