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Radiology · Spine imaging: cervical spondylotic myelopathy
Sample itemA 65-year-old man has gait unsteadiness, clumsy hands and brisk reflexes. MRI shows multilevel cervical spondylosis with cord compression. Which additional MRI finding indicates cord injury?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. T2 hyperintensity within the cord at the level of compression
High T2 signal within a compressed cord reflects oedema, gliosis or myelomalacia and correlates with myelopathy. Osteophytes and disc bulges are the cause, not a marker of cord damage. Surgical decompression is considered when symptoms progress.
Option by option
A. T2 hyperintensity within the cord at the level of compression (correct)
Correct. Intramedullary T2 hyperintensity marks cord damage.
B. Marrow fat in the vertebral bodies
Normal marrow fat has no bearing on cord injury.
C. Normal CSF around the cord
Preserved CSF would argue against significant compression.
D. Facet joint osteophytes
Osteophytes explain the cause but do not show cord injury.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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