Instructions

In the first set of cases, you will be shown coned-down images from an MRI of the lumbar spine. For each case, you will be provided with a single axial and a single sagittal T2 weighted image (you will not be able to scroll). The level of the axial image will be indicated by a cross-reference line. The lumbosacral junction (L5-S1) will be visible at the lower aspect of the sagittal image.

For each case, please make the following determinations:

• What is the size/degree of the posterior disc contour abnormality at the indicated level? Although you will see examples of disc bulges, protrusions, and extrusions, please ignore the differences between their morphologies. Only grade the size of the contour abnormality.

• What is the degree of spinal canal narrowing at the indicated level? This narrowing may be caused by the disc abnormality, developmental narrowing, ligamentum flavum hypertrophy, and other causes. Please provide a grading of the degree of overall narrowing.

You will be asked to grade these findings using the following criteria: Normal, Minimal, Mild, Mild-to-moderate, Moderate, Moderate-to-severe, and Severe.

After making a selection, you will be shown the correct answer, as determined by consensus by six academic musculoskeletal radiologists. Although you should consider each case carefully, you will receive a point (1) for the consensus response and partial credit (0.75) within one answer choice from the consensus response. At the end of the module, you will be provided with a summary of your results.