Clinical question: Klippel-Feil syndrome and neck pain with syrinx, evaluate for change. Signs and symptoms: Yearly evaluation. Nonenhanced cervical MRI:There is revisualization of a stable few is right arch of C1 bone and with intravenous increased bony volume/hypertrophy similar to prior exam. There is mild dorsiflexion of the dens with resultant effacement of ventral subarachnoid space and mild mass effect and posterior displacement of the cervical medullary junction of the cord without central spinal stenosis or interval change since prior exam.The alignment of vertebral column and 8 signal intensity remains within normal and stable since prior study.Impression there is a uniform thin linear increased T2 signal intensity traversing the entire cervical cord and into the upper visualized thoracic cord identical to prior exam. Findings could represent central canal or less a nonexpansile syrinx. The caliber of the cord remains within normal for age and without detectable signal abnormality otherwise.There is no evidence of spinal canal or neural foraminal compromise at any level.Unremarkable paraspinal soft tissues.Nonenhanced thoracic MRI:Examination demonstrates normal signal intensity and alignment of vertebral column without detectable congenital anatomical anomaly.There is no evidence of a spinal canal or neural foraminal compromise.There is a mildly expansile syrinx of thoracic cord identical to prior exam and extending from C5-C6 disc level inferiorly to mid T9 level without evidence of interval change in extent or size since prior study. The finding measures maximum of 2.5 mm in transverse axis. The nonexpansile and segmental syrinx extends superiorly to the cervical cord and inferiorly to approximately T12 similar to prior exam.No detectable paraspinal abnormalities and unremarkable signal intensity of the cord otherwise.
1.No evidence of an acute or new finding since prior study.2.Revisualization of fusion of the right arch of C1 with the occipital bone.3.Revisualization of syrinx of cervical and thoracic cord measuring maximum of 2.5 mm in short segmental expanded thoracic component of syrinx and approximately 1 mm in the nonexpansile component of syrinx similar to prior exam.