Date : 00.00.00

Name of the Patient : Abc Xyz B. Slmn / F / 53 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Lumbo-sacral Spine.

CLINICAL PROFILE :

C/O backache radiating to the RLE since 2 months.
H/O fall.

EXAMINATION :

M.R.I of the lumbo-sacral spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted axial images.

OBSERVATION :

There is marked loss of water content of the L4-L5 and L5-S1 intervertebral discs and slight loss of water content of all the lumbar intervertebral discs.

There is a posteriorly bulging disc with posterior peridiscal osteophytes at the L5-S1 level with slight bilateral neural foraminal narrowing more so on the right side. The right facet joint at the L5-S1 level appears slightly hypertrophied.

A posterior disc bulge with peridiscal osteophytes is noted at the L4-L5 level with slight left neural foraminal narrowing.

Type I degenerative marrow changes (hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images) are noted in the L5 vertebral body adjacent to the L5-S1 intervertebral disc. Schmorls node is noted along the inferior margin of the L4 vertebral body.

The rest of the lumbar vertebral bodies show normal signal intensity. The rest of the facet joints and the visualized pre and paravertebral soft tissues are unremarkable.

The conus medullaris terminates at the L2 level and the thecal sac terminates at the S2 level.
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The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :

18.0 mm at L1-L2

18.0 mm at L2-L3

18.0 mm at L3-L4

13.0 mm at L4-L5

12.0 mm at L5-S1.

IMPRESSION :

1. A posteriorly bulging disc with posterior peridiscal osteophytes at the L5-S1 level with slight bilateral neural foraminal narrowing more so on the right side. The right facet joint at the L5-S1 level appears slightly hypertrophied.

2. A posterior disc bulge with peridiscal osteophytes at the L4-L5 level.