Clinical question: Spinal stenosis or demyelinating disease. Signs and symptoms: Spinal stenosis, demyelinating disease of CNS. Nonenhanced cervical spine MRI:Foramen magnum is unremarkable.C2-C3 is unremarkable.C3-C4 is unremarkable.C4-C5 is unremarkable.C5-C6 demonstrate moderate to advanced disc disease, loss of disc height and mild facet and ligamentum flavum degenerative/hypertrophic changes. There is resultant mild reversal of cervical lordosis at this level. Findings also result in mild central spinal stenosis with moderate the right and mild to moderate left neural foraminal compromise.There is a tiny focus of T2 hyperintensity in the anterior aspect of cervical cord posterior to the body of C6 suspicious for myositis likely secondary to degenerative changes at this level. The findings demonstrate no significant change since prior exam from 2014.The signal intensity of the cervical and upper most visualized thoracic cord remains normal otherwise.C6-C7 is unremarkable.C7-T1 is unremarkable.Upper most visualized thoracic spine demonstrate no spinal stenosis or neural foraminal compromise.
1.Moderate degenerative disease only at C5-C6 level with resultant mild central spinal stenosis and bilateral neural foraminal (right greater than left) compromise as detailed. Small focus of T2 hyperintensity in the anterior cord at this level is believed to represent related myelitis.2.There is no detectable additional foci of cord signal abnormality.3.There is no evidence of any significant degenerative changes at other levels and no detectable spinal canal or neural foraminal compromise.