Severe neck pain. History of trauma. Postcontrast images are requested after paraspinous edema seen on earlier noncontrast study. Examination is limited to post contrast sequences and demonstrates moderate degree of enhancement in the left paraspinous musculature, maximal at the left C4-C5 level but extending craniocaudally from approximately the upper C3 to the C6-C7 levels. There also appears to be mildly increased enhancement in the right lower cervical paraspinous soft tissues.Degenerative changes including multilevel facet arthropathy, particularly on the left are noted. There is no evidence of discitis osteomyelitis or clear evidence of septic arthritis involving a particular facet joint.There is no abnormal enhancement within the spinal canal. There are also no enhancing bony lesions.
Examination limited to post contrast sequences demonstrates enhancement in the left paraspinous soft tissues corresponding to the paraspinous edema noted on earlier noncontrast cervical spine study. Differentials again include inflammation related to prior trauma or inflammation related to facet arthropathy. Infection is not excluded although there is no discrete fluid collection to indicate abscess.