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 TeamJuly 31, 20265 min read

Modular reporting phrases converging into a coherent radiology report at a clinical workstation

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.

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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.

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.

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.

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.

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.

Common Reporting Phrases for Lumbar Spine MRI

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Technique and overall alignment

Bone marrow and endplate changes

Disc degeneration and diffuse bulging

Protrusion, extrusion, and migration

Spinal canal, lateral recess, and foraminal stenosis

Facet joints, ligaments, and other findings

Write a clinically readable impression

Quick check before signing the report

References

Clinical use note

Stop rewriting these phrases from scratch

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.

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.

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Continue learning

Technique and overall alignment

Bone marrow and endplate changes

Disc degeneration and diffuse bulging

Protrusion, extrusion, and migration

Spinal canal, lateral recess, and foraminal stenosis

Facet joints, ligaments, and other findings

Write a clinically readable impression

Quick check before signing the report

References

Clinical use note

Stop rewriting these phrases from scratch