Clinical question: Evaluate for demyelinating disease. Signs and symptoms: Spasticity. Nonenhanced cervical MRI:The examination demonstrates normal signal intensity and caliber of cervical cord and without convincing evidence of a demyelinating plaque.The signal intensity of the vertebral column demonstrate changes related to mild degenerative disease and unremarkable otherwise.At C3 -- C4 mild degenerative changes results in mild right neural foraminal compromise and unremarkable otherwise.At C5 -- C6 there is mild degenerative disk disease with resultant significant right and mild left neural foraminal compromise and without central spinal stenosis.At C6 -- C7 there is moderate left neural foraminal compromise and unremarkable otherwise.Nonenhanced thoracic MRI:There is normal signal intensity and caliber thoracic cord with convincing evidence of demyelinating disease.There is normal signal intensity and alignment the vertebral column.There is no evidence of spinal canal or neural foramina compromise at any level.
1.Negative nonenhanced MRI of cervical and thoracic spine for demyelinating disease.2.Degenerative changes of cervical spine with resultant multilevel neural foraminal compromise however without central spinal stenosis as detailed above.3.No evidence of spinal canal or neural foraminal compromise of thoracic spine.