History of rheumatoid arthritis and motor vehicle collision presenting with intermittent neck pain and bilateral cervical radiculopathy. Cervical spine:Straightening of the cervical lordosis related to spondylitic changes. There is mild loss of vertebral body height affecting multiple levels from C3 to C6 without frank compression fracture. No sequela of rheumatoid arthritis are identified. There is no significant pannus formation or erosions involving the dens. Flexion and extension sagittal images do not indicate atlantoaxial instability. The cervical spinal canal measures between 9 and 11 mm in AP dimension which is borderline for congenital canal narrowing. A superimposition of multiple disc osteophyte complexes and hypertrophy of the ligamentum flavum from C2 to C7. Diffuse mild spinal canal stenosis. While there is mild distortion of the cord at multiple levels, no abnormal cord signal is identified.Level by level findings are as follows:C2-C3: Small disc osteophyte complex and mild thickening of the ligamentum flavum. Minimal bilateral neural foraminal stenosis.C3-C4: Small disc osteophyte complex, uncovertebral joint hypertrophy, and hypertrophy of ligamentum flavum. Mild left neural foraminal stenosis.C4-C5: Moderate disc osteophyte complex, thickening of the ligamentum flavum, and uncovertebral joint hypertrophy. No significant foraminal stenosis.C5-C6: Mild disc osteophyte complex, hypertrophy of the ligamentum flavum, uncovertebral joint hypertrophy. Mild left neural foraminal stenosis.C6-C7: Mild disc osteophyte complex and hypertrophy of ligamentum flavum. Moderate spinal canal stenosis. Mild right neural foraminal stenosis.C7-T1: No disc bulge, spinal canal stenosis, or neuroforaminal narrowing.
1. Multilevel spondylitic changes superimposed on a borderline congenitally narrow cervical spinal canal result in diffuse mild cervical canal stenosis2. Mild multilevel neural foraminal narrowings as described.3. No erosions, transformation, atlantoaxial instability, or other sequela of rheumatoid arthritis in the cervical spine.