Common Reporting Phrases for Lumbar Spine MRI
One of the most common problems in lumbar spine MRI reports is the ambiguous mixing of disc morphology and clinical significance within the same sentence. “Bulge,”...
RadPhrases Editorial Team5 min read
REPORTING PHRASES · LUMBAR SPINE MRI
One of the most common problems in lumbar spine MRI reports is the ambiguous mixing of disc morphology and clinical significance within the same sentence. “Bulge,” “protrusion,” “extrusion,” “nerve-root contact,” and “compression” are distinct concepts and should not be used interchangeably.
The examples below support level-by-level reporting and consistent disc terminology. Imaging findings alone do not establish the source of symptoms; concordance with the symptomatic side and dermatomal distribution should be assessed separately.
| Important usage note The sentences in this article are educational examples. Prefabricated text does not replace image review or the radiologist’s clinical judgment. Laterality, level, size, technical adequacy, comparison, and impression must be reverified for every case. |
|---|
Technique and overall alignment
| Scenario / purpose | Example reporting phrase and usage note |
|---|---|
| Standard technique | Lumbar spine MRI was performed using sagittal T1-weighted and sagittal and axial T2-weighted sequences. |
| Motion artifact | Assessment is partially limited by motion artifact, particularly on the axial images. |
| Lordosis | Lumbar lordosis is maintained / straightened. |
| Listhesis | There is approximately ... mm of anterolisthesis of L4 on L5. |
| Scoliosis | There is mild lumbar scoliosis with the apex at the ... level. |
| Vertebral body heights | Vertebral body heights are maintained; no acute compression fracture is identified. |
Bone marrow and endplate changes
| Scenario / purpose | Example reporting phrase and usage note |
|---|---|
| Bone marrow | Vertebral body marrow signal is appropriate for age. |
| Modic type 1 | T1-hypointense and T2/STIR-hyperintense Modic type 1 degenerative changes are present adjacent to the L4-5 endplates. |
| Modic type 2 | Modic type 2 changes compatible with fatty marrow conversion are present adjacent to the L5-S1 endplates. |
| Hemangioma | A lesion with typical signal characteristics of a hemangioma is present in the L2 vertebral body. |
| Indeterminate lesion | A focus with ... signal characteristics is present in the L3 vertebral body; correlation with prior imaging and clinical history is recommended. |
| Possible spondylodiscitis | Edema and irregularity at the L... disc space and adjacent endplates, with paravertebral soft-tissue changes, are suspicious for spondylodiscitis; clinical and laboratory correlation is required. |
Disc degeneration and diffuse bulging
| Scenario / purpose | Example reporting phrase and usage note |
|---|---|
| Disc desiccation | Degenerative desiccation with loss of T2 signal is present in the L4-5 and L5-S1 discs. |
| Loss of disc height | There is marked loss of disc height at L5-S1. |
| Symmetric disc bulge | There is a broad circumferential disc bulge at L4-5. |
| Asymmetric disc bulge | There is an asymmetric disc bulge at L3-4, greater on the left. |
| Terminology note | Bulging refers to diffuse extension involving a broad portion of the disc circumference; it is not synonymous with focal disc herniation. |
Protrusion, extrusion, and migration
| Scenario / purpose | Example reporting phrase and usage note |
|---|---|
| Central protrusion | A broad-based central disc protrusion at L4-5 mildly indents the ventral thecal sac. |
| Paracentral protrusion | A right paracentral disc protrusion at L5-S1 narrows the right lateral recess and contacts the right S1 nerve root. |
| Foraminal protrusion | A left foraminal disc protrusion at L3-4 narrows the left neural foramen. |
| Extrusion | A central to right paracentral disc extrusion with caudal migration is present at L4-5. |
| Sequestration | A free disc fragment without visible continuity with the parent disc is present posterior to the L5 vertebral body. |
| Terminology note | In a protrusion, the base of the herniation is wider than the outward-projecting component. In an extrusion, at least one dimension of the outward-projecting component may be wider than the base, or the material may extend beyond the disc level. |
Spinal canal, lateral recess, and foraminal stenosis
| Scenario / purpose | Example reporting phrase and usage note |
|---|---|
| Central canal stenosis | There is moderate central spinal canal stenosis at L4-5 due to disc bulging, facet arthropathy, and ligamentum flavum thickening. |
| Lateral recess | The right lateral recess is narrowed, with compression of the traversing right L5 nerve root. |
| Foraminal stenosis | There is bilateral neural foraminal stenosis at L5-S1, greater on the right. |
| Exiting nerve root | Right neural foraminal stenosis compresses the exiting right L5 nerve root. |
| Contact without deformity | Disc material contacts the left S1 nerve root without definite deformity. |
| Compression | There is nerve-root compression with posterior displacement and contour deformity. |
| Cauda equina | No significant clumping or compression of the cauda equina nerve roots is identified. |
Facet joints, ligaments, and other findings
| Scenario / purpose | Example reporting phrase and usage note |
|---|---|
| Facet arthropathy | Degenerative hypertrophy and increased joint fluid are present in the bilateral facet joints at the lower lumbar levels. |
| Ligamentum flavum | Ligamentum flavum thickening contributes to central canal narrowing. |
| Synovial cyst | A ... mm synovial cyst adjacent to the left L4-5 facet joint narrows the left lateral recess. |
| Pars defect | There are bilateral pars interarticularis defects at L5 with associated low-grade anterolisthesis. |
| Conus | The conus medullaris terminates at L1 and demonstrates normal signal. |
| Paraspinal soft tissues | No definite abnormal signal is identified in the paravertebral soft tissues. |
Write a clinically readable impression
| Scenario / purpose | Example reporting phrase and usage note |
|---|---|
| Single dominant level | Moderate central canal stenosis at L4-5 with compression of the traversing right L5 nerve root in the right lateral recess. |
| Multilevel disease | Multilevel degenerative disc and facet disease in the lower lumbar spine, most pronounced as moderate canal stenosis at L4-5 and right foraminal stenosis at L5-S1. |
| Distinguishing contact from compression | There is contact with the left S1 nerve root without definite root deformity. |
| Clinical correlation | Correlation with the symptomatic side and distribution of radicular symptoms is recommended. |
| Impression to avoid | Rather than repeating every mild degenerative finding in the impression, prioritize the one to three most important findings that may relate to the patient’s symptoms. |
Quick check before signing the report
- Was each level assessed in the same sequence?
- Were diffuse bulging and focal herniation distinguished?
- Is the term protrusion/extrusion appropriate for the morphology?
- Were central canal, lateral recess, and foraminal stenosis documented separately?
- Is it clear whether there is only nerve-root contact or compression with displacement/deformity?
References
- American College of Radiology. ACR Practice Parameter for Communication of Diagnostic Imaging Findings. Revised 2025. Source (opens in a new tab)
- Hartung MP, Bickle IC, Gaillard F, Kanne JP. How to Create a Great Radiology Report. RadioGraphics. 2020;40(6). Source (opens in a new tab)
- Fardon DF, Williams AL, Dohring EJ, Murtagh FR, Rothman SLG, Sze GK. Lumbar disc nomenclature: version 2.0. The Spine Journal. 2014;14(11):2525-2545. Source (opens in a new tab))00409-4/fulltext
Clinical use note
This content is educational and is not patient-specific medical advice. Every phrase, template, classification result, and recommendation must be verified and adapted by a physician using the complete examination, clinical context, current guidelines, and institutional protocol.
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