Male, 13 years old, with imbalance. Evaluate for demyelination. Multiple patches of T2 hyperintensity are seen within the spinal cord including at the C2-3, C6, C7 and T4 levels. Lesions at C2-3 and C7 show mild enhancement with questionable enhancement at T4. The lesions result in no significant spinal cord expansion. Elsewhere, cord signal intensity, morphology and pattern of enhancement are within normal limits.Anomalous vertebral development is seen at C3-4 with a small C3-4 disk space and mild wasp-waisting of the vertebral bodies, as well as fusion of the right sided C3-4 facet joints and the spinous processes.Vertebral body morphology is otherwise unremarkable. There is a mild reversal of the normal cervical lordosis centered at C3-4. Elsewhere spinal alignment is smooth and anatomic. Marrow signal characteristics are within normal limits. No pathologic marrow enhancement is seen.The spinal canal and neural foramina are widely patent throughout.
1. Multiple spinal cord lesions are demonstrated which would be compatible with a diagnosis of demyelinating disease. At least two of these lesions show evidence of enhancement.2. Abnormal vertebral body morphology at C3-4 which may represent a Klippel-Feil spectrum anomaly.