Clinical question: Right shoulder pain, C5-C6 foraminal stenosis. Signs and symptoms: Right shoulder pain. Nonenhanced cervical MRI:Examination at the level of foramen magnum is unremarkable.C2-C3 demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise.C3-C4 demonstrate degenerative disease with resultant significant right neural foraminal compromise and mild central spinal stenosis.C4 C5 demonstrate mild disc disease and extensive facet hypertrophic changes. Constellation of findings results in moderate left and mild right neural foraminal compromise and mild central spinal stenosis.C5-C6 demonstrate moderate disc disease, loss of disc height, mild to moderate bilateral facet hypertrophic changes and mild grade 1 retrolisthesis. Constellation of findings results in moderate central spinal stenosis and with significant right and moderate left neural foraminal compromise.C6-C7 demonstrate mild disc disease and hypertrophic changes of posterior elements. No central spinal stenosis however mild left neural foraminal compromise is noted.C7-T1 demonstrate mild degenerative disc disease and asymmetric extensive right facet hypertrophy. There is no central spinal stenosis however moderate right neural foraminal compromise is detected.The signal intensity and caliber of the cord remains within normal.Upper most visualized thoracic spine and thoracic cord demonstrate no signal abnormality of the cord or central spinal stenosis.
1.Degenerative changes of cervical spine results in mild central spinal stenosis at C3-C4, C4-C5 and moderate stenosis at C5-C6 levels.2.There are multilevel neural foraminal compromise (some significantly) as detailed per level above.3.There is mild retrolisthesis at C5-C6 secondary to degenerative disease.4.The signal intensity of the cord remains within normal.