Severe neck pain, history of colon cancer. Evaluate for metastasis or abscess. Examination is mildly technically degraded as patient had difficulty tolerating the study. There is mild retro-odontoid soft tissue without mass effect, frequently related to CPPD in this age group. Craniovertebral junction appears otherwise within normal limits. The cervical vertebral bodies are appropriate in height. Alignment is maintained aside from mild anterolisthesis of C4 on C5 and mild retrolisthesis of C6 on C7. Bone marrow signal is benign.The cervical spinal cord has normal signal characteristics and overall morphology. No suspicious enhancing lesions are appreciated. There is mild nonspecific edema and enhancement involving the paraspinous musculature and interspinous region at the posterior C1-C2 level. There is also mild fluid involving the lateral atlantoaxial joints. There is no discrete mass to suggest tumor. No evidence of abscess.There is enhancement involving the lung apices and the upper thoracic paravertebral region favored to be related to scarring and better assessed on prior chest CT. There is a 2 cm right thyroid nodule.Degenerative changes are seen in the cervical spine as described below:C2-3: No significant compromise to the spinal canal or neural foramina. Mild facet arthropathy, particularly on the left.C3-4: Small disc osteophyte complex with mild uncovertebral hypertrophy and mild ligamentum flavum thickening. There is facet arthropathy, particularly on the left. There is no spinal canal stenosis. Mild bilateral neural foraminal stenosis.C4-5: Small disc osteophyte complex and mild uncovertebral hypertrophy. There is no spinal canal stenosis. There is moderate right and mild left neural foraminal stenosis. There is facet arthropathy, particularly on the right.C5-6: Small disc osteophyte complex and mild uncovertebral hypertrophy. No significant spinal canal stenosis. There is mild stenosis of the bilateral neural foramina. Bilateral facet arthropathy, greater on the right.C6-7: Small disc osteophyte complex and ligamentum flavum thickening. No significant spinal canal stenosis. There is mild right and minimal left neural foraminal stenosis. There is bilateral facet arthropathy, greater on the right.C7-T1: No significant compromise to the spinal canal or neural foramina.There is a small retropharyngeal fluid collection measuring up to 6 mm in thickness and extending from the C1 to the C6 levels.
1. No findings to suggest metastatic disease or abscess in the cervical spine, as questioned.2. There are multilevel degenerative changes throughout the cervical spine without significant spinal canal stenosis at any level. There is multilevel facet arthropathy and foraminal stenosis, relatively worse at the right C4-C5 level where there is moderate right neural foraminal stenosis.3. There is mild soft tissue edema and enhancement at the C1-C2 level posteriorly as described above which is nonspecific and may on a degenerative, inflammatory, or traumatic basis.4. Small retropharyngeal fluid collection extending from C1 to C6 which is nonspecific. CT neck with contrast may be considered for further evaluation as clinically warranted.