Other musculoskeletal symptoms referable to limbs(729.89) [729.89], Reason for Study: ^Reason: r/o demyelinating disease History: L leg weakness C-spine:There are multifocal moderate to severe spinal stenosis or cervical spine.In particular, at the level of C4-5 and C6-7, there are subtle high signal intensities of spinal cord on sagittal STIR images indicating development of possible compressive myelopathy.The cranial-cervical junction is normal. There is normal cervical lordosis. The cervical spine alignment is anatomic. The vertebral body height is preserved. The bone marrow and end plates demonstrate degenerative spondylosis.There is no evidence of abnormal enhancement. Degenerative changes are specified by the intervertebral level as follows: C2-C3: no neuroforaminal narrowing or spinal stenosis. C3-C4: Diffuse bulging of disc with bilateral diffuse narrowing of neural foramen. Minimal to mild spinal stenosis. C4-C5: Underlying diffuse bulging of disc with a focal central bulging of disc with significant bilateral uncovertebral joint hypertrophy resulting moderate to severe spinal stenosis and bilateral neural foraminal stenosis. Subtle high signal intensity of spinal cord indicating possible compressive myelopathy.C5-C6: Diffuse bulging of disc with bilateral moderate to severe uncovertebral joint hypertrophy resulting moderate to severe spinal canal stenosis and bilateral neural foraminal stenosis. C6-C7: Diffuse bulging of disc with bilateral severe neural foraminal stenosis and moderate to severe spinal stenosis. Subtle high signal intensity on sagittal STIR image indicating possible compressive myelopathy.C7-T1: Minimal bulging of disc otherwise unremarkable. Thoracic spine:At the level of T56, the left side neural foramen appears to be a bit wider than that of the right. In addition, on STIR image, the left neural foramen shows high signal intensity. On T1 axial images, there is tubular low signal intensity lesion which shows diffuse enhancement on post Gad T1 image. These findings suggest possible diagnosis of neurogenic tumor. However, prominent venous plexus including venous varix cannot be completely excluded.Unless clinically significant, no further imaging investigation is necessary. There is normal thoracic kyphosis and lumbar lordosis. The spine alignment is anatomic. The vertebral body height is preserved. The bone marrow and end plates demonstrate a normal MR appearance. The signal of the visualized cord is normal. The epidural space, thecal sac, and spinal cord are preserved with no evidence of spinal canal/neural foraminal narrowing, cord compression, or myelopathy. The conus medullaris terminates at the L1-L2 level.
1. Degenerative spondylosis of C spine, including moderate to severe spinal stenosis at the level of C45 and C67 with possibly compressive myelopathy.2. Prominent enhancement of left T56 neural foramen, diagnostic possibilities include incidental neurogenic tumor, venous plexus or venous varix.