Clinical question: R/O R cervical radiculopathy. Signs and Symptoms: Intermittent numbness in the RUE mostly in a R C6 distribution Nonenhanced cervical MRI:There is mild uniform generalized smaller than expected size of the spinal canal which is believed to represent a congenital anatomical variation.Foramen magnum is unremarkable.C2-C3 is unremarkable.C3-C4 demonstrate mild degenerative changes, mild bilateral ligamentum flavum hypertrophy and mild bilateral facet degenerative changes. There is a tiny right lateral disc protrusion and uncovertebral hypertrophy which results in moderate right neural foraminal compromise (sagittal oblique series 901 image 5 and sagittal T2 series 401 image 9). Patent left neural foraminal and no central spinal stenosis.C4-C5 demonstrate mild disc desiccation, mild bilateral (right greater than left) uncovertebral hypertrophic changes, mild bilateral ligamentum flavum and facet degenerative/hypertrophic findings. No central spinal stenosis. Moderate right and neural foraminal compromise (sagittal T2 oblique series 901 image 5 and 6) and patent left neural foramen.C5-C6 demonstrate moderate disease on loss of disc height, mild bilateral (right greater than left) uncovertebral hypertrophic changes and mild ligamentum flavum hypertrophy. No central spinal stenosis however moderate bilateral neural foraminal compromise secondary to degenerative changes is detected (sagittal oblique series 901 and 1001).C6-C7 demonstrate moderate disc disease and loss of disc height, bilateral significant uncovertebral hypertrophy changes, mild bilateral facet and ligamentum flavum hypertrophy. There is a shallow broad-based disc protrusion with resultant effacement of subarachnoid space, mild flattening and posterior displacement of the cord and mild central spinal stenosis. Significant bilateral (right greater than left) neural foraminal compromise is also detected.C7-T1 demonstrate mild degenerative disease and unremarkable otherwise.There is subtle increased T2 signal intensity of the cord anteriorly at this level suspected of myelopathy.
1.At C6-C7 degenerative changes including uncovertebral hypertrophic changes and a broad-based disc protrusion results in central spinal stenosis and significant (right greater than left) neural foraminal compromise. Subtle T2 hyperintensity of the cord at this level is concerning for myelopathy.2.Uniform generalized smaller size of spinal canal represent a congenital anatomical variation of small canal.3.Mild degenerative changes at other levels however without convincing evidence of central spinal stenosis.4.There are multilevel bilateral (right greater than left) neural foraminal compromise at other levels as detailed.5.Please review detailed report above.