Clinical question: Rule out cord compression. Signs and symptoms: Pain, right arm weakness and leg pain. Non-enhanced total spine MRI:Examination is performed utilizing cord compression and without dedicated axial images.Examination demonstrate normal height and alignment the vertebral column. There is diffuse marrow signal abnormality or vertebral column consistent with patient's known osseous metastatic lesions. There is no convincing evidence of any significant spinal canal compromise. Very subtle effacement of subarachnoid space at T10 is suggestive of mild epidural spread of tumor. There is no detectable mass effect on the cord and with maintained normal caliber and signal intensity of the cord. This finding can be further assess with a dedicated pre-and post enhanced thoracic MRI. Previously reported suspected signal abnormality of the cord at T3 and T4 is not identified on this exam.A well demarcated near CSF signal intensity collection in the soft tissues of the spine with interval decreased size since prior exam at L1 and L2 is again noted.
1.Normal signal intensity and caliber of the cord.2.Subtle epidural spread of tumor from diffuse osseous metastatic lesions at T10 with subtle effacement of subarachnoid space is noted. This finding is not associated with any cord signal abnormality.3.Diffuse osseous metastatic lesions without evidence of fracture or malalignment.