X-RAY OF LEFT RIBS AND CHEST - 3 VIEWS Template

Radiology Report  
  
Patient Name: John Doe  
Patient ID: 123456  
Date of Birth: 01/15/1975  
Date of Examination: 10/20/2023  
Referring Physician: Dr. Jane Smith  
Examination: MRI of the Lumbar Spine  
  
Clinical History:  
The patient presents with chronic lower back pain radiating to the left leg, with intermittent numbness and tingling. Symptoms have persisted for approximately three months, with no significant relief from physical therapy or medication.  
  
Technique:  
MRI of the lumbar spine was performed without contrast using standard T1, T2, and STIR sequences in sagittal and axial planes.  
  
Findings:  
- Alignment: Normal lumbar lordosis is maintained. No evidence of spondylolisthesis.  
- Vertebral Bodies: Normal height and signal intensity of the vertebral bodies. No acute fractures or lesions identified.  
- Intervertebral Discs:  
  - L1-L2, L2-L3, L3-L4: No significant disc bulge or herniation.  
  - L4-L5: Mild disc bulge with slight effacement of the thecal sac. No significant neural foraminal narrowing.  
  - L5-S1: Moderate disc herniation with impingement on the left S1 nerve root.  
- Spinal Canal and Neural Foramina: No significant spinal canal stenosis. Mild narrowing of the left neural foramen at L5-S1.  
- Paraspinal Soft Tissues: Unremarkable.  
  
Impression:  
1. Moderate disc herniation at L5-S1 with impingement on the left S1 nerve root, correlating with the patient's symptoms of left leg radiculopathy.  
2. Mild disc bulge at L4-L5 without significant neural compromise.  
  
Recommendations:  
Consider referral to a spine specialist for further evaluation and management, including potential surgical consultation if symptoms persist or worsen.  
  
Radiologist: Dr. Emily Carter  
Date of Report: 10/21/2023