Clinical question: Reason for left arm pain and finger numbness. Signs and symptoms: As above. Pre-and post-enhanced cervical MRI:Foramen magnum is unremarkable.C2 -- C3 is unremarkable and stable since prior study.C3 -- C4 demonstrate minimal degenerative changes and unremarkable otherwise. No change since prior exam. C4 -- C5 demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise or interval change.C5 -- C6 demonstrates mild to moderate disk disease and loss of disk height and mild facet degenerative changes with minimal interval progression. There is a shallow broad-based disk protrusion with subtle interval progression however without spinal stenosis or appreciable neural foraminal compromise.C6 -- C7 demonstrate moderate disk disease and loss of disk height moderate bilateral ligamentum flavum hypertrophy and mild facet disease. There is also hypertrophic changes of posterior longitudinal ligament at C5 through C7 levels with interval progression since prior exam. There is a broad-based disk protrusion with interval progression since prior exam. Findings resulting mild flattening deformity of the cord and central spinal stenosis. There is a small left lateral disk extrusion present at this level without significant change since prior exam. The finding results in mass effect on the thecal sac and the exiting left nerve roots on the left (axial T2 series 7 image 22 and sagittal T2 series 3 image 11). These no convincing area so any significant change of this finding since prior exam.There is mild reversal of cervical lordosis centered at C5 and C6 levels with subtle interval worsening since prior exam. This finding however could be positional. The signal intensity of the cervical cord remains within normal.C7 -- T1 is unremarkable.Uppermost visualized thoracic spine the thoracic cord is unremarkable.
1.Mild progression of degenerative / hypertrophic changes at C5 -- C6 and C6 -- C7 levels.2.Mild interval increase size of broad-based disc protrusion at C6-- C7 level as detailed. Stable small left lateral disk extrusion at this level and associated mass effect on the thecal sac and exiting nerve roots on the left since prior exam. Central spinal stenosis is present at this level is identified.3.Normal signal intensity and caliber of the cervical and uppermost visualized thoracic cord.