Multiple sclerosis. Numbness in hands. Low back pain. Cervical spine: Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. Mild retrolisthesis of C3 on C4 is unchanged. Alignment is otherwise maintained. Bone marrow signal is benign. Previously seen disc extrusion at the C3-C4 level is no longer present.Patchy T2 signal abnormality is again seen throughout the cervical cord. There is a T2 hyperintense lesion at the right mid C2 level not seen previously. There is also a right dorsal C2-C3 lesion not present previously. Multiple additional lesions more inferiorly appear to be present on prior study. Focal volume loss is noted involving the right dorsal cord at the C5 level and present previously.Degenerative changes are seen in the cervical spine as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: Previous seen disc extrusion is no longer present. No significant compromise to the spinal canal. There is moderate left neural foraminal stenosis related to uncovertebral hypertrophy and facet arthropathy which was present previously.C4-5: No significant compromise to the spinal canal or right neural foramen. Minimal left neural foraminal narrowing as before.C5-6: Mild disc bulge without significant compromise to the spinal canal. There is mild to moderate left neural foraminal narrowing which was present previously. Minimal right neural foraminal narrowing.C6-7: No significant compromise to the spinal canal. Mild bilateral neural foraminal narrowing which was present previously.C7-T1: No significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.Lumbar spine: Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. Alignment is within normal limits. Bone marrow signal is benign. The conus medullaris is normal in position.There is multilevel disc desiccation without significant disc height loss. Additional details described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis.L3-L4: Minimal disc bulge. No spinal canal or neural foraminal stenosis.L4-L5: Mild disc bulge and dorsal annular fissure. Mild facet arthropathy. No spinal canal stenosis. Mild right and minimal left neural foraminal stenosis.L5-S1: Mild disc bulge and dorsal annular fissure. Mild facet arthropathy. No spinal canal stenosis. Mild bilateral neural foraminal narrowing. Paraspinous soft tissues are within normal limits.
1. Multiple T2 hyperintense lesions throughout the cervical cord compatible with known demyelinating disease. There are at least 2 new lesions at the right C2 and C2-C3 levels not evident on prior outside MRI from 10/3/2013. More recent cervical spine MRI is not available for comparison.2. Multilevel degenerative changes in the cervical spine are again seen which are overall similar to prior, aside from the previously seen disc extrusion at C3-C4 which is no longer present. There is no significant spinal canal stenosis at any level. There is multilevel neural foraminal narrowing, left relatively worse than right, as detailed above.3. Mild degenerative changes in the lumbar spine without significant spinal canal stenosis at any level. Minimal to mild neural foraminal narrowing as described above.