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Some to explain this MRI as the doctor is injection happy


Exam: MRI Lumbosacral spine without contrast Completion Time: 03/06/2017 14:14
Clinical History: LBP.
Comparison: Lumbar spine x-rays 11/19/2013
Technique: Routine pulse sequences were obtained including sagittal and axial T1 and T2-weighted images. In addition, sagittal STIR images were obtained.
Findings: The lumbosacral spine is normal in position and alignment. The conus medullaris is clearly visualized and terminates at a normal level without evidence of intrinsic or extrinsic lesions. There is
disc desiccation at L3-L4 and L4-L5 with mild disc height loss at L3-L4. The bone marrow signal is unremarkable.
Axial images were obtained from L1 through S1.
L1-L2: There is a small broad-based right central protrusion with annular fissure. No significant canal or foraminal stenosis. The
        
facet joints are unremarkable.
L2-L3: There is no evidence of disc bulge. No narrowing of the spinal canal or stenosis of the neural foramina is seen. The facet joints are unremarkable.
L3-L4: Mild right and moderate to large left disc osteophyte complex is noted lateralizing to the left foramen with superimposed protrusion and annular fissure. There is moderate to severe left foraminal stenosis with contact/impingement of the exiting left L3 nerve roots in the extraforaminal zone. No significant right
foraminal or canal stenosis. There is contact of the descending left L4 nerve roots. The facet joints are unremarkable.
L4-L5: There is mild to moderate left facet disease with thickening of ligamentum flavum bilaterally. There is a mild left posterior disc osteophyte complex and moderate right lateralizing to the foraminal zone with small superimposed foraminal protrusion and annular fissure. There is moderate right foraminal stenosis and mild to moderate left foraminal stenosis without canal stenosis. There is contact/impingement of the exiting right L4 and descending right L5 nerve roots.
L5-S1: There is a tiny central protrusion with mild marginal disc osteophyte complex. No significant canal or foraminal stenosis. The facet joints are unremarkable.
Impression: MRI Lumbosacral spine without contrast
1. Degenerative changes as detailed above most advanced at L3-L4 and L4-L5. There is contact/impingement of the exiting left L3 and right
L4 nerve roots with contact of the descending left L4 and right L5
nerve roots secondary to disc disease.
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