Review Question - QID 220822

A 16-year-old healthy female gymnast presents for evaluation of a two-month history of activity-associated lower back pain and hamstring tightness. She denies any bowel/bladder incontinence or radiculopathic pain. Physical exam is significant for tenderness to the lower spine and pain with lumbar extension while standing on one leg. Spine radiographs and a MRI are obtained. After review, you instruct the patient to rest, initiate activity restriction, and begin physical therapy. Which of the following MRI findings is most consistent with the patient’s history, clinical findings, and proposed treatment plan?