Differential Diagnosis

• Single most likely diagnosis
  • Degenerative Disc Disease (DDD): This is the most likely diagnosis given the mild disc height loss, presence of a posterior disc osteophyte complex, mild spinal stenosis, and neuroforaminal narrowing. These findings are characteristic of the degenerative changes seen in DDD.
• Other Likely diagnoses
  • Spondylosis: The presence of osteophytes and disc space narrowing suggests spondylosis, which is a common condition associated with aging and wear and tear on the spine.
  • Herniated Nucleus Pulposus (HNP): Although not directly mentioned, the presence of neuroforaminal narrowing could be associated with a herniated disc, which could be contributing to the patient's symptoms.
  • Spinal Stenosis: While mentioned as mild, spinal stenosis is a significant finding that could be contributing to the patient's symptoms, especially if it is causing compression of the spinal cord or nerve roots.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Spinal Epidural Abscess: Although unlikely, a spinal epidural abscess could present with similar symptoms and would require urgent medical attention to prevent serious complications, including paralysis or death.
  • Cauda Equina Syndrome: This is a medical emergency that could present with similar symptoms, including neuroforaminal narrowing and spinal stenosis. Prompt diagnosis and treatment are necessary to prevent permanent damage.
  • Malignancy (e.g., metastatic disease): Although rare, malignancy could present with similar findings, including osteophytes and spinal stenosis. A thorough evaluation, including imaging and laboratory studies, would be necessary to rule out this possibility.
• Rare diagnoses
  • Ankylosing Spondylitis: This is a rare inflammatory condition that could present with similar findings, including disc space narrowing and osteophytes. However, it would typically be associated with other systemic symptoms and findings.
  • Diffuse Idiopathic Skeletal Hyperostosis (DISH): This is a rare condition characterized by excessive bone growth, which could present with similar findings, including osteophytes and spinal stenosis. However, it would typically be associated with other systemic symptoms and findings.