A 35 year old lady presented with severe onset back and bilateral radicular leg pain, left leg worse affected than the right. She also reported urgency of micturition and some weakness of the left leg. On examination she had signs suggestive of a lumbar disc prolapse.

• She went on to have an MRI scan of the lumbar spine
• What would these signs likely include?
• Label the MRI scan, pointing out abnormalities

What can you see in this scan done seven months post spinal surgery?

• Is there a recurrent disc prolapse?
• Can you see any post operative relevant changes?
• Is there any other pathology?

Look at the MRI scan of the rest of the spine and brain – what can you see?

• What is the likely diagnosis?
• What is your next course of action?
• What other tests are likely to be done?