Diagnosis: Neoplasm of uncertain behavior of bone and articular cartilageClinical question: Eval change to Cervical lesion for changeSigns and Symptoms: upper extremity numbness The cervical vertebral bodies are appropriate in overall alignment and height. No abnormal enhancing lesions are identified in the cervical spine. There is multilevel disc desiccation presentAt C2-3 there is no significant compromise to the spinal canal. There is some left-sided facet hypertrophy present at this level associated with narrowing of the left neural foramen and mild to moderate encroachment of the left-sided exiting nerve roots. This is stable compared to the prior exam.At C3-4 there is no significant compromise to the spinal canal. There is loss of disc space height at this level associated with uncovertebral osteophytes and narrowing of the neural foramina bilaterally with mild to moderate encroachment of the exiting nerve roots bilaterally. This is stable compared to the prior exam. There are associated contrast enhancement within the right posterior lateral aspect of the C3 vertebral body which is unchanged since the previous exam and may represent some subacute inflammatory change related to DJD.At C4-5 there is no significant compromise to the spinal canal. There is a left paramedian disc protrusion present at this level which partially effaces spinal fluid ventral to the left hemicord. There are uncovertebral osteophytes present at this level associated with disc material especially in the left side where there is encroachment of the left-sided exiting nerve roots. This is stable compared to the prior exam.At C5-6 there is loss of disc space height, disc desiccation and endplate and uncovertebral osteophytes associated with disc material. There is posterior ligamentous hypertrophy at this level. There is partial effacement of spinal fluid ventral and posterior the spinal cord at this level resulting in a mild to moderate degree of spinal stenosis. There is bilateral neural foramen encroachment of exiting nerve roots at this level which is worse on the right than the left side. This is stable compared to the prior exam.At C6-7 there is some loss of disc space height, disc desiccation and endplate uncovertebral osteophytes. There is some posterior ligamentous hypertrophy at this level. There is effacement of the spinal fluid ventral and posterior the spinal cord at this level associated with some mild flattening of the spinal cord as well as cord signal change. There is encroachment of the neural foramina bilaterally at this level which is worse on the right side compared to the left . Overall there is a moderate degree of spinal stenosis at this level. This is stable compared to the prior exam.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.At T1-T2 and T2-T3 there are uncovertebral osteophytes present bilaterally with narrowing of the neural foramina bilaterally.The vertebral artery flow voids appear to be intact.There is a 15 x 12 mm axial dimension enhancing focus adjacent to the left C6-7 facet joint which has been stable since prior exams at the adjacent to posterior elements of C7 lamina there is some contrast enhancement present which was also present on prior exams. There is a PET scan from 3/18/15 which suggests that these are most likely inflammatory reaction.
1.There are multilevel degenerative changes present in the cervical spine which are worse at C6-7 where there is moderate spinal stenosis and cord signal change suggestive of a spondylitic myelopathy. There is a moderate degree of spinal stenosis present at C5-6 and multilevel encroachment of exiting nerve roots as detailed above. Overall there is no significant interval change when compared to the previous exam2.A ring-enhancing lesion at the C3 vertebral body and a lesion at the left posterolateral aspect of C7 are stable. Continued follow-up would help insure that these are not neoplastic.