Dr. Vivek Chail
General Practitioner
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have chronic right leg spasticity, migraines, muscle pain, ataxia, nausea, vertigo, and pins and needles in hands and feet. Please, could you review my scans to see what is the cause of my various neurological symptoms? Is it cervical myelopathy or MS?
Hello,
Welcome to icliniq.com.
I have gone through your scans (attachment removed to protect patient identity).
There are cervical disc problems at many levels and mild cervical spondylosis. There is a neural foraminal compromise and nerve root compression in C4-C5, C5-C6 and C6-C7 cervical disc levels which is maximum in C5-C6 cervical disc level. There is no cervical myelopathy. There is no acute abnormality in the MRI (magnetic resonance imaging) brain scan.
Regards.
Patient's Query
Hi,
Thank you doctor.
Are you sure? On the transverse images, the cord looks compressed and the CSF interrupted. Maybe it would look worse on an upright scanner.
Hello,
Welcome back to icliniq.com.
There is no cervical cord myelopathy and I am sure of it. There is an indentation of the dura covering the spinal cord, but there is no significant damage to the cord.
Regards.
Patient's Query
Hi,
Thank you doctor.
What is the hyperintensity showing on the cord side of C5? Does it look like a fracture? Also, what are the white areas on the STIR image?
Hello,
Welcome back to icliniq.com.
Fat and fluid are white or hyperintense on T2. So, the first image shows a hyperintense area in T2 posterior to the vertebrae which are epidural fat and the white area in the disc might be minimal fluid. On STIR (short tau inversion recovery), the white lines are likely to be tiny blood vessels supplying the vertebrae.
Regards.
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General Practitioner
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