Clinical question: 73-year-old male with bilateral arm pain and numbness, evaluate for cord compression. Signs and symptoms: Burning pain in both arms, syncope. Nonenhanced total spine MRI:Examination is performed utilizing cord compression protocol which does not include axial images.Examination demonstrates diffuse patchy foci of marrow signal replacement consistent with extensive osseous metastatic lesions throughout the cervical, thoracic and lumbosacral spine.Metastatic lesions at C6 and to a lesser degree C5 levels demonstrate extraosseous spread of tumor into the epidural space and resultant mass effect on the cord however without central spinal stenosis and no convincing evidence of cord edema.Mild extraosseous cyst. Of tumor from T8 vertebral body into the spinal canal is also noted without mass effect on the cord or central spinal stenosis. Minimal ventral epidural spread of tumor at T12 is also noted without spinal stenosis or mass effect on the cord.There is no evidence of fracture or malalignment. There is no detectable cord signal abnormality.The findings on this exam can be further and more accurately assessed if clinically deemed pertinent with pre and post enhanced dedicated spine MRI study.
1.Extensive osseous metastatic lesions throughout the spine as detailed.2.Small regions of epidural spread of tumor into the spinal canal more noticeably at C6 however without resultant central spinal stenosis or detectable cord signal abnormality as detailed.3.Normal signal intensity and caliber of the cord and cauda equina.