Differential Diagnosis for MRI Findings
Single Most Likely Diagnosis
- Lumbar Degenerative Disc Disease: The presence of disc space narrowing, central protrusion, and abutment of nerve roots at L4-L5 and L5-S1 levels are characteristic findings of lumbar degenerative disc disease, which is a common condition in the aging population.
Other Likely Diagnoses
- Lumbar Spondylosis: This condition involves wear and tear on the spine, including the discs, joints, and ligaments, which can lead to disc space narrowing and nerve root compression.
- Lumbar Disc Herniation: The central protrusion at L4-L5 and small disc protrusion at L5-S1 are indicative of disc herniation, which can cause nerve root compression and symptoms such as pain, numbness, and weakness.
- Lumbar Spinal Stenosis: The abutment of the L5 nerve roots and right S1 nerve root suggests possible spinal stenosis, which is a narrowing of the spinal canal that can cause nerve compression.
Do Not Miss Diagnoses
- Spinal Infection (e.g., Discitis or Osteomyelitis): Although less likely, spinal infection can cause disc space narrowing and nerve root compression, and is a potentially serious condition that requires prompt diagnosis and treatment.
- Spinal Tumor: A tumor in the spine can cause nerve root compression and disc space narrowing, and is a critical diagnosis that should not be missed.
- Cauda Equina Syndrome: This is a serious condition that occurs when the nerves in the cauda equina are compressed, which can cause severe symptoms such as bowel and bladder dysfunction, and requires urgent medical attention.
Rare Diagnoses
- Spondylolisthesis: A condition where one vertebra slips forward over another, which can cause disc space narrowing and nerve root compression.
- Spondylolysis: A defect in the pars interarticularis, which can cause disc space narrowing and nerve root compression.
- Arachnoiditis: Inflammation of the arachnoid membrane, which can cause nerve root compression and disc space narrowing.