Diagnosis of<unk> <unk>  is primarily diagnosed by clinical exam findings. Because the term<unk>  describes a clinical syndrome that can be caused by many pathologies the differential diagnosis of<unk>  is extensive. In some cases the onset of<unk>  is rapid, in others, such as CSM, the course may be insidious with symptoms developing slowly over a period of months. As a consequence, the diagnosis of CSM is often delayed. As the disease is thought to be progressive, this may impact negatively on outcome. Diagnosis of etiology Once the clinical diagnosis<unk>  is established, the underlying cause must be investigated. Most commonly this involves medical imaging. The best way to visualize the spinal cord is magnetic resonance imaging (MRI). Apart from T1 and T2 MRI images, which are commonly used for routine diagnosis, more recently researchers are exploring quantitative MRI signals. Further imaging modalities used for evaluating<unk>  include plain X-rays for detecting arthritic changes of the bones, and Computer Tomography, which is often used for pre-operative planning of surgical interventions for cervical spondylotic<unk> . Angiography is used to examine blood vessels in suspected cases of vascular<unk> . The presence and severity of<unk>  can also be evaluated by means of transcranial magnetic stimulation (TMS), a neurophysiological method that allows the measurement of the time required for a neural impulse to cross the pyramidal tracts, starting from the cerebral cortex and ending at the anterior horn cells of the cervical, thoracic or lumbar spinal cord. This measurement is called Central Conduction Time (CCT). TMS can aid physicians to: * Determine whether<unk>  exists * Identify the level of the spinal cord where<unk>  is located. This is especially useful in cases where more than two lesions may be responsible for the clinical symptoms and signs, such as in patients with two or more cervical disc hernias * Follow-up the progression of<unk>  in time, for example before and after cervical spine surgery TMS can also help in the differential diagnosis of different causes of pyramidal tract damage.
Myelopathy
Myopathy
Osteopathy
Laminopathy
Arthropathy
Peripheral neuropathy
Spondylopathy
Osteodystrophy