Findings:
The signal intensity of bone marrow is abnormally diffusely hypointense, compatible with an infiltrative bone marrow disease.
At L2/3 there is fluid disc signal, irregular endplates with bone marrow oedema involving the endplates of L2 and L3 vertebral bodies. Mild surrounding prevertebral inflammation without evidence of abscess formation or epidural collection.
No further inflammatory process, no fracture.
Modic-2 endplate changes are seen at L3/4 – L5/S1.
The craniocervical junction is normal. The cord and conus are unremarkable, as is the cauda equina. The cord terminates at T12/L1.
Moderate disc degeneration is seen in the whole spine with decreased signal intensity of the intervertebral discs.
Mild disc bulging is seen at C4/5 – C6/7.
Minimal disc bulging is also noted at L3/4 and L4/5. No central canal stenosis.
Cardiomegaly is noted. Bilateral pleural effusion is seen. The predominant mediastinal lymph nodes are seen.
Noted splenomegaly. Mild dilatation of the CBD is seen.
Conclusion:
Spondylodiscitis at L2/3 without abscess formation or epidural collection.
Diffuse bone marrow infiltration, suggesting underlying malignant disease. Further evaluation is advised.
Mild bilateral pleural effusion and possible mediastinal lymphadenopathy.