Legend
Lt image: Sagittal T1WI shows a mass anterior to L5 that extends superiorly to mid L4
inferiorly to mid S1. The L5-S1 disk space is narrowed & the end plates are irregular.
The bone marrow of L5 & upper S1 is distinctly hypointense. The bone marrow of the
upper vertebral bodies is also too hypointense for a T1WI.
Middle image: Sagittal T2WI reveals hyperintensity in the same regions, as well as
in the L4-5 disk and the L4 vertebra.
Rt images: Axial T1WI's show hypointense lesion in the sacrum extending
anteriorly into the prevertebral space. Also, the bone marrow of the ilium has
a heterogeneous appearance.
Legend
Sagittal & axial T1WI's with Gd show enhancement of the prevertebral
mass, the adjacent vertebral bodies & disk spaces. A small anterior
epidural mass is also present behind L5.
Key words: mri lumbar sacrum infection inflammation
Spine Diagnosis:
Streptococcal diskitis/osteomyelitis
& red marrow conversion due to anemia