Reason: New onset of right arm and leg weakness for the past two weeks. History: right arm and leg weakness for the past two weeks. The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. At 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.At C4-5 there is no significant compromise to the spinal canal. There is heterogeneous signal within the C4-5 disk space associated with endplate reactive changes which are bright on T2 and dark on T1 and irregularity of the adjacent endplates. There is also associated pre-vertebral signal hyperintensity. There is left-sided facet hypertrophy at this level associated with narrowing of the left neural foramen and encroachment of the left-sided exiting nerve roots.At C5-6 there is no significant compromise to the spinal canal or neural foramina.At C6-7 there is no significant compromise to the spinal canal. There is a diffuse disk bulge at this level associated with narrowing of the neural foramina.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 inflammatory changes present the C4-5 disk space. The possibility of this is related to a diskitis cannot be excluded. Given the fact that the patient is on hemodialysis, hemodialysis related arthropathy may be an additional possibility here.2.There is encroachment of the left-sided exiting nerve roots at C4-5 related to left-sided facet hypertrophy.3.There are milder degenerative changes present at C6-7.4.Findings were reported to Andrew Benchman at the time of this dictation.