Abnormal reflex [796.1] / Disturbance of skin sensation [782.0], Reason for Study: ^Reason: assess for demyelinating disease History: bladder symptoms, numbness in the legs, R.sided hyperreflexia T-SpineThere is flattening of upper to lower thoracic spinal cord from T4-5 to T T10 level without evidence of abnormal spinal cord signal.Well circumscribed slightly high signal intensity on both T1 and T2 weighted image lesion at T3 vertebral body represents vertebral body hemangioma.At the level of T8-9, there is a focal protrusion of disc which abuts thecal sac.There is minimal focal protrusion of disc at the level of T9-10.Broad-based disc protrusion central to left at the level of T 10-11 and T12-L1.There is normal thoracic kyphosis and lumbar lordosis. The spine alignment is anatomic. The vertebral body height is preserved. The bone marrow and end plates demonstrate a normal MR appearance. The signal of the visualized cord is normal. L-SpineThe conus finishes at the level of L34 intervertebral disc level, however, there is no abnormal spinal cord signal intensity. On axial scan, the spinal cord is located posterior aspect of the spinal canal.There is partial spina bifida of L5 vertebral body. However, there is no evidence syringomyelia, no evidence of fat-containing mass, no evidence of myelomeningocele, no evidence of thickening of filum.There is no abnormal enhancement.Multiple vertebral body lesions which are well circumscribed, high signal intensity on both T1 and T2-weighted images indicate vertebral body hemangioma at T11, L2 and S1 vertebral bodies.Minimal disc desiccation with the diffuse bulging of disc was seen at the level of L4-5.There is no evidence of spinal canal stenosis or neural foraminal stenosis.Constellation of above described findings including flattening of upper thoracic spinal cord, and low-lying conus at the level of L3-4 indicate possible tethered cord syndrome. Since there is no evidence of other associated findings for tethered cord, prone position MRI can be considered if clinically indicated.
1. Lower lying conus medullaris with posterior location in spinal canal suggests tethered cord.2. Multi-level degenerative disc diseases, as described above.