50-year-old female with right arm pain. Evaluate for causes of right C5 cervical radicular symptoms. Somewhat motion limited exam. There is straightening of the cervical lordosis and the spinal canal is developmentally narrowed. The cervical spine alignment is maintained and the cervical vertebral bodies are appropriate in height. There is mild disc narrowing at the C4-5 level and diffuse disc desiccation throughout the cervical spine. A hemangioma or focal fat is seen in the posterior superior T1 vertebral body. The bone marrow signal is otherwise within normal limits. The cervical spinal cord has normal signal characteristics and overall morphology.Degenerative changes are seen in the cervical spine as described below:C2-3: Trace diffuse disc osteophyte complex with left paracentral prominence as well as mild uncovertebral hypertrophy contributes to mild-moderate left neural foraminal narrowing. There is also mild spinal canal stenosis.C3-4: Mild diffuse disc osteophyte complex with some central prominence and left greater than right uncovertebral hypertrophy contributes to moderate right and moderate to severe left neural foraminal stenosis. There is also mild to moderate spinal canal stenosis.C4-5: Trace diffuse disc osteophyte complex and bilateral uncovertebral hypertrophy contributes to moderate right and moderate to severe left neural foraminal stenosis. There is mild to moderate spinal canal stenosis. There is flattening of the right ventral cord with likely impingement of the right ventral C5 nerve root.C5-6: Small diffuse disc osteophyte complex with a right. Central disc protrusion which contributes to mild spinal canal stenosis. There is no significant compromise to the neural foramina. C6-7: Trace diffuse disc osteophyte complex without significant compromise to the spinal canal or neural foramina.C7-T1: No significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits. There is caudal extension of the slightly pointed left cerebellar tonsil to 6 mm below the foramen magnum, without significant crowding.
1.Developmental narrowing of the cervical canal with superimposed spondylotic change most prominent at the C4-5 level resulting in mild-moderate spinal canal stenosis at this level. There is also up to moderate to severe left and moderate right foraminal stenosis at the C4-5 level, with flattening of the right ventral cord and likely impingement of the right ventral C5 nerve root.2.Caudal extension of the left cerebellar tonsil to 6 mm below the foramen magnum with a slightly pointed configuration and no significant crowding, favoring left tonsillar ectopia. 