Disc extrusion compressing L5 and S1
Sometimes it is difficult to say whether a disc abnormality is mostly extrusion or hematoma. I think this is mostly, if not all, extrusion. You can see a dark structure within the mass that is likely herniated anulus (could also be clot). There is a huge anular defect. The mass crosses midline a bit, which is more characteristic of an extrusion, whereas a hematoma is typically limited at midline by the peridural membrane. Ive included dermatomes in this case. This patient has elected conservative treatment because of the lack of weakness and also because of improving pain.

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