Clinical question: Rule out myelitis. Signs and symptoms: Paraplegia. Pre-and post-enhanced cervical MRI:The examination demonstrates subtle uniform diffuse T2 hyperintensity of the cervical cord without convincing detectable increase in cord caliber. The finding appears to extend from approximately mid C2 level inferiorly to approximately T1. There is no convincing evidence of enhancement of this finding on post infused images. Findings are suspected for myelitis.The signal intensity of vertebral column is unremarkable other than changes related to degenerative disease and without evidence of abnormal spinal enhancement.Minimal degenerative changes at C3 -- C4 with resultant mild central spinal stenosis is also noted. C4 -- C5 demonstrate moderate disk disease and loss of disk height as well as broad based ventral bulging disk resulting in flattening and posterior displacement of the cord and moderate central spinal stenosis as well as significant right and moderate left neural foraminal compromise. C5 -- C6 demonstrate degenerative changes with resultant mild left neural foraminal compromise.C6 -- C7 degenerative changes also results in mild to moderate left neural foramina compromise.Pre-and post-enhanced thoracic MRI:Examination demonstrate no convincing evidence of cord signal abnormality other than above mentioned changes on MRI of cervical spine. There is also no detectable abnormal enhancement of thoracic cord.T9 -- T10 demonstrate moderate disk disease and loss of disk height and a left lateral and far lateral broad-based disk protrusion which results in mild to moderate left neural foraminal compromise and no central spinal stenosis.Minimal degenerative changes at other levels are also noted however without spinal stenosis or neural foraminal compromise.
1.Pre-and post-enhanced MRI of cervical spine demonstrate uniform diffuse T2 hyperintensity extending from mid C2 level to approximately T1 and without evidence of change in the cord caliber or abnormal enhancement. Findings are suggestive of myelitis. Degenerative changes of cervical spine results in moderate central spinal stenosis at C4 -- C5 and there is some neural foraminal compromise. Mild central spinal stenosis at C3 -- C4 is also noted. There are multilevel neural foraminal compromise as detailed the level above.2.Pre-and post-enhanced MRI of thoracic spine demonstrates no convincing evidence of cord signal abnormality or enhancement. Degenerative changes and a disk protrusion at T9 -- T10 results in left neural foraminal compromise. No evidence of spinal stenosis or any significant other levels of neural foraminal compromise is detected.