Clinical question: Left chest pain around T10. Signs and symptoms: As above. Nonenhanced thoracic MRI:There is normal anatomical alignment of vertebral column and the normal signal intensity on all MRI sequences.T1-T2 is unremarkable.T2-T3 is unremarkable.T3-T4 demonstrate mild disc disease and loss of disc height without spinal stenosis or neural foraminal compromise.T4-T5 demonstrate no spinal stenosis or neural foraminal compromise. Very subtle compression deformity of superior endplate of T5 without associated marrow signal changes could be an anatomical variation or a remote mild compression fracture.T5-T6 demonstrate mild degenerative disease without spinal stenosis or neural foraminal compromise. Very subtle flattening of the superior endplate of T6 without associated marrow signal changes is of questionable clinical significance.T6-T7 demonstrate minimal degenerative changes and unremarkable otherwise.T7-T8 demonstrate mild degenerative changes without spinal stenosis however mild left neural foraminal compromise is detected questionable clinical significance.T8-T9 demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise.T9-T10 demonstrate mild degenerative disc disease and mild facet/ligamentum flavum hypertrophy. There is a tiny central disc protrusion which is best appreciated on axial T2 series 7 image 31. The finding minimally effaces the ventral subarachnoid space however without mass effect on the cord or central spinal stenosis. Mild left neural foraminal compromise secondary to degenerative disease however is detected (sagittal T2 series 5 image 12).T10-T11 demonstrate mild degenerative disease without spinal stenosis. Mild bilateral neural foraminal compromise (left greater than right) however is noted (sagittal T2 series 500 images 11 and 12 on the right and image 6 on the left). There is however no detectable mass effect on the exiting nerve root on either side.T11-T12 and T12-L1 levels are unremarkable.The signal intensity and caliber of the thoracic cord is unremarkable.Perispinal soft tissues are unremarkable.
1.Very mild degenerative changes of the thoracic spine are noted without evidence of central spinal stenosis at any level.2.Mild neural foraminal compromise without mass effect on the nerve roots at T7-T8 through T10-T11 levels are noted as detailed above.3.Normal caliber and signal intensity of the cord.4.Unremarkable paraspinal soft tissues.