Male, 56 years old, generalized weakness. Evaluate extent of disseminated nocardia. Cervical:No discrete spinal cord lesion or cord edema is detected. The AP caliber of the spinal cord is subjectively smaller than typical. No epidural abnormality is seen.The usual lumbar lordosis is reversed. Sagittal alignment is otherwise unremarkable. Mild degenerative vertebral body loss of height is seen at C6 and C7. No pathologic marrow replacement is detected.C2-3: No spinal canal stenosis or neuroforaminal narrowing. C3-4: Mild facet hypertrophy. No spinal canal stenosis. No significant foraminal narrowing. C4-5: Facet hypertrophy. No significant spinal canal stenosis. No significant foraminal narrowing.C5-6: Mild posterior disc-osteophyte complex formation. No significant spinal canal stenosis. No significant foraminal narrowing. C6-7: Right facet hypertrophy. Mild posterior disc-osteophyte complex formation. No significant spinal canal stenosis. Mild bilateral foraminal narrowing.C7-T1: No spinal canal stenosis or neuroforaminal narrowing. Thoracic:No discrete spinal cord lesion or cord edema is detected. As above, the AP diameter of the spinal cord may be somewhat smaller than typical. No epidural abnormalities are suspected.Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits. No concerning marrow signal abnormality is detected. The intervertebral discs are preserved. No spinal canal or foraminal compromise is seen.A large left pleural effusion and left lower lobe opacification is partially visualized. A nodule in the right upper lobe is better assessed on CT as well.Lumbar:The visualized distal spinal cord, conus and nerve roots of the cauda equina are unremarkable. No intrathecal lesions are detected. No epidural abnormality is suspected.Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits. No concerning marrow replacement is seen. Intervertebral disc height is preserved. Mild disc bulging is seen at L4-5 causing mild to moderate foraminal narrowing but no significant spinal canal compromise. Elsewhere, no significant spinal canal or foraminal narrowing is seen.A thoracic duct cyst is suspected at the L1 level. The native kidneys are severely atrophic. A renal transplant is seen in the right pelvis.
1.No convincing evidence of any lesions in the spine to suggest nocardia involvement.2.The AP caliber of the spinal cord is subjectively somewhat small. This could simply represent an anatomic variation, though the possibility of chronic cord volume loss is not excluded.3.Scattered degenerative disease and other incidental findings as discussed above.