Stiff-man syndrome [333.91] / Muscle weakness (generalized) [728.87], Reason for Study: ^Reason: stenosis, inflammation? History: severe neck pain and hyperreflexia C-SpineThere is mild diffuse bulging of disc at the level of C34 which abuts thecal sac with mild kyphotic angulation, no significant interval change since prior scan.There are bilateral multifidus muscle patchy enhancement at the level of C45. This finding could suggest possible inflammatory changes or atrophic changes of multifidus muscle. Since there is no STIR abnormality on those lesions, the possibility of atrophic change is low.No evidence of abnormal signal intensity of spinal cord.The cranial-cervical junction is normal. The vertebral body height is preserved. The bone marrow and end plates demonstrate a normal MR appearance. The signal of the visualized cord is normal. The epidural space, thecal sac, and spinal cord are preserved with no evidence of spinal canal/neural foraminal narrowing or myelopathy. The paraspinal soft tissues are unremarkable.There is no evidence of abnormal enhancement, cord compression or mass. T-SpineThere is normal thoracic kyphosis and lumbar lordosis. The spine alignment is anatomic. The vertebral body height is preserved. The bone marrow and end plates demonstrate a normal MR appearance. The signal of the visualized cord is normal. The epidural space, thecal sac, and spinal cord are preserved with no evidence of spinal canal/neural foraminal narrowing, cord compression, or myelopathy. The conus medullaris terminates at the L1-L2 level.
1. Patchy enhancement of C45 level multifidus muscles indicating possible inflammatory changes or atrophic changes.2. No change of mild disc bulging of disc at the level of C45.3. No abnormal spinal cord signal intensity. No abnormal enhancement.