Severe neck stiffness (less than 20 degrees in any direction x1 month). History of Hepatocellular carcinoma. There is an enhancing lesion in the dens and a portion of the C2 body anteriorly. There is diffuse heterogeneous bone marrow signal from C3 through C7 with endplate irregularities and small disc-osteophyte complexes that appear to mildly indent the spinal cord. The vertebral body heights appear to be grossly preserved, however. There is no evidence of significant lymphadenopathy in the neck. The salivary glands are unremarkable. There is a T1 and T2 hyperintense nodule in the left thyroid gland that measures up to 7 mm. There are T1 hyperintense secretions in the right sphenoid sinus. There is a small amount of fluid in the left mastoid air cells. The imaged portions of the intracranial structures and orbits are unremarkable.
1. A lesion in the dens and a portion of the C2 body anteriorly likely represents metastatic disease. 2. Diffuse heterogeneous bone marrow signal from C3 through C7 is likely degenerative in nature, with endplate irregularities and small disc-osteophyte complexes that appear to mildly indent the spinal cord. 3. A small nodule in the left thyroid gland likely represents a colloid cyst. 