Increased weakness of right leg, patient has multiple sclerosis. Rule out disc herniation in cervical spine. Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. Alignment is maintained. Bone marrow signal is within normal limits. There are multiple T2 hyperintense lesions throughout the cervical cord consistent with known demyelinating disease. Relatively larger of these lesions are seen including the dorsal upper C2 level, dorsal and left ventral C3 level with focal volume loss, right lateral C4-C5 level, and right lateral C5 to C6 levels where there is also focal volume loss. Thoracic lesion at the right T1-T2 level is also noted and was present on prior thoracic MRI. No lesions with enhancement are definitively appreciated. Apparent high signal on the sagittal post gadolinium sequence at the C7 level is not corroborated on the axials and is most likely artifactual.Mild degenerative changes are seen in the cervical spine as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: No significant compromise to the spinal canal or left neural foramen. Mild to moderate right neural foraminal stenosis related to uncovertebral hypertrophy and facet arthropathy.C4-5: No significant compromise to the spinal canal or neural foramina.C5-6: Mild disc bulge and bilateral uncovertebral hypertrophy with mild bilateral neural foraminal narrowing. No significant spinal canal stenosis.C6-7: Small disc osteophyte complex and bilateral uncovertebral hypertrophy. There is no significant spinal canal or neural foraminal stenosis.C7-T1: No significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
1. Multiple T2 hyperintense lesions throughout the cervical cord consistent with chronic demyelinating disease. No lesions with enhancement are definitively appreciated to suggest active demyelination. Comparison can be made to prior study if made available.2. Mild degenerative changes in the cervical spine without significant spinal canal stenosis at any level. There is mild neural foraminal narrowing as detailed above. No high-grade neural foraminal stenosis at any level.