Diagnosis: Unilateral primary osteoarthritis, left knee Lumbago with sciatica, right side Lumbago with sciatica, left sideClinical question: DDD of lumbar spineSigns and Symptoms: back and leg pain Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is loss of disc space height, disc desiccation and diffuse disc bulge associated with endplate osteophytes at this level. There is mild facet and ligamentum flavum hypertrophy present at this level. There is a left far lateral disc protrusion present which abuts the left-sided exiting nerve root after it exits the neural foramen.At L4-5 there is no significant compromise to spinal canal or neural foramina. There is loss of disc space height, disc desiccation, endplate reactive changes and diffuse disc bulge at this level associated with mild facet hypertrophy and moderate ligamentum flavum hypertrophy. There is a left far lateral disc protrusion present which abuts the left-sided exiting nerve root after it exits the neural foramen.At L3-4 there is no significant compromise to spinal canal or neural foramina. There is mild loss of disc space height and a disc bulge at this level associated disc desiccation. There is mild ligamentum flavum hypertrophy at this level.At L2-3 there is no significant compromise to spinal canal or neural foramina. There is mild loss of disc space height and a disc bulge at this level associated disc desiccation. There is mild ligamentum flavum hypertrophy at this level.At L1-2 there is no significant compromise to spinal canal or neural foramina.The uterus is large and contains a multiple large calcific lesions probably representing fibroids.There are large retroperitoneal lymph nodes present. A lymph node in the right periaortic region at the level of the C2-3 disc space currently measures 31 x 15 mm axial dimensions. Additional lymph nodes are identified elsewhere in the retroperitoneal space.
1.There are multilevel degenerative changes present in the lumbar spine without significant compromise to spinal canal or neural foramina. There are left-sided far lateral disc protrusions at L4-5 and L5-S1 which affects the left-sided exiting nerve roots at these levels.2.Multiple uterine fibroids.3.Findings suggest retroperitoneal lymphadenopathy. This was also present on the prior CT of the abdomen. A better assessment would be made using abdomen CT if clinically appropriate.