Left upper extremity weakness. Question multiple sclerosis versus vasculitis. Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. Alignment is maintained aside from straightening which may be positional. Bone marrow signal is benign with scattered foci of T1 hyperintensity including C6 and T1 vertebral bodies compatible with hemangiomas. Smaller but similar lesions are noted involving the posterior elements at the C3, C5, and C7 levels.The cervical spinal cord has normal signal characteristics and overall morphology with no evidence of abnormal enhancement.Degenerative changes are seen in the cervical spine as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: Small central disc protrusion with effacement of the ventral thecal sac. No significant compromise to the spinal canal overall or neural foraminal stenosis.C4-5: Small disc osteophyte complex with effacement of the ventral thecal sac but no significant spinal canal stenosis overall. There is mild to moderate right and mild left neural foraminal stenosis related to disc and uncovertebral hypertrophy.C5-6: Small disc osteophyte complex with partial effacement of the ventral thecal sac. No significant spinal canal stenosis. Mild left and minimal right neural foraminal narrowing.C6-7: No significant compromise to the spinal canal or neural foramina.C7-T1: No significant compromise to the spinal canal or right neural foramen. Minimal left neural foraminal narrowingThe vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.There is a large heterogeneous nodule involving the left thyroid lobe measuring approximately 2.6 x 3.4 cm in the AP and transverse dimensions and 5.2 cm in the craniocaudal dimension. There is also a smaller nodule anteromedially in the left thyroid lobe.
1. No cord signal abnormality or evidence of demyelinating disease in the cervical cord.2. Mild degenerative changes in the cervical spine as described above without high-grade spinal canal or neural foraminal stenosis at any level.3. Approximately 2.6 x 3.4 x 5.2 cm heterogeneous mass/nodule at the level of the left thyroid lobe with extension into the mediastinum. Further evaluation with ultrasound is suggested.