Foraminal lumbar disc protrusion

Case contributed by Dr Henry Knipe

Presentation

Back and right thigh pain.

Patient Data

Age: 60 years
Gender: Female

Right foraminal L3/4 disc extrusion that is mildly T2 hyperintense resulting in severe narrowing and impingement of the exiting nerve root. 

Mild L4/5 and L5/S1 central disc protrusions. 

Annotated image

Foraminal disc protrusion (white arrow) obliterates the normal T1 neural exit foraminal fat signal, which can be easily seen surrounding the exiting nerve root (grey arrow) at the level below. 

Case Discussion

Sagittal T1 is useful for evaluating the neural exit foramen, looking for loss of normal fat signal, indicating a foraminal disc protrusion which can be overlooked on other sequences. In particular, if the disc protrusion/extrusion is acute or subacute it can be T2 hyperintense, mimicking normal T2 fat signal. 

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Case information

rID: 59813
Published: 26th Apr 2018
Last edited: 27th Apr 2018
Inclusion in quiz mode: Included

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