Lab Studies:
X-ray:
- No bony or soft tissue abnormalities
- Loss of lordosis
Case Photo #1
MRI:
- Mild L4-5 posterior disc osteophyte and large L4-5 disc extrusion
- Disc extrusion migrated into the L4-5 left subarticular zone, resulting in severe left subarticular zone narrowing and possible impingement of the traversing left L5 nerve root
- Encroaches into the L4 left lateral recess and L3-4 left subarticular zone where it contacts and likely impinges on the traversing left L4 nerve root
Case Photo #2 Case Photo #3
Consultations:
His foot drop indicated a high-risk structural lesion and he was immediately admitted for spine surgery
Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.