Clinical question: Evaluate for DJD, cervical stenosis. Signs and symptoms: Neck pain shooting down the right hand. Unenhanced simple MRI:There is normal signal intensity and alignment of vertebral column.Foramen magnum is unremarkable.C2 -- C3 is unremarkable.C3 -- C4 demonstrate asymmetric right-sided uncovertebral hypertrophy with resultant moderate right neural foraminal compromise (axial T2 series 7 image 18 sagittal T2 and T2 stir image 6). Mild central bulge of the disk and additional partial effacement of ventral subarachnoid space and subtle flattening deformity of the cord and results in mild central spinal stenosis. Tiny T2/T2 stir hyperintensity within the fundus of the disk in the midline is consistent with an annular fissure (sagittal T2/T2 stir image 8 and axial T2 series 7 image 19.C4 -- C5 demonstrates a mild right-sided uncovertebral hypertrophy with resultant mild right neural foraminal compromise and unremarkable otherwise.C5 -- C6 demonstrate mild lesion at this disease, mild loss of disk height, mild bilateral facet and ligamentum flavum hypertrophy. Constellation of changes results in moderate bilateral (right greater than left) neural foraminal compromise and no central spinal stenosis.C6 -- C7 demonstrate minimal degenerative changes without spinal stenosis or neural foraminal compromise.C7 -- T1 is unremarkable.Uppermost visualized thoracic cord demonstrate a tiny focus of cord hyperintensity visible only on sagittal T2 stir image 7 measuring approximately 3 mm in size. There are no axial images acquired at this level. Finding cannot be identified on sagittal T1 or T2 weighted images. Although possibility of an artifact cannot be excluded follow-up with a dedicated MRI of thoracic spine is recommended.
1.There is mild central spinal stenosis only at C3 -- C4 secondary to degenerative disease.2.Mild degenerative changes of cervical spine with resultant moderate right neural foraminal compromise at C3 -- C4, mild right neural foraminal compromise at C4 -- C5 and moderate bilateral ( R>L ) neural foraminal compromise at C5 -- C6 levels.3.Tiny midlie annular fissure at C3 -- C4 is noted.4.There is a tiny focus of cord hyperintensity visible only on sagittal T2stir at T3 level and follow-up with dedicated thoracic MRI is recommended. Please see above comments. Normal signal intensity of the cervical cord.