Clinical question:Thoracic radicular pain. R UE pain. Metastatic breast CA. Please compare to PET.Signs and Symptoms: thoracic radicular pain. RUE pain. Pre-and post enhanced cervical MRI:There is normal anatomical alignment and signal intensity column.There is normal signal intensity and caliber cervical cord.There is no detectable abnormal enhancement the vertebral column, cord or leptomeninges to suggest presence of a metastatic lesion.There is mild degenerative changes of cervical spine however without evidence of spinal stenosis at any level.Unremarkable images at the level of foramen magnum.No evidence of mural foramina compromise at any level.Unremarkable appearing spinal soft tissues.Pre-and post enhanced thoracic MRI:There is normal anatomical alignment the vertebral column however with mild exaggerated kyphosis of the upper thoracic.There is a mild chronic compression fracture of the superior endplate of T4 without associated bone marrow edematous changes or enhancement and consistent with a benign chronic fracture.Unremarkable signal intensity of vertebral column otherwise and without detectable abnormal enhancement.Normal signal intensity and caliber of thoracic cord and without evidence of enhancement.Minimal degenerative changes of thoracic spine are noted however without evidence of a spinal canal or neural foraminal compromise at any level.Pre-and post enhanced lumbar MRI:There is normal clinical alignment and vertebral column however right straightening of the lumbar lordosis. There is no detectable abnormal enhancement of the vertebral column.There is normal signal intensity of the lower most visualized thoracic cord, conus and cauda equina without abnormal enhancement.T2 -- L1, L1 -- L2 and L2 -- L3 levels demonstrate mild degenerative disease without spinal canal or neural foramina compromise.L3 -- 4 demonstrated moderate disk disease and loss of disk height, shallow broad-based left lateral and far lateral disk protrusion with subtle mass effect on the thecal sac however without spinal stenosis or neural foramina compromise is noted.L4 -- L5 demonstrate advanced disk disease and loss of disk height, extensive adjacent Modic bony signal changes of the endplates and mild ligamentum flavum hypertrophy is noted. No spinal stenosis or neural foramina compromise.Five chest one demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise.
1.Pre-and post enhanced MRI of cervical spine demonstrate mild degenerative disk disease and unremarkable otherwise. 2.Pre-and post enhanced MRI of thoracic spine demonstrate no evidence of metastatic disease. Mild chronic benign compression deformity of the superior endplates of T4 as detailed. Minimal degenerative disease without spinal canal or neural foramina compromise at any level.3.Pre-and post enhanced MRI lumbosacral spine demonstrate no evidence of metastatic disease. Moderate L3 -- L4 and severe L5 -- S1 disk disease is present, however there is no neural foraminal or central spinal stenosis at any level.