Diagnosis: Other specified disorders of muscleClinical question: Evaluate for Disc diseaseSigns and Symptoms: Left arm and leg numbness and weakness and hyporeflexia MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.Incidental note is made of a developmental venous anomaly located in the left centrum semiovale.There is a punctate focus of signal hypointensity in the subcortical white matter of the right frontal lobe. In isolation this is probably of little clinical significance.The visualized portions of the paranasal sinuses demonstrate some mild mucosal thickening. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. There is mild reversal of the normal cervical curvature present.. There is multilevel disc desiccation presentAt C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina. There is a small left lateral recess disc protrusion at this levelAt C4-5 there is no significant compromise to the spinal canal. There is a broad-based left lateral recess disc protrusion at this level which narrows the left neural foramenAt C5-6 there is no significant compromise to the spinal canal. There is a left lateral recess disc protrusion present at this level which encroaches on the left-sided exiting nerve roots within the neural foramen at this level. This is associated with uncovertebral osteophytes.At C6-7 there is no significant compromise to the spinal canal. There are uncovertebral osteophytes and a left lateral recess disc protrusion which encroaches on the left-sided exiting nerve roots at this level.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
1.There are left-sided lateral recess disc protrusions associated with uncovertebral osteophytes at C5-6 and C6-7 which encroach on the left-sided exiting nerve roots. To a lesser degree there is some narrowing of the left neural foramen.2.There is no evidence for cerebral infarction.3.There is a developmental venous anomaly in the left centrum semiovale. This is an incidental finding.