Clinical question: Evaluate stenosis. Signs and symptoms: Worsening left arm pain. Unenhanced cervical MRI:There is generalized small caliber cervical spinal canal which is believed to be a congenital anatomical variation.Foramen magnum is unremarkable.C2 -- C3 demonstrate minimal left neural foraminal compromise and unremarkable otherwise.C3 -- C4 demonstrate mild degenerative disk disease and loss of disk height and no significant hypertrophy changes of posterior elements. Mild degenerative changes at this level in combination with congenitally small canal results in mild central spinal stenosis. There is moderate (R>L) neuroforaminal compromise and without appreciable change since prior exam.C4 -- C5 demonstrate mild degenerative disk disease and minimal bilateral facet degenerative changes. There is mild bilateral neural foraminal and central spinal stenosis without significant change since prior exam. C5 -- C6 demonstrate mild this disease with mild loss of disk height, mild bulging disk and asymmetric (L > R ) uncovertebral hypertrophic changes. New since prior exam is a right paramedian disk protrusion with resulting subtle flattening deformity of the right ventral aspect of the cord. Constellation of changes and including congenitally small canal results in moderate central spinal stenosis, significant left and moderate right neural foraminal compromise. There is no detectable signal abnormality of the cord.C6 -- C7 demonstrate mild disk disease and loss of disk height, shallow broad-based bulging disk, hypertrophic changes of posterior longitudinal ligament along the dorsal aspect of C6 vertebrae, asymmetric left uncovertebral hypertrophic changes. Constellation of changes results in mild central spinal stenosis, moderate left neural foraminal compromise and mild on the right.C7 -- T1 is unremarkable.Uppermost visualized thoracic spine the thoracic cord to T3 level is unremarkable
1.There is uniform generalized a smaller caliber of the spinal canal believed to present a congenital anatomical variation. This finding in combination with mild degenerative changes resulting in multilevel mild central spinal stenosis. 2.At C5 -- C6 there is a new right paramedian small disk protrusion with resultant flattening deformity of the right ventral cord, moderate central spinal stenosis and neural foraminal compromise. No detectable cord signal abnormality.3.Mild degenerative changes at other levels without significant change since prior exam as detailed per level.