Clinical question: concern for cervical stenosis vs. radiculopathySigns and Symptoms: left sided numbness, weakness, and pain MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. There is some mild multilevel disc desiccation present.At 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 a small central disc protrusion present at this level.At C5-6 there is no significant compromise to the spinal canal or neural foramina.At C6-7 there is no significant compromise to the spinal canal or neural foramina. There is a small central disc protrusion present at this level.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.Small disc protrusions are also present at T1-2 and T2-3 without any obvious compromise to the spinal canal or exiting nerve roots.
1.There are mild degenerative changes present in the cervical spine without significant compromise to spinal canal or neural foramina.2.There is no evidence for intracranial mass lesion or spinal cord lesion to explain the patient's symptoms of left-sided weakness, numbness and pain