[JB214]

Can someone experienced with reading MRI results translate in layman;s terms for me. My primary care said the MRI didn't show much. Another doctor says it shows a lot and I just want to confirm what the MRI shows. I appreciate any feedback on what it shows and possible treatments since PT didn't work. I believe the next step is an epidural steroid injection since it has been almost six months of pain. Summary is as follows:
Symptoms: Moderate to severe pain predominately in right lower back, buttocks, hip and thigh. Mild tingling sensation to foot along with the feeling of continuous vibrations going through foot. Can’t sit for a period longer than ten minutes or standing for more than a half hour without causing intense back pain. Laying down with legs up is the only tolerable position.

Symptoms have been ongoing since mid July 2011 and a six-week course of PT was completed in October 2011 without any improvement.


MRI LUMBAR SPINE WITHOUT CONTRAST

Technique:
Sagittal T1 weighted spin echo, STIR sagittal and T2 weighted TSE (4mm) images for the lumbar spine are obtained. In addition, axial TSE T2 weighted angle images through the disc at L3-S1 and axial spin echo T1 weighted straight images from L3-S1 are acquired.

Comments:
Evaluation of the lumbar spine demonstrates straightening of the lordosis without any acute compression fracture deformity. There is no spinal stenosis. The conus terminates normally at L1. The STIR images do not demonstrate any discrete vertebral body lesions or bone marrow edema. There is relative decrease in the amount of bone marrow fat seen on T1 and T2 weighted images. This could be related to the high portions of hematopoietic marrow in the lumbar spine.
Evaluation of the axial images demonstrate the following:

At the level of L3-4, there is a small disc protrusion without any neural foraminal narrowing. There is moderate facet joint disease.

At the level of L4-5, there is no neural foraminal narrowing. There is a small disc protrusion with a posterior midline annular tear, which is in close proximity to the exiting nerve root of the lower level without any mass effect. There is moderate facet joint disease. This protrusion is indenting the ventral aspect of the thecal sac with borderline spinal stenosis.

At the level of L5-S1, there is mild to bilateral neural foraminal narrowing caused by a combination of disc protrusion and facet joint arthropathy.

Impression:
Mild degenerative discogenic disease and facet joint arthropathy of the lumbar spine. More so in the mid and lower levels. Especially at L5-S1. There is borderline spinal stenosis at L4-5.

Thanks in advance