Chronic intractable neck pain There is edema involving the left C1 and C2 lateral masses with abnormal enhancement and small amount of synovial fluid distending the joint at this level on prior brain MRI from 6/28/2014. The cervical vertebral bodies are appropriate in height. There is minimal retrolisthesis of C5 on C6 and C6 on C7 and mild loss of cervical lordosis. Alignment is otherwise maintained. The cervical spinal cord has normal signal characteristics and overall morphology.Mild degenerative changes are seen in the cervical spine as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: No significant compromise to the spinal canal or neural foramina. Left-sided facet arthropathy.C4-5: No significant compromise to the spinal canal or neural foramina. Left-sided facet arthropathy.C5-6: Minimal retrolisthesis and small disc osteophyte complex with partial effacement of the ventral thecal sac. There is no significant spinal canal or neural foraminal stenosis.C6-7: Minimal disc osteophyte complex and retrolisthesis. No significant compromise to the spinal canal or neural foramina.C7-T1: No significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
1. Edema involving the lateral mass articulation of C1 and C2 on the left. Prior brain MRI from 6/28/2014 also demonstrates mild edema, mild joint distention, and surrounding enhancement at this level. Findings may be on a degenerative basis versus a chronic inflammatory arthropathy. CT may be helpful to better assess the osseous anatomy and degenerative changes in this region.2. Mild degenerative changes elsewhere in the cervical spine including left-sided facet arthropathy as described above, without significant spinal canal or neural foraminal stenosis at any level.