Acute on chronic LBP with vertebral tenderness, please r/o fracture or other acute abnormality vs prior MRI in 2014 History: h/o chronic LBP, acute worsening Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment. There is mild loss of the disc height at the L2-3 and L5-S1 levels. No abnormal cord signal.T12-1: Mild degenerative disc disease and loss of height but no neuroforaminal or spinal canal stenosis.L1-L2: Mild degenerative disc disease and loss of height but no neuroforaminal or spinal central spinal canal stenosis. There is a far lateral left annular fissure noted on series 701, image 43 which just abuts the left L1 nerve root.L2-3: Moderate disc disease in moderate facet and ligamentum flavum hypertrophic changes, including bilateral facet effusions and facet joint widening which has progressed compared to the previous exam. There is a shallow broad-based disc bulge along the lateral right and far lateral right neural foramen which causes mild neuroforaminal stenosis but this was seen previously. No central spinal canal or left neuroforaminal stenosis.L3-4: Mild degenerative disc disease and moderate bilateral facet and ligamentum flavum hypertrophic changes, including bilateral facet effusions right greater than left. There has been progression of the facet effusion and widening of the facet spaces. Similar to the previous exam, there is resultant mild central canal stenosis and the transverse dimension but not in AP dimension. No neuroforaminal stenosis.L4-5: Mild degenerative disc disease and moderate to severe left and moderate right facet degenerative changes. No central spinal canal or neuroforaminal stenosis. Again seen is evidence of a prior left-sided laminectomy.L5-S1: Moderate degenerative disc disease with mild facet degenerative changes. No central spinal canal or neuroforaminal stenosis. A tiny annular fissure is noted but unchanged.The paraspinous soft tissue structures appear within normal limits. Within the right SI joint is a small amount of increased signal which may represent a small joint effusion.
Multilevel degenerative changes appearing similar to the prior exam with the exception of progression of the facet joint effusions and facet joint widening at the L2-3 and L3-4 levels which can be a cause of increased pain.