Episodes of left leg numbness, weakness, and pain. Rule out cord lesion. Cervical: There is a T2 hyperintense lesion involving the right ventral aspect of the cord at the upper C2 level. Motion degradation limits evaluation however no additional lesions in the cervical cord are definitively appreciated. No abnormal enhancement in the cord or elsewhere in the cervical spine.Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. Alignment is grossly maintained aside from some loss of cervical lordosis which may be in part positional. Bone marrow signal is benign. Multilevel degenerative changes are seen multilevel disc desiccation and up to moderate disc height loss at the C4-C5 and C5-C6 levels. Individual levels as below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: Small right paracentral disc protrusion. No significant compromise to the spinal canal or neural foramina.C4-5: Small disc osteophyte complex including uncovertebral hypertrophy. No significant compromise to the spinal canal. Minimal bilateral neural foraminal narrowing, right relatively worse in left.C5-6: Small disc osteophyte complex. No significant compromise to the spinal canal. Minimal bilateral neural foraminal narrowing, right relatively worse than left.C6-7: Small disc osteophyte complex including a right paracentral disc protrusion and uncovertebral hypertrophy. There is no significant spinal canal stenosis. There is mild to moderate right and mild left neural foraminal stenosis.C7-T1: No significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits. There appears to be a 1 cm nodule along the posterior aspect of the right thyroid gland, which is not well assessed but also appears to enhance.Partially imaged parotid glands demonstrate mild heterogeneity including multiple T2 hyperintense foci.Thoracic: There is a T2 hyperintense lesion involving the left aspect of the cord at the T4 level, best seen on axial image 8 of series 2401. This lesion appears to mildly enhance, axial series 3201 images 10-12 and sagittal series 2901 image 8. No additional thoracic cord signal abnormality is definitively appreciated. The thoracic spine is in normal alignment. The vertebral body heights are well maintained. Bone marrow signal is benign with a T1 T1 hyperintense focus involving the posterior aspect of the T2 vertebral body compatible with a small hemangioma or focus of fat. Mild degenerative changes include minimal scattered disc bulges and protrusions without significant spinal canal or neural foraminal stenosis at any level.
1. T2 hyperintense nonenhancing lesion in the right ventral cord at the upper C2 level. There is also a left T4 thoracic cord lesion which appears to enhance. Differentials include demyelinating disease as well as other inflammatory myelopathies.2. Mild heterogeneity of the parotid glands with T2 hyperintense foci which can be seen with Sjogren's and other connective tissue diseases. Unclear if this finding is related to the above mentioned cord lesions.3. Mild degenerative changes in the cervical and thoracic spine as described above, but without significant spinal canal stenosis at any level.4. Probable 1 cm nodule which appears to enhance in the posterior aspect of the right thyroid lobe. This lesion is not well imaged and may represent a thyroid nodule or a parathyroid adenoma. Ultrasound can be considered for better assessment as clinically indicated.