Diffuse right upper extremity pain with history of multiple shoulder surgeries, evaluate for brachial plexopathy There are postsurgical changes of anterior cervical fusion at the C5-C6 level. Small disc osteophyte complexes are seen without significant spinal canal or neural foraminal stenosis.Postsurgical changes including scalenectomy and right first rib resection are noted. There is minimal asymmetric increased T2 signal without enhancement involving the proximal aspect of the right C8 nerve root beyond the neural foramen, which may be reactive to the surrounding postsurgical changes. Asymmetric increased enhancement is noted near the right lung apex surrounding the right T1 nerve root; no abnormal signal or enhancement within the nerve root however is appreciated; finding may represent postsurgical change. Otherwise no abnormal signal or enhancement is definitively seen within the right brachial plexus. No masses or extrinsic compression is appreciated.
Postsurgical changes related to decompression for thoracic outlet syndrome are seen including resection of the right first rib. There is minimal asymmetric T2 hyperintensity involving the proximal aspect of the right C8 nerve root beyond the neural foramen which may be reactive to the surrounding postsurgical changes. No convincing signal abnormality is seen in the brachial plexus to suggest residual compression or plexitis.