Reason: cord compression History: weakness of extremities.Additional history collected from electronic medical record: Mr. Warshall is a 66 y/o male with a PMH of COPD, HTN, and metastatic melanoma (BRAF mutant; mets to brain, lymph nodes, mediastinum, and lungs). There are multilevel degenerative changes affecting the cervical spine, with mild to moderate spinal canal stenosis spanning from C4 to C6 with mild cord deformity. There is mild anterolisthesis of C4 on C5. There is moderate retrolisthesis of C6 on C7. There is a compression fracture of the L1 vertebral body, affecting the superior endplate. Otherwise, vertebral bodies are appropriate in the overall alignment and height. Bone marrow signal intensity is diffusely heterogeneous, which is nonspecific and not well evaluated on this examination. Bone marrow signal abnormality is relatively more prominent within the C5 and L2 vertebral bodies. No obvious cord signal abnormality or evidence of acute cord compression. Previously described left upper lobe and lingular opacities are incompletely evaluated on this examination.
This is a limited exam specific for the exclusion of cord compression only and does not exclude more subtle lesions such as intrinsic cord abnormalities. No acute cord compression is identified.Up to moderate spinal canal stenosis in the cervical spine is suspected spanning the C4-C6 levels, with mild cord deformity, which can be better assessed with dedicated cervical spine MRI.Marrow signal abnormality is most conspicuous at the C5 and L2 levels. Consider dedicated spine imaging with contrast to better assess for osseous metastatic disease. Due to the screening nature of this protocol details are not as evident on imaging as dedicated protocols of the spine.