Clinical question: Metastatic disease? Signs and symptoms: History of cancer, neck pain on the left. Pre and post enhanced cervical MRI:There is normal anatomical alignment of vertebral column and stable since prior exam.There is a short segmental focus of T2/T2 STIR hyperintensity within the cervical cord at C3 level with decreased cord caliber and without abnormal enhancement representing a focus of nonspecific myelomalacia. This finding demonstrate no interval change since prior exam from 2012. The signal intensity of the cord is otherwise within normal limits and without abnormal enhancement.The signal intensity of vertebral column is unremarkable and without abnormal enhancement to suggest metastatic disease.Foramen magnum is unremarkable.C2-C3 is unremarkable.C3-C4 demonstrate mild left neural foraminal compromise secondary to degenerative disease and unremarkable otherwise.C4-C5 is unremarkable.C5-C6 demonstrate a right ventral small disc-osteophyte complex with resultant partial effacement of subarachnoid space without central spinal stenosis or neural foraminal compromise. There is no significant change of this finding since prior exam from 2012.History 6/C7 is unremarkable.C7-T1 is unremarkable.Upper most visualized thoracic spine and thoracic cord is unremarkable.
1.Pre- and post enhanced cervical MRI demonstrate no evidence of metastatic disease.2.Small focus of myelomalacia of cord at C3 without change since prior exam from 2012.3.Normal signal intensity of the cord otherwise and without abnormal enhancement.4.Stable small disc-osteophyte complex on the left at C5-C6 since 2012.5.No central spinal stenosis at any level.