Clinical question: Evaluate for multiple sclerosis. Patient has some in cervical spine and has a left foot drop. Signs and symptoms: Left foot drop. Pre and post enhanced thoracic MRI:Examination demonstrates no convincing evidence of any lesion within the cord or abnormal enhancement of the cord/leptomeninges.The signal intensity and caliber of thoracic cord remains within normal.There is also normal anatomical alignment of vertebral column and no evidence of central spinal stenosis or clinically significant neural foraminal compromise at any level.No detectable abnormal enhancement of the vertebral column.Unremarkable. Spinal soft tissues.Pre- and post enhanced lumbar MRI:Examination demonstrates normal signal intensity, morphology and caliber of the lower most visualized thoracic cord, conus and cauda equina without detectable abnormal enhancement.T11-T12 demonstrate mild degenerative changes and unremarkable otherwise.T12-L1 demonstrate mild degenerative changes and unremarkable otherwise.L1-L2 demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise.L2-L3 demonstrate moderate disc disease and loss of disc height, mild bilateral facet and ligamentum flavum hypertrophy without central spinal stenosis however mild right neural foraminal compromise is noted.L3-L4 demonstrate moderate disc disease and loss of disc height, moderate bilateral facet and ligamentum flavum hypertrophy and a small right lateral shallow disc protrusion. Constellation of findings results in moderate central spinal stenosis and mild-to-moderate right neural foraminal compromise.L4-L5 demonstrate mild to moderate disc disease and loss of disc height, moderate to severe bilateral ligamentum flavum and mild to moderate facet hypertrophic changes are noted at this level. Constellation of changes at this level results in moderate to severe central spinal stenosis and mild to moderate left neural foraminal compromise.L5-S1 demonstrate mild disc disease and moderate facet hypertrophic changes. No spinal stenosis however moderate to severe left neural foraminal compromise is present.Incidental note is made of multiple nonenhancing well-demarcated cyst like lesions in the liver. Follow-up with dedicated imaging including ultrasound is recommended.
1.Pre- and post enhanced MRI of thoracic spine demonstrate no evidence of demyelinating disease. No evidence of spinal canal or neural foraminal compromise at any level.2.Pre and post enhanced MRI of lumbar spine demonstrate no evidence of demyelinating disease or abnormal enhancement. Degenerative changes at L3-4 and L4-L5 levels results in central spinal stenosis. Degenerative changes at L5-S1 resulting in moderate to severe left neural foraminal compromise and no central spinal stenosis. Please review above the detailed report per level for additional levels of neural foraminal compromise.3.Incidental note is made of multiple nonenhancing well-demarcated cyst like lesions within the liver. Follow-up with dedicated imaging including ultrasound is recommended.