Clinical question: myoclonus, including the trunk and Rt leg. Signs and Symptoms: as above MRI THORACIC SPINE WWO:There is normal anatomic alignment and the signal intensity of the vertebral column.There is normal signal intensity and caliber all thoracic cord.There is no evidence of spinal canal compromise or stenosis at any level.There is no appreciable neural foraminal compromise at any level.Small central disk protrusion at C7 -- T1 is noted without spinal stenosis or neural foraminal compromise.There is a right paramedian disk protrusion at T6 -- T7 with resultant flattening deformity of the right ventral aspect of the cord. There is however no signal abnormality of the cord or spinal stenosis at this level.Tiny central disk protrusion at T8 -- T9 with resultant tiny indentation of ventral aspect of the cord.Unremarkable images of all other levels.No detectable paraspinal soft tissue abnormalities.There is no detectable abnormal enhancement of the cord or the leptomeninges. Post-enhanced images however demonstrate expected minimal enhancement of the small disk protrusions as detailed above.MRI LUMBAR SPINE WWO:The signal intensity of the vertebral column is unremarkable other than minimal changes secondary to degenerative disease. There is mild grade 1 anterolisthesis at L5 -- S1 with suspected left sided pars defects and unremarkable alignment of the vertebral column otherwise . At the L5 -- S1 there is mild to moderate facet and ligamentum flavum hypertrophic changes however without spinal stenosis or neural foraminal compromise.There is normal signal intensity and morphology of the conus and cauda equina.There is no evidence of a spinal canal or neural foraminal compromise at any level.Post enhanced images demonstrate no detectable abnormal enhancement of the lower most visualized cord, conus or cauda equina. There is subtle expected enhancement of degenerative changes of posterior elements in the normal lumbar spine.
1.Pre-and post enhanced MRI of the thoracic spine demonstrate normal signal intensity and caliber the cord and without abnormal enhancement. There are multilevel small disk protrusions more noticeably at the right paramedian T6 -- T7 level which results in slight flattening deformity of the cord without associated cord signal change or central spinal stenosis. No spinal stenosis or neural foraminal compromise at any level.2.Pre-and post enhanced MRI of the lumber spine demonstrate normal signal intensity and morphology Conus and cauda equina without abnormal enhancement. There is a mild grade 1 anterolisthesis with suspected pars defect at L5 -- S1 level as detailed. No central spinal stenosis at any level. 