Male, 62 years old, with sudden onset of left upper extremity weakness following windmill like swinging of the arms. Concern for nerve root avulsion or brachial plexus injury. Cervical spine:Trace retrolisthesis of C6 relative to C7 is noted. The cervical lordosis is mildly straightened which is likely positional.Vertebral body height and morphology are within normal limits. Mild edema is seen along the right posterior aspect of the C7-T1 endplate. Elsewhere marrow signal characteristics are unremarkable.The visualized spinal cord is free of significant signal abnormality. Beginning at the C7-T1 level, the spinal cord does deviate towards the right aspect of the spinal canal. However, no obvious intraspinal or paraspinal fluid collection is observed.C2-3: Left facet arthropathy. No spinal canal stenosis or neuroforaminal narrowing. C3-4: Bilateral facet arthropathy. No significant spinal canal or foraminal stenosis.C4-5: Right uncovertebral hypertrophy. No significant spinal canal stenosis. Mild right foraminal narrowing. C5-6: Bilateral facet arthropathy. Posterior disc-osteophyte complex formation. Mild effacement of ventral thecal sac. Moderate to severe bilateral foraminal narrowing. C6-7: Facet arthropathy. Posterior disc-osteophyte complex formation. Mild effacement of the ventral thecal sac. Moderate to severe bilateral foraminal narrowing. C7-T1: Minimal posterior disc-osteophyte complex formation. No significant spinal canal or foraminal stenosis. Brachial plexus:The left C8 nerve root is mildly thickened and T2 hyperintense from the level of the foramen distally to at least the level of the brachial plexus trunk. No obvious mass or fluid collection is seen. More distally, the left brachial plexus is unremarkable.
1.Edema of the left C8 nerve root is seen continuing into the brachial plexus to at least the level of the trunks. No obvious hematoma or pseudomeningocele is demonstrated. Findings may therefore represent a stretching injury of the nerve.2.The spinal cord at the C7-T1 level deviates slightly towards the right within the spinal canal. Although this can be seen in cases of nerve root avulsion, it may also be secondary to a mild coronal curvature of the thoracic spine.3.Multilevel disc degeneration is demonstrated. Although there were no areas of high-grade spinal canal stenosis, the neural foramina at C5-6 and C6-7 are significantly narrowed bilaterally.4.Edema along the right posterior C7-T1 endplate is seen which could reflect endplate degeneration or mild traumatic injury.