Systemic lupus erythematosus [710.0] / Unspecified cause of encephalitis, myelitis, and encephalomyelitis [323.9] / Other causes of myelitis [323.82], Reason for Study: ^Reason: 22 y/o with SLE and cerebritis c/o neck/back pain evaluate changes Brain MRI:No evidence of acute ischemic or hemorrhagic lesion on the scan.No evidence of abnormal signal intensity on FLAIR imaging.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.C-spine:There are multifocal some continuous and some are interrupted high signal intensity lesions on cervical spine from cervico medullary junction to the level of C6 vertebral body. Most prominent lesion is located on the posterior aspect of the spinal cord between C2-C3 to C3-C4 level. The MR characteristics of these lesions are consistent with demyelinating disease involvement of cervical spine with various stages. These lesions were not conspicuous on prior scan.On post enhancement scan, the lesion at the level of C23 disc space shows subtle nodular enhancement indicate possible active lesion.Minimal kyphotic angulation centered at the level of C45 with intervertebral disc degenerations are again seen, no change since prior scan.There is diffuse bulging of disc which abuts thecal sac at level of C45, no change since prior scan.There is no evidence of neural foraminal narrowing, nor spinal canal stenosis.
1. Normal brain MRI2. Interval development of multistage demyelinating disease involving cervical spine as described above. The enhancing lesion at the level of C23 disc space may indicate active lesion.