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CSF cytology and HIV serology were both negative. EMG, however, confirmed the clinical findings of polyradiculopathy. T1W and T2W MRI of the lumbar spine demonstrated diffuse thickening of the nerve roots of the cauda equina, which enhanced following intravenous gadolinium administration (Figs. 1 and 2). No parenchymal involvement was seen.
At l5 S1 no disk protrusion, no canal narrowing or neural forminal narrowing. However, this is asymmetric enlargemnt of the left unexited nerve root. Again clinical correlation is suggested. There is noted vacuum phenomenon in the left sacroiliac joint indicating moderate/severe degererative changes. Facet degenative changes noted in the lower lumbar levels. Impression broad based disk at the L4-5 level which extends laterally to the left , likely causing significant narrowing of the neural foramen at that level.