Diagnosis: Other musculoskeletal symptoms referable to limbs(729.89)Clinical question: concern for cervical compression of descending corticospinal tractsSigns and Symptoms: weakness of the left leg, tingling of the left arm MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Incidental note is made of partial empty sella.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. There is straightening of the normal cervical curvature. The exams is degraded by patient motion.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina. There is a disk bulge at this level with mild narrowing of the spinal canal. The CSF behind the cord is not effaced.At C4-5 there is no significant compromise to the spinal canal or neural foramina. There is a disk bulge at this level with mild narrowing of the spinal canal. The CSF behind the cord is not effaced.At C5-6 there is no significant compromise to the spinal canal or neural foramina. There is a disk bulge at this level with mild narrowing of the spinal canal. The CSF behind the cord is not effaced.At C6-7 there is no significant compromise to the spinal canal or neural foramina. There is a mild disk bulge at this level with mild narrowing of the spinal canal. The CSF behind the cord is not effaced.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
1.Multilevel disk bulges are present in the cervical spine without significant compromise to the spinal cord or exiting nerve roots.2.Straightening of the normal cervical curvature is a non-specific finding which may related to patient positioning or muscle spasm.3.Partial empty sella is an incidental finding.4.Exam is degraded by patient motion which may obscure more subtle abnormalities.