Clinical question: Evaluate cord compression. Signs and symptoms: Unable to move lower extremities. Nonenhanced total spine MRI:Examination is performed utilizing cord compression protocol and without dedicated axial images.Examination demonstrates diffuse marrow signal changes of vertebral column consistent with patient's previously known diffuse metastatic disease. There is no fracture or malalignment and no significant interval change since prior exam. There is a an epidural defect at C3-C4 level similar to prior exam and with resultant significant central spinal stenosis. There is a focus of T2 increased signal intensity which is suspected of being within the cord similar to prior exam and is believed to represent a focus of edema or myelomalacia. This finding however demonstrate no change since prior MRI exam in this limited evaluation.The signal intensity of the cord is otherwise appears normal on this suboptimal motion degraded images. There is diffuse lumbar stenosis extending from L2 inferiorly to S2 levels similar to prior exam. Lack of intravenous contrast also reduces the sensitivity of the exam for better assessment. This appearance however is believed to be secondary to congenitally small pedicle as well as hypertrophic changes.
1.Diffuse osseous metastatic lesions throughout the spine without fracture - malalignment or interval change since prior exam.2.Significant central spinal stenosis at C3-C4 and a focus of myelomalacia of the cord similar to prior exam.3.Uniform spinal stenosis in the lower lumbar spine which is believed to be secondary to hypertrophic changes as well as congenitally short pedicles without change since prior MRI study.