Sarcoid with worsening pain, assess for progression. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There are multiple new T1 hypointense lesions throughout the lumbar spine compared to 6/5/2010, as well as the partially imaged lower thoracic spine and pelvis compatible with known history of osseous sarcoidosis. The relatively largest lesion is present at the L4 level measuring approximately 17 x 17 mm in the sagittal plane. Posterior element involvement is also seen at multiple levels. STIR hyperintensity and enhancement is associated with the lesions. T1 hyperintensity is seen associated with some of the lesions perhaps indicating chronicity/healing.In comparing the partially imaged pelvic lesions with the more recent pelvic MRI from 6/25/2015, some lesions demonstrate increase in T1 hyperintensity, perhaps reflecting healing.Vertebral body heights in the lumbar spine are normal. There is minimal superior endplate depression involving the T12 endplate with small Schmorl's node, which remains unchanged since 6/5/2010. Alignment is maintained. The conus medullaris is normal in position. No nodular leptomeningeal enhancement involving the conus or cauda equina is appreciated.Mild multilevel degenerative changes include disc height loss at the L4-L5 level. Additional details as below:L1-L2: Small left paracentral disc extrusion with mild craniocaudal migration is not significantly changed. No spinal canal or neural foraminal stenosis.L2-L3: There is a small right paracentral and foraminal disc protrusion. Mild facet arthropathy. There is mild narrowing of the right neural foramen. Spinal canal and left neural foramen are patent.L3-L4: Mild disc bulge and mild facet arthropathy. No spinal canal or neural foraminal stenosis.L4-L5: There is a disc bulge with a mild left foraminal protrusion component which is slightly larger. There is associated partial effacement of the left lateral recess. Central spinal canal remains patent. There is mild narrowing of the left neural foramen related to the disc and mild left-sided facet arthropathy. Right neural foramen is patent. L5-S1: Minimal disc bulge. No spinal canal or neural foraminal stenosis.Paraspinous soft tissues are within normal limits.
1. Numerous osseous lesions in the lumbar spine, partially imaged thoracic spine, and pelvis consistent with known osseous sarcoidosis. No recent lumbar spine MRI is available for comparison but there has been significant progression since 8/5/2010 with multiple new lesions. Of note, however, recent pelvic MRI for which there are recent comparisons did not demonstrate progression. 2. Mild multilevel degenerative changes in the lumbar spine which have slightly progressed as detailed above. There is mild right L2-L3 and mild left L4-L5 neural foraminal stenosis. No high-grade neural foraminal or spinal canal stenosis at any level. 