Diagnosis: Brachial neuritis or radiculitis NOSClinical question: assess for L.C 6/7 radiculopathySigns and Symptoms: LUE radicular pain and weakness The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. No abnormal enhancing lesions are identified in the cervical spine. There is T2 signal hyperintensity within the C6 and C7 vertebral bodies. The endplates appear intact at C6-7 and the disc has similar signal to other levels. There is no associated perivertebral signal hyperintensityAt C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina. There is a minor disc bulge at this level.At C4-5 there is no significant compromise to the spinal canal or neural foramina. There is a broad-based right lateral recess disc protrusion at this level which mildly narrows the right neural foramen and mildly encroaches on the right-sided exiting nerve roots at this levelAt C5-6 there is no significant compromise to the spinal canal. There are small bilateral uncovertebral osteophytes present at this level associated with a diffuse disc bulge and some mild narrowing of the neural foramina with mild encroachment of the exiting nerve roots..At C6-7 there is no significant compromise to the spinal canal. There is a broad-based left lateral recess disc extrusion present which extends into the left lateral recess and left neural foramen and encroaches on the left-sided exiting nerve roots within the left neural foramen. Some disc material tracks behind the C7 vertebral body. There are associated uncovertebral osteophytes present.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The left vertebral artery flow-void is not readily identified. There is an MRI of the brain from July 10, 2009 demonstrating that the left vertebral artery was patent at that time intracranially. The right vertebral artery flow voids appears to be intact.
1.The left vertebral artery flow-void is not readily identified. This raises the question of occlusion or near occlusion of the left vertebral artery. If clinically appropriate additional imaging of the vertebrobasilar vascular system may be helpful to further evaluate this. There is an MRI of the brain from July 10, 2009 demonstrating that the left vertebral artery was patent at that time. 2.There is encroachment of the left exiting nerve roots at C6-7 due to disk extrusion and uncovertebral osteophytes.3.There are degenerative changes present in the cervical spine. There are associated signal changes within the C6 and C7 vertebral bodies which are suggestive of subacute inflammatory change most likely due to degenerative change. There is mild encroachment of exiting nerve roots bilaterally at C5-6 and on the right side at C4-5 due to degenerative change.4.An email and an alphanumeric page were sent to Dr. Rezania regarding the above findings.