Clinical question: Evaluate for radiculopathy. Signs and symptoms: Left arm weakness. Pre-and post enhanced cervical MRI:Foramen magnum is unremarkable.C2 -- C3 is unremarkable.C3 -- C4 demonstrate a small centrally located disk protrusion with slight flattening and posterior displacement of the cord and no central spinal stenosis. There is mild kyphotic deformity of the cervical spine at this level. No neural foraminal compromise.C4 -- C5 is unremarkable.C5 -- C6 demonstrate mild disk disease and loss of disk height, shallow broad base disk protrusion in the midline with some effacement of ventral subarachnoid space however without the spinal stenosis. There is also a right lateral small disk protrusion and tiny bony spur which results in mild right neural foraminal compromise.C6 -- C7 demonstrate mild degenerative changes with resultant mild right neural foraminal compromise and unremarkable otherwise. C7 -- T1 demonstrate mild degenerative disk disease, minimal grade 1 anterolisthesis and mild facet hypertrophic changes. There is however moderate bilateral neural foraminal compromise.Uppermost visualized thoracic spine and the entire cervical and uppermost visualized thoracic cord demonstrate normal signal intensity.
1.Degenerative changes at C3 -- C4 and including a centrally located disk protrusion results in subtle flattening and posterior displacement of the cord. No spinal stenosis or neural foraminal compromise.2.Degenerative changes at C5 -- C6 results in mild right neural foraminal compromise. A small central disk protrusion with subtle effacement of subarachnoid space is also present.3.Mild degenerative disease, minimal anterolisthesis and bilateral neural foraminal compromise at C7 -- T1 as detailed.4.Normal signal intensity and caliber of the cervical and uppermost visualized thoracic cord.