Male, 2 years old, with difficulty walking upstairs, sitting down, hypotonic lower extremities, decreased overhead motion of the upper extremities. Brain:The cerebral and cerebellar hemispheres and brainstem show normal signal intensity and morphology. No restricted diffusion is seen. No pathologic parenchymal or extra-axial enhancement is detected.The pattern of white matter myelination is appropriate for age and essentially mature. The pituitary region is within normal limits. The brainstem, cerebellar vermis and cerebellar hemispheres are unremarkable. The corpus callosum is fully formed and normal.No evidence of parenchymal edema, mass, or mass effect is seen. There is no evidence of intracranial hemorrhage or abnormal extra-axial fluid. The ventricular system is normal in caliber and morphology. Spine:A full complement of normally formed vertebral bodies is present. Marrow signal intensity and pattern of enhancement are within normal limits. Spinal alignment is anatomic.The spinal cord demonstrates normal morphology and, allowing for mild motion degradation, shows no evidence of any pathologic signal abnormality. No abnormal cord or leptomeningeal enhancement is seen. The conus tip terminates at the L1-2 level which is within normal limits. The nerve roots of the cauda equina dispersed evenly through the thecal sac. No intraspinal fatty material is observed.The paraspinal musculature is diffusely hyperintense on T2-weighted images and shows diffuse pathologic enhancement.
1.Unremarkable evaluation of the brain.2.Unremarkable evaluation of the spinal cord and osseous spine.3.Diffuse paraspinal muscular signal abnormality and enhancement is seen compatible with a systemic myositis.