Differential Diagnosis
- Single most likely diagnosis
- Chronic Degenerative Spondylosis: This diagnosis is the most likely due to the presence of multilevel disc space narrowing, attenuated disc hydration signal, diffuse disc bulges, and degenerative facet arthrosis, which are all characteristic findings of chronic degenerative spondylosis.
- Other Likely diagnoses
- Spondylolisthesis: The presence of a stable Grade 2 anterolisthesis of L4 on L5 with moderate spinal canal stenosis supports this diagnosis.
- Degenerative Disc Disease: The findings of disc space narrowing, attenuated disc hydration signal, and diffuse disc bulges at multiple levels are consistent with degenerative disc disease.
- Facet Joint Syndrome: The presence of bilateral degenerative facet arthrosis at the L3-L4 level suggests facet joint syndrome as a possible diagnosis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Spinal Stenosis with Cauda Equina Syndrome: Although the report mentions moderate spinal canal stenosis, it is essential to consider the possibility of cauda equina syndrome, which is a medical emergency.
- Spinal Infection (e.g., Discitis or Osteomyelitis): Infection can cause disc space narrowing and destruction, and it is crucial to rule out this possibility, especially if there are symptoms such as fever, chills, or recent trauma.
- Spinal Tumor: Although less likely, a spinal tumor could cause similar findings, and it is essential to consider this possibility, especially if there are atypical symptoms or a history of cancer.
- Rare diagnoses
- Ankylosing Spondylitis: This inflammatory condition can cause disc space narrowing and fusion, but it is less likely given the absence of other characteristic findings such as bamboo spine or sacroiliitis.
- Diffuse Idiopathic Skeletal Hyperostosis (DISH): This condition can cause disc space narrowing and osteophyte formation, but it is relatively rare and would require additional imaging and clinical correlation to support the diagnosis.