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Dr. German
Dr. German, Doctor (MD)
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Experience:  MD
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. MRI SCAN: Lumbosacral Spine with scout of left Hip TECHNIQUE: Sagittal/Ax

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MRI SCAN: Lumbosacral Spine with scout of left Hip

Sagittal/Axial – T1 and T2 weighted


Sagittal images demonstrate normal vertebral body height and alignment. No focal bone marrow signal changes apart from endplate discogenic marrow reactive changes at the inferior endplate of L4 and at the inferior endplate of L5/superior endplate of S1 where disc space narrowing and evidence of disc desiccation is evident at the L4/5 and L5/S1. The spinal cord terminates at T12/L1 level with normal morphology of the conus demonstrated.

Axial images through the intervertebral disc spaces L1/2, L2/3 and L3/4 demonstrate normal concavity of the posterior disc margins, normal appearance of the thecal sac, lateral recesses and neural foramen. No evidence of nerve root impingement or compression.

At the L4/5 level diffuse annular bulge is evident causing effacement of the anterior epidural fat and flattening of the anterior aspect of the thecal sac with narrowing of the lateral recesses, potential site for nerve root irritation on the traversing L5 nerve roots but no evidence of nerve root compression is seen at this time. Facet joint hypertrophic change with ligamentum flavum hypertrophy is seen at early stage at this level.

At the L5/S1 level diffuse bulge of the annulus causes effacement of the anterior epidural fat with evidence of slight narrowing of the left lateral recess which is a potential site for nerve root irritation on the left S1 nerve root but no evidence of nerve root impingement or compression is seen.

NAME: Lomas Beebakhee REF. DR: Dr. G. Araujo
SCAN DATE : 20-Jun-2013
DOB: 26-Apr-1960 SEX: Male AGE: 53yrs PAT NO: 003585/37035

Normal appearances of the paravertebral musculature.

Scout coronal view of pelvis/hips shows no focal bone marrow signal changes within the proximal femora or femoral capiti but there is evidence of degenerative change with a subcortical cyst identified in the superior aspect of the left acetabulum and there is also evidence of a small effusion within the left hip. Appearances are consistent with degenerative change with a small effusion in left hip.
Welcome and thanks for your question I am Dr. German I would be here to help you and give you assistance until you are satisfied, in this MRI scan ,the findings that are significative are:

1-The marrow reactive changes ,the disc desiccation,the disc space narrowing
2- The annular bulge at L4/L5
3-The annular bulge at L5/S1
4- Left hip effusion ,subcortical cyst and degenerative changes

To begin with , what they observe is characteristic of having osteoarthritis , a disease or medical condition in which there is joint inflammation,cartilage and bone loss and loss of the lubrication fluid .

This condition can affect multiple joints from your back , your hips , your arms and legs .

In your case , it has affected your lower back,specially the vertebrae L4,L5 and S1 and your leg hip where the femur connects with the hip bone .

1- The marrow is basically the middle or the inner part of a bone , in your case, there are reactive changes ( bone loss and surrounding tissue inflammation ) ,desiccation ( this happens when you lose lubrication fluid ) and disc space narrowing ( when your vertebrae experience inflammation ,the intervertebral space becomes reduced and this could compress the nerve roots that travel through that space , in your case , there is inflammation but there is no compression).

2 and 3, there are soft discs between the spine vertebrae , with osteoarthritis , the discs could lose elasticity , break down ,rupture and push outside called herniated discs ( in your case ,there is a mild disc herniation between L4 and L5 and L5 and S1 ) .

4 , the acetabulum is a cavity at the hipbone where the femur head connects with the pelvic bone , there is a cyst ( which is a small translucent cavity in your bone and is also caused by the degenerative changes osteoarthritis produces where there is bone loss and there is fluid accumulation . Like I explained with degeneration comes inflammation and fluid buildup or effusion ).

Besides pain medication, there are other treatments that your doctor could give you including : the use of antiinflammatory medications, cortisone shots to alleviate the inflammation, surgery to align the lower back disks or decompress nerve roots ,plastic or metal prostheses to replace some lost joint surfaces and physical therapy.

If you need any additional information I will be happy to continue further and assist you until you are completely satisfied .

Good luck to you and have a good day !

Please leave a positive feedback ( click on excellent or good service ) if you are satisfied with my answer.
Dr. German and 2 other Health Specialists are ready to help you
I do not think surgery is necessary at this time .
According to what they describe your condition could be managed with a combination of antiinflammatory medications,physical therapy ,losing weight if you are overweight and taking some alternative supplements which you can get over the counter with glucosamine and chondroitin.
Customer: replied 3 years ago.

Dear Dr.German,

Whewwwwww,lol... thank you so much for for putting my mind at ease.I have only ten lbs. to lose, I was 230lbs ,waist 42 ,-presently 197lbs ,waist 38.It took about 2years to get there since everytime i challenged myself i will get lots of back pain that will take me out for weeks at time.

Presently i only take the Doloneurobine only when the pain incapacitates me,(I am a travelling officer and sit for long periods at times in traffic).On a daily basis i use Glucoplex(maximum Strength), from Pharmalife,it contains the glucosamine and Chondrotin sulfate.not (HCL) and herbs like curcumin, boswellia,and also shark cartilage ,and combine this with Triple Strength Fish Oil from GNC.This really helps with the inflammation.I dont know why the the report did not mention that i have a right "High Hip" which has also posed a problem.I walk with a slight but noticeable limp.

.I have now purchased a Dvd from the Healthy Back Institute- google Lose the Back Canon.They address muscle imbalance as being the cause of most back pain.(make sense to me).It focuses on the weaker muscles for strengthening and toning .I will be working with my PT,to do some Core strengthening exercises,and supplement this with some Dry needling trigger Point therapy,especially in the areas of the paravertebral muscles,and deep tissue massages in the areas of the ilopsoas,QL,IT band,Glutes and piriformis.

If it ok? i will messsage you after my appointment with Orthopedic Dr. for his findings and course of treatment.

You have been God sent to me at this time to take away the the stress on my fears ,Thank you so much

May God continue to bless you..


Yours Sincerely,

Lomas. .

Thank You , have a really nice day !