• There is diffuse low signal intensity throughout the L2 vertebral body on T1 and T2 sequences, partially extending into the pedicles, with several small focal areas of retained fat signal intensity within the L2 vertebral body. On the sagittal T2 fat-suppressed Dixon sequence, the L2 vertebral body is slightly hyperintense as compared to the adjacent vertebral bodies. It has mildly increased anteroposterior dimensions when compared to the adjacent vertebral bodies. No oedema, pathological collapse or extra soft extraosseous soft tissue mass is present, and there is no associated spinal canal stenosis or neural compression. No further similar lesions are visible elsewhere within the lumbar spine. With the exception of a posterior disc prolapse at L4/L5 impinging on the descending right L5 nerve root in the lateral recess, the lumbar spine is otherwise unremarkable. The conus and cauda equina appear within normal limits.
• Summary: Diffusely hypointense signal of the L2 vertebral body on T1 and T2 weighted sequences, with mild vertebral expansion. The most likely differential diagnosis is Paget’s disease.