Presentation
Low back pain, fever and left sciatica of acute onset.
Patient Data
Abnormal osseous texture involving L5 & S1 vertebral bodies showing multiple osteolytic lesions, subchondral sclerosis and subtle bony erosive changes with narrowing of the intervening L5/S1 disc space.
MRI was recommended for this patient.
An inflammatory process is seen centered upon the L5 and S1 vertebrae and their intervening disc. They elicit patchy predominantly low signal at T1 WI and patchy predominantly high signal at T2 & STIR WI showing intense post-contrast enhancement. It's associated with a large fairly defined epidural and smaller pre-vertebral and left paravertebral soft tissue components, which elicit low T1 high T2 signal showing intense post-contrast enhancement. The epidural component is seen effacing the epidural fat, significantly compressing the theca and entangling the adjacent nerve roots. It measures roughly about 7 cm along its maximum craniocaudal dimensions. No evidence of vertebral structural collapse.
L2 vertebral body hemangioma.
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