[Houstonbabs]

I tried to post these in my original post but for some reason it did not go through. There is so much to wade through here and I so much appreciate everyones time. I posted for the first time yesterday and it was suggested I put all of my current reports up so here they are.

CLINICAL HISTORY: Recheck status of syrinx, rule out MS.
TECHNIQUE: MRI of the cervical spine was performed utilizing multiple sequences in axial and
sagittal planes without and with IV contrast material.
COMMENTS:
The visualized osseous elements are intact with no evidence of fracture or dislocation. The marrow signals are within normal limits. Note is made of a small spinal cord syrinx measuring approximately 1 mm in diameter extending from approximately level of C5-C6 through C7-T1 measuring 4 cm in craniocaudad dimension.

There is straightening of cervical lordosis compatible with muscle spasm.

Multilevel dehydration and desiccation is seen. There is no evidence for tonsilar herniation. Limited views of the posterior fossa reveal no abnormalities. At C5-C6, moderate loss of disc space height is noted.
Post gadolinium sequences reveal no evidence for abnormal enhancement.

Evaluation of individual level presents the following:
At C2-C3, there is no disc herniation or bulge present. Canal and foramina are patent.
At C3-C4, minimal disc bulge indents the ventral thecal sac. Canal and foramina are patent.
At C4-C5, disc bulge indents the ventral thecal sac. Canal and foramina are patent.
At C5-C6, broad-based disc herniation/protrusion is noted. It measures approximately 20 mm in transverse and 3 mm in AP dimension produces mild mass effect on the spinal cord with mild canal stenosis. Both foramina are moderately stenotic. Uncovertebral joint hypertrophy contributes. Syrinx is noted at this level.
At C6-C7, central disc herniation is in contact with the cord. It measures 15 mm in transverse and 3mm in AP dimension. Canal is borderline stenotic. Foramina are remained patent. Small syrinx is
noted at this level. Note is made of bilateral lateral meningoceles at this level. The one on the left measures 7 x 4 mm. The one on the right measures 5 x 3 mm.
C7-T1, there is no disc herniation or bulge present. Small syrinx is noted at this level.


Lumbar MRI
HISTORY: Pain in hip and back.
TECHNIQUE: MRI of the lumbar spine was performed utilizing multiple sequences in axial and sagittal planes without IV contrast material. STIR sequence was performed.
FINDINGS:
Transitional vertebral body is present. This study will be interpreted with presumption that the last disc level labeled as L5-S1. Using this, spinal cord terminates at L1 level. Incidental note is made of small bilateral Tarlov cysts at second sacral level the largest of which measures 18 x 13 mm.

Note is made markedly diffusely heterogeneous bone marrow pattern which may be seen in the setting of developmental or metabolic disorder including resulting in marrow reconversion. Clinical correlation is recommended. Consider short term follow up study in six months to document stability.

Note is made of several small T1 and T2 hyperintense lesions within several lumbar vertebral bodies most compatible with small hemangiomas versus lipid rests.
There is no evidence of marrow edema. There is no evidence of acute fracture.
Incidental note is made of small bilateral lateral meningoceles at T9-T10 and T10-T11 levels.
Consider follow up with a dedicated MRI of the thoracic spine.

The visualized osseous elements are intact with no evidence of fracture or spondylolisthesis. The normal lordotic curvature of the lumbar spine is well maintained. The conus medullaris and cauda equina are within normal limits.

Evaluation of individual levels presents as follows:
At L5-S1 there is no disc herniation or bulge present. Canal and foramina are patent.
At L4-L5 annular tear is seen. There is a small central disc herniation which is in contact with the
ventral thecal sac. Canal and foramina are patent. Moderate hypertrophic facetdisease is present.
At L3-L4 disc bulge indents the ventral thecal sac. Foramina are mildly narrowed. Canal is patent.
Mild hypertrophic facet disease is seen.
At L2-L3 there is no disc herniation or bulge present. Canal and foramina are patent.
At L1-L2 there is no disc herniation or bulge present. Canal and foramina are patent.
5 mm cortical cyst is present in the left kidney.

CLINICAL HISTORY: Recheck status of syrinx, rule out MS.
TECHNIQUE: MRI of the brain was performed utilizing multiple sequences in axial, coronal and
sagittal planes without and with IV contrast material. Diffusion-weighted sequences was performed.
COMMENTS:
Note is made of a 5 mm lesion in the posterior aspect of the pituitary gland which is bright on T1 with
a drop in signal on FLAIR and low signal on T2-weighted sequence. This may represent lipoma versus small hemorrhagic pituitary adenoma. The lesion does not appear to be enhancing. Considerfurther evaluation with dedicated pituitary MRI pre and postcontrast.

The corpus callosum and
cerebellar tonsils are of normal configuration and position. There are no intra or extra-axial
collections. There is no mass effect or midline shift. There is no evidence of hematoma formation.
There is no hydrocephalus.
The parasellar areas are unremarkable. Pituitary stalk is midline. Optic chiasm is within limits of
normal.
The visualized arterial structures demonstrate normal appearing flow voids. The seventh and eighth
nerve bundles are visualized and are unremarkable in appearance.
There is evidence of mild mucosal thickening involving ethmoid and maxillary sinuses compatible
with chronic sinusitis.
Diffusion-weighted sequence demonstrates no evidence of restriction.
Post gadolinium images demonstrate no evidence for abnormal enhancement.