Diagnosis: Cervicalgia Other chronic painClinical question: evaluate for persistent neck pain with scalp, shoulder radiculopathySigns and Symptoms: neck pain, radiculopathy The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. There is a 7 mm well-circumscribed lesion within the odontoid at its junction with the C2 vertebral body which is bright on T2 and low signal on T1. It is adjacent to the C2 fusion plate. It is associated with marrow replacement within the right aspect of the C2 vertebral bodyAt 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.At C4-5 there is no significant compromise to the spinal canal or neural foramina. There is loss of disc space height at this level as well as small endplate osteophytes and a minor disc bulge.At C5-6 there is no significant compromise to the spinal canal or neural foramina. There are small uncovertebral osteophytes present at this level.At C6-7 there is no significant compromise to the spinal canal or neural foramina. There is a diffuse disc bulge present at this level associated with some mild posterior ligamentous hypertrophy. There is effacement of spinal fluid ventral but not posterior to the spinal cord at this level. There are uncovertebral osteophytes present associated with disc material bilaterally which mildly narrow the neural foramina but do not significantly compromise the exiting nerve roots.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. The right vertebral artery is very small.
1.There are some degenerative changes present in the cervical spine without significant compromise to the cervical spinal canal or exiting nerve roots.2.There is a C2 vertebral body cystic appearing lesion present. If clinically appropriate a CT of the cervical spine may be of benefit to further evaluate this as her is some infiltration of the adjacent bone marrow. It is suspected to be degenerative in nature. Alternatively it could represent a solitary bone cyst.