Clinical question: Possible myelopathy. Signs and symptoms: Numbness and tingling. Nonenhanced cervical MRI:Examination demonstrates multiple small foci of T2/T2 STIR hyperintensity in the cervical and upper most visualized thoracic cord summed with suggestion of subtle underlying cord volume loss. Distribution of the findings are highly suggestive of demyelinating disease. Findings are best appreciated on sagittal T2 STIR series 4 image 7 as well as axial T2 series 5 and images 16, 19, 20, 23 and 25.There are no prior exams for comparison and this examination is performed without intravenous contrast.There is normal signal intensity of vertebral column. There is straightening of cervical lordosis which may be positional.Foramen magnum is unremarkable.C2-C3 is unremarkable.C3-C4 demonstrate subtle wasting at the level disc level which could indicate attempted congenital partial fusion. No spinal stenosis or neural foraminal compromise.C4-C5 demonstrate mild degenerative disc disease and shallow central disc protrusion without spinal stenosis or neural foraminal compromise.C5-C6 demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromiseC6-C7 demonstrate mild degenerative disc and mild bilateral ligamentum flavum hypertrophy however without spinal stenosis or neural foraminal compromise.C7-T1 is unremarkable.
1.Multiple small foci of T2/T2 STIR hyperintensity in the cervical spine and upper most visualized thoracic cord with morphology and distribution highly suspicious for demyelinating disease.2.Mild degenerative changes of cervical spine however without central spinal stenosis or neural foraminal compromise. Please see above comments.