Diagnosis: Malignant neoplasm of prostateClinical question: R/o cord compression 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 low T1 and T2 signal (compatible with sclerosis) involving the C2, C4, C5 and C6 vertebral bodies without compression fracture. There is multilevel disk dessication present.At C2-3 there is no significant compromise to the spinal canal or neural foramina. There is a broad based central disk protrusion at this level .At C3-4 there is no significant compromise to the spinal canal or neural foramina. There is a disk bulge and mild posterior ligamentous hypertrophy at this level associated with mild narrowing of the spinal canal and neural foramina. Overall there is a mild degree of spinal stenosis. There are small uncovertebral osteophytes at this level.At C4-5 there is no significant compromise to the spinal canal or neural foramina. There is are small uncovertebral osteophytes at this level.At C5-6 there is no significant compromise to the spinal canal. There is a broad based disk protrusion at this level encroaching on the left exiting nerve roots at this level.At C6-7 there is no significant compromise to the spinal canal or neural foramina. There is a mild disk bulge 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.MRI thoracic spine:The thoracic vertebral bodies are appropriate in the overall alignment and height. The thoracic spinal cord has normal signal characteristics and overall morphology. There is no compromise of thoracic spinal canal or exiting nerve roots. There are foci of low T1 and T2 signal intensity marrow replacement at T3, T6, T9 andT11 vertebral bodies and posterior elements as well as foci of marrow replacement within posterior elements at T7 andT10.There is 10mm T1 hyperintense lesion in theT2 vertebral body most likely representing hemangioma.There are Schmorl's nodes at T5-6, T9-10, T10-11, T11-12 .Foci of low T1 and T2 signal intensity marrow are also present in the right T7, left T8 and left T9 ribs.Lumbar spine:Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall height. The conus medullaris on sagittal imaging is grossly intact. There are foci of low T1 and T2 signal intensity marrow replacement at L1-L5 vertebral bodies and posterior elements. Foci of low T1 and T2 signal intensity marrow are also present in the sacrum (right sacral ala) and visualized right iliac bone.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is bilateral facet and ligamentum flavum hypertrophy at this level.At L4-5 there is is bilateral facet and ligamentum flavum hypertrophy at this level associated with a mild disk bulge and mild anterior subluxation of L4 on L5 resulting in moderate spinal stenosis and bilateral encroachment of exiting nerve roots..At L3-4 there is no significant compromise to spinal canal or neural foramina.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.There is enlargement of the left renal pelvis associated with a shunt catheter.There is a 4.2cm right renal cyst along it's inferior pole.
1.Multiple sclerotic lesions throughout the cervical, thoracic and lumbar spine without compromise to the spinal canal.2.Degenerative changes in the lumbar spine with spinal stenosis, mild subluxation and bilateral encroachment of exiting nerve roots.3.Degenerative changes are also present in the cervical spine with encroachment of the left exiting nerve roots at C5-6 and a mild degree of spinal stenosis at C3-4.4.Some degenerative changes are present in the thoracic spine.5.There is a spinal hemangioma at T3.6.There is enlargement of the left renal pelvis associated with a shunt catheter.7.Sclerotic lesions are also present in the sacrum, visualized right iliac bone and right T7, left T8 and left T9 ribs.8.There is a 4.2cm right renal cyst along it's inferior pole.