Patient Name: Diker, Hasan A
Date of Service: 06/29/10
Page 2
Continued
Puyallup Imaging Sunrise Imaging Bonney Lake Imaging
Center Center Center
222 15th Avenue 11212 Sunrise Blvd. 21110 SR 410
SE E, # 200 East, #110
Puyallup, WA Puyallup, WA 98374- Bonney Lake, WA
98372-3754 8847 98391

Phone: 253-841- Phone: 253-841-4353 Phone: 253-841-4353
4353 Fax: 253-445-0314 Fax: 253-862-1656
Fax: 253-845-3680
Patient Diker, Hasan A Date of 09/08/1972
Name: Birth:
Patient Num.: 463585
Date of Service: 06/29/10 Accession Num.: 6611059
Service 222 Professional Center
Location:
Requesting Referring *Unspecified, Dr FMEC E6
Provider:

Copies to:
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MRI LUMBAR SPINE WITHOUT AND WITH CONTRAST

HISTORY: A 37-year-old male with chronic low back pain, numbness in the
legs, and possible arachnoiditis.

PROCEDURE: Magnetic resonance imaging of the lumbar spine is performed on
the 1.5 Tesla Siemens Espree open MRI scanner, with T1-weighted sagittal
and axial, T2-weighted spin-echo sagittal and axial before and after
contrast with 20 mL OptiMARK, and STIR sagittal images obtained.

COMPARISON: Comparison is made to the previous lumbar spine MRI obtained
on June 16, 2009, performed in Portland, Oregon.

FINDINGS: No compression fracture is present. The conus medullaris is
normal. The paraspinal soft tissue structures visualized are normal. No
clumping of nerve roots in the lumbar spine are identified to suggest
arachnoiditis. No abnormal enhancement of individual nerve roots is
identified.

L1-L2: No disc herniation, central canal stenosis, or foraminal stenosis is
present. The facet joints are normal.

L2-L3: No disc herniation, central canal stenosis, or foraminal stenosis is
present. The facet joints are normal.

L3-L4: No disc herniation, central canal stenosis, or foraminal stenosis is
present. The facet joints are normal.

L4-L5: Degenerative disc disease is present with a posterior annular tear.
A small 3-4 mm central disc protrusion is present without thecal sac
compression, and with mild bilateral foraminal stenosis. Mild facet
arthrosis is present.

L5-S1: Degenerative disc disease is present with disc space narrowing and a
posterior annular tear. A small 3 mm central disc protrusion is present
without thecal sac compression or nerve root compromise. No central canal
stenosis or foraminal stenosis is present. Mild facet arthrosis is present.





IMPRESSION:

1. Small 3-4 mm central disc protrusion at L4-L5, with slight compression
of the underlying thecal sac and mild bilateral foraminal stenosis.
2. Small 3 mm central disc protrusion at L5-S1, without thecal sac
compression or nerve root compromise.
3. Degenerative disc disease present at the L4-L5 and L5-S1 levels, as
described above.
4. No evidence of arachnoiditis identified in the lumbar spine.
5. No interval change noted from the previous lumbar spine MRI of June 16,
2009.
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Dan H. Martin, MD
Diagnostic Imaging Northwest

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NORTHWEST/DIAGNOSTIC IMAGING NORTHWEST AND MAY NOT BE MODIFIED OR AMENDED
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Document approved by: Jamy Marie Pulliam Date: 06/29/10 15:29