Presentation
Low back pain
Patient Data
Infiltration of most of L3 vertebra and left side of L4 vertebra with hypointense signal on T1 and T2 with no loss of signal in T1 out-of-phase sequence. A rounded focal osseous lesion at the right ala of the sacrum with similar MRI features. No extraosseous growth is noted.
Fracture pars interarticularis of L5 with mild spondylolisthesis of L5 over S1.
Degenerated L5-S1 disc with vacuum effect and diffuse posterior pseudo-disc bulge, partially encroaching upon exit foramina.
L4-5 diffuse posterior disc bulge, effacing ventral thecal aspect and partially encroaching upon the inferior aspect of exit foramina.
Case Discussion
The patient has a known history of breast cancer. Osseous changes are in keeping with vertebral metastases. They generally appear of low signal on T1 and T2 with no loss of signal in out-of-phase sequence. MRI is sensitive to metastatic disease and is used for assessment of nerve roots and cord compression.
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