Clinical question: MS; f/u progression. Signs and Symptoms: Paresthesias. Nonenhanced thoracic MRI:Stable chronic demyelinating plaque in the right posterior aspect of thoracic cord at T3 demonstrate no change since prior study.Demyelinating plaque of thoracic cord at T6 level demonstrate no interval change since prior exam.Demyelinating plaque in the left lateral aspect of the cord at T7 demonstrate no change.Ill-defined demyelinating plaque at T9 level on the right is again identified without change since prior study.Small demyelinating plaque on the right lateral aspect of the cord at T11 is again identified and without change.There is no convincing evidence of any new lesions since prior MRI exam from December 2014.There is normal signal intensity and anatomical alignment of vertebra, without spinal stenosis or neural foraminal compromise.Nonenhanced lumbar MRI:Normal signal intensity and caliber of the lower most visualized thoracic cord and the conus.Normal signal intensity and morphology of cauda equina.Normal signal intensity and alignment of vertebral,. No spinal stenosis or neural foraminal compromise at any level. Examination at L3-L4, L4-L5 and L5-S1 levels demonstrate mild to moderate facet and ligamentum flavum hypertrophy without resultant spinal canal or neural foraminal compromise.
1.Stable scattered foci of T2/T2 STIR hyperintensity of the thoracic cord consistent with patient's known multiple sclerosis and without convincing evidence of a new finding.2.Unremarkable MRI examination of lumbar spine with the exception of mild to moderate hypertrophic/degenerative changes of posterior elements in the lower lumbar spine as detailed. No spinal stenosis or neural foraminal compromise.