Demographics:
25 years old, Male
Indication:
Low back pain
Findings
- T2/STIR signal hyperintensity and enhancement in the left L5-S1 facet joint, in the adjacent left S1 superior articular process, L5 inferior articular process, and left L5 pedicle, and in the surrounding soft tissues without discrete peripherally-enhancing collection
- Small broad-based disc bulge at L5-S1 without significant spinal canal or neural foraminal stenosis
- Peripherally enhancing left posterior perinephric collection measuring 3.8 x 1.3 cm in maximum axial dimensions, incompletely imaged on this study, with surrounding enhancing soft tissue and anterior displacement of the left kidney
- 2.4 cm lesion in the medial interpolar left kidney which is hypoenhancing relative to the adjacent renal parenchyma
Diagnosis
Septic facet arthritis and renal/perinephric abscesses
Sample Report
Edema and enhancement in and surrounding the left L5-S1 facet joint, concerning for septic facet arthritis. Enhancement in the surrounding soft tissues without discrete peripherally-enhancing collection.
3.8 x 1.3 cm peripherally enhancing left posterior perinephric collection and 2.4 cm lesion in the medial interpolar left kidney are concerning for abscesses. Surrounding enhancing soft tissue and anterior displacement of the left kidney. Recommend further evaluation with contrast-enhanced CT of the abdomen and pelvis.
Discussion