Multiple sclerosis of the spine

Case contributed by Dr Vougiouklis Nikos

Diagnosis almost certain

Presentation

38 years-old man with hemiparesis of the left foot for a month.

Patient Data

Age: 38

Gender: Male

From the case: Multiple sclerosis of the spine

MRI

Loading images...

Sagittal T2

T2 TSE acquisition shows a high signal oblong lesion in peripheral lateral zone of the cervical spine.

T1 post gadolinium image shows ring like enhancement of the lesion .

FLAIR image shows high signal of the WM in contact with the occipital horns of the lateral ventricles, an additional finger like lesion was seen in the corpus callosum.
The last findings, the character of the spinal lesion and the clinical image make the diagnosis of multiple sclerosis the first choice.

Case Discussion

Spinal lesions in multiple sclerosis rarely show an expansion over more than the height of two vertebral bodies. Bigger lesion should cause thinking about differential diagnoses.