Clinical question: Numbness in left hand. Signs and symptoms: Numbness in left hand. Unenhanced cervical MRI:There is normal anatomical alignment of the home. There is unremarkable signal intensity of the vertebral column other than changes related to degenerative disease.There is normal signal intensity and caliber of the cervical and uppermost visualized thoracic cord.Foramen magnum is unremarkable.C2 -- C3 demonstrate mild degenerative changes resulting in mild right neural foramina. There is a tiny centrally located disk protrusion which partially effaces the ventral subarachnoid space thereC3 -- C4 demonstrate mild degenerative disk disease and mild facet and ligamentum flavum hypertrophy. There is a tiny central disk protrusion is appreciated on axial T2 series 5 image 17. There is mild bilateral (right greater than left) neural foraminal compromise and no central spinal stenosis.C4 -- C5 demonstrate moderate disk disease and loss of disk height and mild (left greater than right) ligamentum flavum hypertrophy. Changes result in moderate left neural foramina compromise and no central spinal stenosis.C5 -- C6 demonstrate moderate disk disease and loss of disk height, mild (left greater than right) ligamentum flavum hypertrophy and mild (greater than right) facet degenerative changes. Changes results in moderate to severe bilateral neural foraminal compromise and no central spinal stenosis.C6 -- C7 demonstrate moderate to advanced disk disease and loss of disk height, mild facet and ligamentum flavum hypertrophy. Changes results in significant bilateral (right greater than left) neural foraminal compromise and mild central spinal stenosis.C7 -- T1 demonstrate mild degenerative changes which results in moderate left neural foramina compromise and unremarkable otherwise.
1.Degenerative changes of the cervical spine results in multilevel bilateral neural foraminal compromise (some significantly) as detailed per level above. There is mild central spinal stenosis at C6 -- C7 level.2.There is normal signal intensity and caliber of the cervical and uppermost visualized thoracic cord.