MyPACS.net: Radiology Teaching Files > Case 9510472

previously visited L5-S1 DISC HERNIATION WITH RIGHT S1 NERVE ROOT COMPRESSION
Contributed by: Fritsch & Thompson, Radiologist, Diagnostic Radiology of Houston, Texas, USA.
Patient: 40 year old male
History:

Rule out lumbar disc herniation.



 

Images:[small]larger

Fig. 1: SAGITTAL T1

Fig. 2: SAGITTAL T2

Fig. 3: SAGITTAL T2 FATSAT

Fig. 4: AXIAL T1

Fig. 5: AXIAL T2

Fig. 6: AP L-SPINE

Fig. 7: AP L-SPINE SPOT

Fig. 8: LATERAL L-SPINE

Fig. 9: LATERAL L-SPINE SPOT
Findings:

MRI of the lumbar spine reveals the following:


L5-S1: There is a right paramedian disc herniation with an apex of approximately 1 cm compatible with an extrusion. This herniation compresses and laterally displaces the traversing right S1 nerve root. Clinical correlation advised for right S1 radiculopathy. The herniation is clearly seen on sagittal images #6 and #7; axial T1 images #15 and #16, and axial T2 images #16 and #17. The posterior elements are well maintained. There is no spondylolysis or spondylolisthesis. There are mild edematous reactive endplate marrow changes.


The remaining intervertebral discs of the lumbar spine are unremarkable. The vertebral bodies do not show any compression fractures or aggressive osseous or marrow lesions. The spinal canal caliber is adequate and there is no intramedullary abnormality of the conus medullaris. The posterior elements of the lumbar spine are well maintained. The posterior lumbar musculature is symmetric but does show mild diffuse atrophy. The retroperitoneal structures visualized on this examination are within expected limits.

Diagnosis:

1. FOCAL RIGHT PARAMEDIAN DISC HERNIATION COMPATIBLE WITH A 1 CM EXTRUSION CREATING NEURAL MASS EFFECT UPON THE TRAVERSING S1 NERVE ROOT AS DESCRIBED. CLINICAL CORRELATION ADVISED FOR RIGHT S1 RADICULOPATHY.

2. MILD ATROPHY OF THE POSTERIOR LUMBAR MUSCULATURE.

3. NO INCIDENTAL AGGRESSIVE BONE, MARROW OR NEUROLOGICAL LESIONS.

References:

REFERRING PHYSICIAN: LESHA ROBERTS, DC

Comments:
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Additional Details:

Case Number: 9510472Last Updated: 06-22-2007
Anatomy: Spine and Peripheral Nervous System   Pathology: Trauma
Modality: Conventional Radiograph, MRExam Date: 06-18-2007Access Level: Readable by all users
Keywords: nerve root compression

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