Foraminal and subarticular lumbar disc prolapse

Case contributed by Ian Bickle
Diagnosis almost certain


Progressive right quadriceps weakness. Right leg pain.

Patient Data

Age: 60 years
Gender: Female

Right foraminal and subarticular disc prolapse at L3/L4. This effaces the fat around the L3 nerve root as it exits the neural foramen at L3-4. 

L4-5 small central bulge. The canal and foramina are preserved.

L1 conus. Normal cauda equina.

Annotated image

From intervertebral disc nomenclature. Illustration by Frank Gaillard.

Case Discussion

Small (easily missable) focal foraminal and subarticular disc prolapse.

The MRI study includes an axial T2 3D volume sequence, offering a higher resolution sequence to enable more refined assessment of the nerve roots, which is particularly useful in this case where the disc pathology is small, subtle and in a confined anatomical space.

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