MyPACS.net: Radiology Teaching Files > Case 183496

never visited FACET CYST
Contributed by: Daniel Saurborn, Radiologist, University of Pennsylvania, Pennsylvania, USA.
Patient: female
Images:[small]larger

Fig. 1

Fig. 2
Findings:

MRI LUMBAR SPINE
H/O LOW BACK PAIN WITH LEFT LEG PAIN

Radiological Report:
COMMENT: The examination is compared to the prior MRI which was
obtained on 5/6/02. The patient is a 75 year old with low back and
left leg pain. There are multiple axial and sagittal imaging
sequences along with a coronal inversion recovery sequence through the
lumbar spine. This was performed at Wayne Imaging on a 1.5-Tesla
magnet.

There was considerable red marrow remaining in the lumbar spine which
was not changed from the prior study. The mild anterior compression
of T12 is again identified, and there is no high signal in it to
suggest that it is new. The anterolisthesis of L4 on L5 is also again
identified. Decreased T2 disc signal is again identified throughout
the entire lumbar spine.

The axial images through T10-11 reveal anterior osteophytes and disc
thinning but without central or foraminal stenosis.

At T11-12, there is mild diffuse disc bulging. There are anterior
osteophytes. Incidental note is made of a hemangioma in T12 that is
unchanged from the prior film. It is on the left in the posterior
aspect of the body.

L1-2 is unremarkable on the sagittal images and is unchanged from the
prior study.

At L2-3, there is no foraminal stenosis or nerve root compression.

At L3-4, there is bilateral facet arthrosis and a small disc bulge.
The neural foramen are minimally narrowed by the bulge.

At L4-5, there is anterolisthesis, facet arthrosis, disc bulging, and
central stenosis. The disc bulge extends into the neural foramen and
is unchanged from the prior study.

At L5-1, there is facet arthrosis and a left sided facet cyst. The
facet cyst is well seen on image 43 of series 6 where it compresses
the thecal sac from the left. It is particularly well seen on series
3 image 23. There is disc degeneration at that level and central
stenosis. The tiny protrusion into the left neural foramen is again
identified. The facet cyst compresses the left S1 nerve root in the
subarticular lateral recess. Please note that this large facet cyst
is new since the prior examination although facet arthrosis was
certainly present on the prior study.

Diagnosis:

IMPRESSION:

Extensive discogenic disease throughout the lumbar spine which is
unchanged except for a large facet cyst at L5-1 on the left side which
compresses the S1 nerve root in the lateral recess and contributes to
central stenosis. Facet cyst was not present on the previous exam.

Comments:
No comments posted.
Additional Details:

Case Number: 183496Last Updated: 10-14-2003
Anatomy: Spine and Peripheral Nervous System   Pathology: Non-Infectious Inflammatory Disease
Modality: MRExam Date: 10-14-2003Access Level: Readable by all users

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